Rural jails lack mental health resources. Inmates can linger for weeks in tiny cells awaiting psychiatric care.

Local jails weren't build to house mentally
ill populations. (KFF Health photo)

Many rural jails lack resources to manage inmates who need mental health treatment. In Polson, a small town in northwestern Montana, "when someone accused of a crime needs mental health care, chances are they’ll be locked in a basement jail cell the size of a walk-in closet," reports Katheryn Houghton of KFF Health News. Jails across the U.S. have problems similar to Polson, where demand for inmate mental health treatment exceeds any state's capacity to provide it.

Polson's basement jail cell was intended to be a short-term solution to keep mentally altered inmates away from the rest of the jail population until a psychiatric bed opened up. Houghton writes, "Last year, a man sentenced for stealing a rifle stayed in that cell 129 days. He was waiting for a spot to open at Montana’s only state-run psychiatric hospital after a mental health evaluator deemed he needed care."

Some jailed individuals haven't been found guilty of crimes because a judge ordered mental health care completed before allowing the case to move forward. At the Grays Harbor County Jail, located in the small town of Montesano, Washington, "approximately 20-30% of the jail population is made up of inmates who are supposed to be receiving [mental health] care," reports Susannah Frame of KING-TV in Seattle. The facility's medical ward is "the size of a closet. There are no mental health professionals on staff. There is not enough staff to safely deal with a crisis."

Wyoming, Nevada and Oregon jail systems have similar struggles. "More than half of Wyoming’s 23 sheriffs told lawmakers there that they were housing people in crisis awaiting mental health care for months," Houghton reports. "Nevada has struggled despite a $500 daily fine for each jailed patient whose treatment is delayed. Disability Rights Oregon has said delays in that state continue after two people died in jail while on the state’s psychiatric waitlist."

In Polson, Vincent River has been the jail's only mental health provider for 25 years. "He said he’s not always available because he’s the only psychologist in four northwestern Montana counties evaluating whether a person in jail needs psychiatric care," Houghton writes. "River said he can’t get people into any psychiatric bed in Montana because there are too few. Instead, he tries to stabilize people while they’re jailed. . . . Some are released without care if they linger too long on the state hospital’s waitlist."