From Ken Ditkowsky–Attorney Activist Andy Ostrowski still missing and what happens when a mental health issue means jail time in the US?

When a mental health emergency lands you in jail



  • Share23
  • Print.

Early last year, two suicidal patients showed up at a hospital emergency room in Pierre, South Dakota, seeking help. Although the incidents happened weeks apart, both patients ended up in an unexpected place: jail.

Across the country, and especially in rural areas, people in the middle of a mental health crisis are locked in a cell when a hospital bed or transportation to a hospital isn’t immediately available. The patients are transported from the ER like inmates, handcuffed in the back of police vehicles. Laws in five states — New Mexico, North and South Dakota, Texas and Wyoming — explicitly say that correctional facilities may be used for what is called a “mental health hold.” Even in states without such laws, the practice happens regularly.

“It is a terrible solution…for what is, at the end of the day, a medical crisis,” said John Snook, executive director of the Treatment Advocacy Center, a national group that advocates for the severely mentally ill. Research shows that the risk for suicide, self-harm and worsening symptoms increases the longer a person is behind bars.

But in a shift, Colorado recently outlawed using jail to detain people in a psychiatric crisis who have not committed a crime. The state delegated just over $9 million — with $6 million coming from marijuana tax revenue — to pay for local crisis centers, training for law enforcement and transportation programs.

The new law was passed after Colorado’s sheriffs lobbied the state to extend the amount of time a person could be detained. In rural counties, sheriffs testified, lack of manpower meant they were forced to hold onto people longer than the 24-hour legal limit. A state task force instead recommended ending the practice entirely.

There are no national figures on how many people are held each year in jail just because they have nowhere else to go in a mental health crisis. Reports from the federal agency overseeing hospitals — the Centers for Medicare and Medicaid Services — offer a glimpse. Since 2011, at least 22 hospitals in 16 states have been cited by CMS for failing to stabilize patients in need of mental health help, instead handing them over to law enforcement to wait for a psychiatric evaluation or a bed. The hospitals span the country, from Alabama and South Dakota to New York and Ohio.

The practice affects patients of all ages. At Avera St. Mary’s Hospital in Pierre, South Dakota, children from 12 to 16 were sent to spend the night in jail on at least seven occasions, CMS inspection reports show. One 16-year-old girl came to the emergency room after overdosing on Motrin and was escorted to jail less than an hour after her arrival, without a psychiatric evaluation. Hospital staff waited until the morning to notify her parents. At the same hospital, a 12-year-old girl arrived in the emergency room after an attempted hanging. She was sent to spend the night in jail less than an hour later. The hospital did not respond to requests for comment.

Few people think jail is an appropriate place for someone in a mental health crisis. Most jails, especially small rural facilities, do not have mental health staffers on site. For the suicidal, law enforcement agencies have few options other than periodically stopping by the cell to check on the person and putting potentially violent individuals in restraints and seclusion. Once someone has been held for 24 hours, he or she has to be charged, transferred to a treatment facility or released. “People should not, because of their mental illness, be in jail,” said Jennie Simpson, a public health analyst with Substance Abuse and Mental Health Services Administration, the federal agency that oversees national behavioral health policies.

The problem highlights a nationwide scarcity of available doctors and inpatient beds for people in a mental health crisis, particularly the poor. The number of psychiatric beds decreased by 96% across the country over the past 50 years, research shows. At the same time, awareness of mental health needs has increased and more people have access to health insurance, allowing them to seek care.

The issue was exacerbated by a 1972 federal law that was intended to help stop the widespread warehousing of people with mental illness. The law forbids the federal government from paying for inpatient mental health and drug treatment at psychiatric facilities with more than 16 beds. States are left to foot the entire medical bill for those on public insurance, straining budgets already struggling in the midst of the opioid crisis. A federal commission recently recommended that exemptions to the law be given immediately to states that request one.

In New Hampshire, a long waitlist for beds led the state to begin sending non-criminals who were ordered committed for their own safety to a prison psychiatric unit for treatment. Patients and inmates participate in the same therapy programs. During group therapy, to protect patients and staff, particularly violent inmates are placed in metal cages with a bench.

The decision of who gets sent to the sheriff and who gets to stay in the ER can have serious consequences. Baptist Memorial Hospital in Union City, Tennessee, was cited by CMS in 2012 for allowing an eye doctor to evaluate suicidal patients. The doctor discharged one patient to jail who returned to the hospital the next day after attempting suicide. He later died of his injuries.

