Therapy Behind Bars (LJP)

by Emily Mottern

As soon as it was deemed safe by Deputy Jacob La Combe, I was allowed to enter the Salem Police Station.

I walked into the lobby which was brightly lit by fluorescent lights and stood next to Crisis Counselor Jennifer Leonard. La Combe and Leonard are a part of Polk County’s Mobile Crisis Response Team. They get calls from people in Dallas and parts of Salem with mental health crises, assess their needs, and follow through with what is best for the situation. Many of the people they encounter commit small offenses, but if it wasn’t for their mental health issues, these crimes would not be happening (Woodworth).

When I got into the Grand Marquis to join La Combe and Leonard for their daily routine, they got a call about a woman who they had met with one time prior to this day which is why I was allowed to observe. Nancy (not her real name) had been diagnosed with bipolar disorder and was having a manic episode which can look a lot like schizophrenia. She was wearing lavender scrubs from her last visit to the hospital and a lanyard that read “I Love Jesus”. Nancy was convinced that her soon to be ex-husband had kidnapped her son and was angry that there were no amber alerts put out for him. Whenever La Combe would speak to her, she would yell, “That is a lie from the pit of hell and you know it!” La Combe was tall and wore his tan Sheriff’s Deputy uniform while Leonard wore all black. Both of them had on bulletproof vests and had a gun in their holster. At times, I felt uncomfortable by Nancy’s actions and threats, especially since I was lacking the feeling of protection that La Combe and Leonard probably had.

People with bipolar usually have a theme that their disorder revolves around. Some common ones include, religion, believing that they are already dead, or even thinking that a family or friend has been replaced by an impostor (Mental Health Daily). For Nancy, talking about the Bible and Jesus seemed to calm her down, which was critical for La Combe and Leonard since they were able to communicate to her more easily. It was very apparent that Nancy cared a lot for her son and wanted him to be home so she could continue to homeschool him. She told the team that, “My son needs to come home and read the Bible.” Leonard told me that “it is really hard to get through to Nancy since she talks a lot and can easily pick up on if someone is not taking her seriously.” La Combe explained to me that, “The best thing you can do is listen and make sure they know you’re listening.” Nancy believes that La Combe and Leonard are the cause of her problems since she is not aware of her mental state and doesn’t think she needs to be taking medications. But at the same time, she is a mom with real life concerns.

After we met with Nancy, we got in contact with her soon to be ex-husband, Tom (not his real name) because Nancy’s phones are not working and they have no way of contacting each other right now. Tom told the team that he had taken their son to his house in Portland since it was not healthy for their second grader to live with Nancy. Tom explained that he is trying to enroll his son in school since Nancy’s homeschooling methods aren’t working because she often “teaches” him until 10 at night. When Nancy is not experiencing a manic episode, there is a good chance she behaves normally, but this manic episode has lasted since her last visit to the hospital in July of 2016. Tom mentioned that Nancy will not stay on her treatment plan and has been having voices in her head for the past four or five years.

Earlier that day, I had the chance to sit down with Mary Bowers, the Mental Health Therapist at Polk County Jail, who told me that that it is, “almost impossible to find someone without any mental health issues.” When she started this job in June of 2016,  she was expecting that she “would find a few elite people who are schizophrenic,” but that is definitely not what she has discovered. Bowers spends a large amount of her time screening new inmates for mental health issues, and usually sees 6-7 inmates a day for counseling sessions. The mental health disorders she deals with can range from schizophrenia and bipolar disorder to PTSD and depression which usually stem from traumatic pasts that influence someone’s current behaviors (Kupers 40). When she meets with patients, she finds it harder to relate to people who have bipolar disorder because they are more likely to not take medication since they think that they are fine. When asked about her schizophrenic patients, Bowers said that “they fascinate me.” That is mainly because not all of them realize that they have voices inside their heads.

With years of experience working with drug addicts, Bowers has discovered that she prefers to meet with them a few days after they arrive so that the drug is out of their system and she can have a more meaningful counseling session with them. In these cases, it is important to find out why they were on drugs in the first place. It is common for meth addicts to self medicate for their schizophrenia since meth makes them feel better than their medication would and the side effects aren’t as bad. One of the many ways to help someone recover from a drug addiction is to separate them from other drug addicts and encourage them to spend time and create relationships with people who are sober (Taylor and Covey 125). With a little over 100 inmates that come and go, Bowers’s job at Polk County Jail is constantly action-packed.

During my ride along, I asked the Mental Health Crisis Team how long their calls usually take. Leonard explained that, “It takes as long as it takes,” since they never really know what or who they are going to encounter. For example, cases when they have to take someone to the hospital or suicidal cases can take a long time especially if you cannot get to the person if they are on a bridge. Suicide rates in jails can be up to nine times higher than they are out in the real world and more than half of suicides occur in the first twenty four hours after the individual is arrested (Kupers 177). With that in mind, Bowers will drop her task of screening new inmates to meet with a suicidal patient who will get put on fifteen minute checks to make sure that they are doing alright.

A goal that both Bowers and the Mental Health Crisis team share is “to break the cycle of repeated incarceration for people with mental health issues.” (Guzman) In the four months Bowers has worked at the jail, she has already seen one individual four times. Inmates have the opportunity to request to meet with her, deputies can also help patients and refer them to Bowers if they see that they need help, and even the initial form that deputies fill out when someone is arrested can help direct Bowers to patients in need of counseling.

Previously, Bowers worked at Oregon Youth Authority which is a local juvenile facility whose focus is to “protect the public and reduce crime by holding youth offenders accountable and providing opportunities for reformation in safe environments.” (Oregon Youth Authority) The patients Bowers saw there could be up to 25 years old depending on when they feel ready to enter the adult prison system, but here in Polk County all of her patients are 18 or older.