At another hospital in Tennessee, a suicidal man who waited 10 hours in a seclusion room was told he would have to finish his wait for a bed in jail. For the next two hours, the man banged on the door to his room, asking staff over and over what he had done to have to go to jail, according to federal inspection reports. Eventually he tried to escape. A security guard pushed him back into the room so hard that he was momentarily airborne before landing and fracturing his neck.

Though local strategies have led to some improvement, it seems the real solution may be federal. “We’re never going to train our way out of this problem,” said Snook of the Treatment Advocacy Center, “The reality is we need much more.”

This article was originally published by The Marshall Project, a nonprofit news organization covering the U.S. criminal justice system. Sign up for their newsletter, or follow The Marshall Project on Facebook or Twitter.

On Tuesday, September 26, 2017, 10:25:51 AM CDT, kenneth ditkowsky <> wrote:
It is now almost noon in PA   – Andy is still in the Gulag  – so far all proceedings are secret and there is a conspiracy of silence.
This Gulag is a Window, providing each of us with the opportunity of experiencing element number 1 of elder cleansing.    The seizing of Attorney Andy Ostrowski from his home, spiriting him off to ‘where-ever’ and maintaining a facade of acting in his “best interests” is exactly what happened in the Cook County guardianship case of MARY SYKES 09 P 4585 and dozens of similar cases in Illinois, Florida, California *****.    This type of gulag/abduction could not occur without CORRUPT JUDGES acting in concert with corrupt opportunists who have little, if any, respect for the American core values, its Constitution, or the Rule of Law.
We have all seen evidence of the corruption in the Courts and the impotency of LAW ENFORCEMENT and Government in General to address it.    Part of the problem is the fact that there is great pecuniary benefits to be obtained by the corruption and the miscreants have no moral compass.   Distortion, Extortion, Intimidation, and perjury are the weapons of these miscreants and they have the ‘clout’ to carry off their felonies and punish all who oppose them.    If you open your eyes examples are available in many many incidents of daily life.    Of course it is not politically correct to challenge the pernicious behavior.
The long and short is the clout of the miscreants is so great that perfidy is fast growing to a state beyond remediation.    The headlines on yesterday’s news highlighted an issue of whether a pregnant policewoman layoff violated the “Americans With Disabilities”     Had the policewoman been kidnapped and placed in a Gulag facility the ACLU, and all the organizations that were traumatized by whether or not pregnancy leave should be x days or y days would have demonstrated not a scintilla of interest.     Indeed, Andy’s right to protest the favoritism being afforded a clout heavy child trafficker  – who happens to be a corrupt judge – takes a back seat to whether or not the President has the free speech to comment on the free speech exercise of disrespect for the flag of the United States of America by millionaires who are paid to play child games many times what we pay the President of the United States.   The media is silent as to the Gulag, but the President’s free speech objection to disrespect is a hue and cry that is misrepresented into advocacy for racial hatred, etc.    The same media ignores actual criminal activity by public officials and elder cleansing.
Of course Hypocrisy is indicative of any society – and the thinking of most individuals; however, so is self protection.   It could be ME – not Andy who was kidnapped by Police from my home and how is being held against his will in some secret place.    Indeed, it could be me who is being fed Opioids or similar stuff to silence me!     IT ALSO COULD BE YOU!
This Andy Ostrowski case may be a LINE IN THE SAND.    Unless, Andy received prior to incarceration a full and complete hearing with adequate NOTICE to all interested parties and was found to not know the objects of his bounty, could not formulate a simple business plan, did not know the extent and nature of his property, and was proven by CLEAR AND CONVINCING EVIDENCE to be a clear and present danger to himself and/or society.    (Anticipating that Andy might do something terrible is not sufficient).
If in fact Andy had such a hearing and the appropriate quantum of proof was provided to a duly constituted court it certainly does not appear to be the case.    Had any semblance of due process or adherence to America’s core values been provided ANDY, the persons responsible for such action would be delighted to demonstrate their ‘good deed!’      However, the secrecy and the deceptions suggest that very serious FELONIES HAVE OCCURRED and pursuant to 18 USCA 4 DEMAND IS MADE OF LAW ENFORCEMENT for an IMMEDIATE HONEST INVESTIGATION and if the law was not strictly observed that CRIMINAL PROSECUTIONS commence immediately and remediation occur as to Andy Ostrowski.

1 thought on “From Ken Ditkowsky–Attorney Activist Andy Ostrowski still missing and what happens when a mental health issue means jail time in the US?

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s