In Polk County Jail, the inmates are separated by gender into different blocks, but Oregon Youth Authority is divided up into four blocks: Alpha houses the young kids, Bravo is where the sex offenders are, Charlie is for violent teens, and Delta is where the older kids are put. Each group has their own mental health therapist and many different programs such as drug and alcohol counseling and life skills. In her downtime there, Bowers used to help a 16 year old boy with his math homework. Out of curiosity, Bowers looked up in the system the reason that he was at OYA, and it turned out that he was convicted of murder. Another time, Bowers was eating breakfast with a young girl who had schizophrenia. The girl turned to Bowers and yelled, “I don’t wanna kill anyone today!” Bowers told me that scary experiences are a part of this job since that young girl could have easily injured or even killed her that day.

Many inmates at Polk County commit some of the same crimes. False reports are among one of the most common ones, which is what I got to witness during my ride along since Nancy was trying to call the police to say that her ex-husband was kidnapping her son. Bowers told me about an individual with schizophrenia who called the police saying that he saw 6 people fighting and about 5 police officers were sent out, but there were no people fighting. This person now meets with a Bower’s colleague, Kim, whose job is to divert people from being charged with crimes and going to jail. According to Bowers, “he is going to be a success story”. Not long ago, Bowers met with a patient who had called the police with many false reports and kept insisting that he was seeing people getting raped. Once he got released from jail, Bowers gave him a crisis card so he would call the crisis line instead of the cops and they can talk him through it instead of calling the cops for no reason. Bowers also sees a lot of people convicted of disorderly conduct, trespassing, and public indecency which are very common with homeless people since they do not have a house or a bathroom.

Lots of inmates are motivated to lie (Rosenfeld and Penrod 148) which is one of the many challenges of Bowers’s job. Many of the people who lie pretend to have mental health issues to get out of the crime they committed, hide what they did, and convince people they are innocent which makes the screening process very difficult (Rosenfeld and Penrod 148). When asked about the best part of her job, Bowers told me, It’s the feeling when you can help someone,” and “seeing clients that actually want help.”

Salem has one of the highest populations of people with mental illnesses in Oregon. With the state hospital being very nearby, many people in Oregon that suffer from mental health issues are admitted there, including many individuals from Polk County Jail. Inmates from the jail get sent to the state hospital if they are a danger to themselves, others, or are unable to care for themselves (Bowers).

Bowers explained to me that many of her clients get referred to Mental Health Court. Mental Health Court is where people with mental health illnesses go if they are convicted of a crime instead of going to a regular court. For example, if an individual with bipolar disorder broke a window during one of their manic episodes they would get referred to Mental Health Court and their charges from the crime would be reduced down. Another option is to freeze their charges and send the patient to an outpatient or inpatient program nearby, but each case is different. With that said, if an individual’s past crimes are worse than their current one, or if they committed a Measure 11 crime which includes murder, kidnapping, assault, robbery, rape, etc., (DOC Research and Statistics) then they are not eligible for treatment programs, but instead have to serve their mandatory prison sentence. Bowers talked to me about four phases of treatment that the Mental Health Court has which include weekly court appearances in front of the judge to make sure that they are following their treatment program. They also offer group programs that range from AA meetings to life skills classes. Individual therapy is also included, as well as incentives, consequences, medication management, and more. (Oregon Judicial Department) Although Bowers said “treatment is only helpful if they want it to be”, the Mobile Crisis Response Team, Mental Health Court, and Bowers help individuals with mental health issues get back on their feet and go.

At the end of my ride along, La Combe, Leonard, and I were driving back to their offices through the farmland of Polk County. I asked them how they felt about how they left things with Nancy. La Combe began to tell me about the three goals that they have for every case. The first is communication. It is very important that the individual they are working with knows that the team is there to help them. The other is rapport building, which helps them understand how the person is feeling. Their third goal is de-escalation. When they met with Nancy, I was only allowed to go in and observe after the team had completed that goal. They had Nancy sit down and eventually got her to feel more emotionally stable so she could leave the police station and go home hopefully knowing that she was heard. This will probably not be the last time the team will encounter Nancy, but according to La Combe, “It was the best outcome.”

Works Cited

Bowers, Mary. Personal interview. 26 Oct. 2016.

“DOC Research and Statistics.” N.p., n.d. Web. 8 Nov. 2016.

Guzman, Jolene. “Mental Health Joins Officers On Duty.” Polk County Itemizer-Observer. N.p., 4 Oct. 2016. Web. 08 Nov. 2016.

Kupers, Terry A. Prison Madness: The Mental Health Crisis behind Bars and What We Must Do about It. San Francisco: Jossey-Bass, 1999. Questia. Web. 8 Nov. 2016.

“Oregon Youth Authority.” N.p., n.d. Web. 8 Nov. 2016.

Polk County Mental Health Court Program Participation Handbook. Dallas: Polk County Mental Health, 2015. Print.

Rosenfeld, Barry, and Steven D. Penrod. Research Methods in Forensic Psychology. Hoboken: Wiley, 2011. Questia. Web. 16 Oct. 2016.

Taylor, Nicolas T., and Herbert C. Covey. Helping People Addicted to Methamphetamine: A Creative New Approach for Families and Communities. Santa Barbara: Praeger, 2008. Questia. Web. 8 Nov. 2016.

Woodworth, Whitney M. “Polk County Creates Mental Health Crisis Team.” Statesman Journal. N.p., 23 Sept. 2016. Web. 10 Nov. 2016.

“4 Types of Delusions & Extensive List of Themes.” Mental Health Daily. N.p., 2016. Web. 3 Dec. 2016.