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Jail hires behavioral health specialist in effort at reforms

BISMARCK--Burleigh County Detention Center is focusing on addressing mental illness and addiction -- seen in a large percentage of jail admissions. The jail hired Mark Kemmet as behavioral health specialist as part of the current administration's...

: Mark Kemmet is a behavioral health specialist in the Burleigh County Detention Center in Bismarck. Kemmet, is a native of Napoleon and graduate of the University of Mary.Photo by Tom Stromme / Bismarck Tribune
: Mark Kemmet is a behavioral health specialist in the Burleigh County Detention Center in Bismarck. Kemmet, is a native of Napoleon and graduate of the University of Mary. Photo by Tom Stromme / Bismarck Tribune
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BISMARCK-Burleigh County Detention Center is focusing on addressing mental illness and addiction - seen in a large percentage of jail admissions.

The jail hired Mark Kemmet as behavioral health specialist as part of the current administration's broader effort at reform, which includes looking at the incarceration of people with mental illnesses and addiction.

Kemmet, a native of Napoleon, N.D., has spent 19 years with the North Dakota Department of Corrections and Rehabilitation, working as a correctional officer and, most recently, a probation officer for the Bismarck-Mandan DUI Drug Court.

Upon booking an inmate, jail employees screen inmates using an eight-question form related to mental health, said Maj. Steve Hall of the Burleigh County Sheriff's Department. Kemmet is flagged to do further assessments based on an inmate's answers.

"What we see a lot with these people with behavioral health issues, they end up spending more time in jail than someone who doesn't have those issues," Kemmet said. "Unfortunately, sometimes jail gets to be the default location for them."

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Hall said, although most people are able to get through the court system and out of jail within five days, it's people with problems navigating the system who end up staying longer.

"(Kemmet's) going to have the opportunity to look and say, 'Why is this person here?'" Hall said. "If it's something related to behavioral health-that they're stuck in the system and they need assistance-that gives us an opportunity to find them the help they need, whether it's a court-appointed attorney, an advocate, whatever they need."

In addition to hiring Kemmet, the jail received a federal grant to look at incarceration rates of people with mental health and addiction. It partnered with the Heartview Foundation to create a Web-based portal inmates can use that directs them to services, including treatment programs.

"It's a nationwide epidemic that people with mental health (issues) and addiction are ending up in the criminal justice system in very high rates. It's not just in North Dakota," Hall said. "(Burleigh County Sheriff Pat Heinert) decided early on that we are missing the mark on what our obligations are to the people that are in our care ... We wanted to get back into doing more than warehousing people."

Burleigh County, in partnership with Morton County, is due to open a new, $69 million, 475-bed jail this spring. With the new facility Kemmet hopes to offer more programs and hire another staff member.

The jail also will consider implementing new plans, to include risk assessments for bond conditions, establishing a mental health court and adding more rehabilitation programs at the new jail.

Kemmet's position isn't novel. In fact, many jails across the country have or are considering placing similar mental health or behavioral health professionals in their facilities.

Ayesha Delany-Brumsey, director of the substance abuse and mental health program at the Vera Institute of Justice, said, New York City has similar staffing across the various boroughs of the city. In Manhattan, the jail hired a nurse and social worker to screen for behavioral and physical health needs.

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"The purpose of those individuals is to help triage very quickly if there are any immediate health concerns," Delany-Brumsey said. "But to also to try to identify any behavioral health needs the person would have. Then they would let that person's lawyer know so they can help connect them with care."

Other jails are looking at Transitions Clinics, which exists in states such as Connecticut and California. A nationwide network of community health workers who go into the jails and meet with people who are incarcerated to determine what their needs are, Delany-Brumsey said. Research shows that there have been better outcomes, including lowering the use of emergency services, she said.

Nancy Fishman, a project director at Vera Institute, is working in Philadelphia where there's a jail that received a grant from a national non-profit to staff a mental health professional who works for the public defender's office. The jail is planning to add another position at its adult probation or parole department to do screening and link people to services.

While many jails across the U.S. are placing more focus on identifying, screening, assessing and treating people with mental illnesses who are incarcerated, jail diversion needs to be part of it, too, Fishman said.

"I think what we're seeing ... is that too many people are going to jail because they're not being diverted to community resources that could address the root cause of whatever behavior may have brought them to the attention of law enforcement," she said.

Mental illness, addiction and homelessness is prevalent in many jails. The Burleigh County Detention Center conducted a voluntary survey for a week in October, which found 48 percent of inmates had perceived behavioral health issues upon intake. Fifty-two percent of those with behavioral health issues had been to the jail before, with 72 percent having been at the jail within the past six months.

Cass County has offered these services at its jail since 2008.

Lynette Tastad is a licensed independent clinical social worker and mental health coordinator at the jail. Her job is to refer people to a mental health diversion program.

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To get into the program, an inmate has to meet a certain diagnostic criteria, as well certain legal criteria. Tastad then makes a recommendation to the judge for referral to the program. Once in the program, she monitors inmates and acts as liaison between the court and treatment provider.

When the program started, some opposed having a mental health professional at the jail, Tastad said.

"I think the hardest thing is being a mental health professional coming into law enforcement's world-it was just kind of difficult in the sense that law enforcement and mental health providers have a very different outlook. Our training is a lot different," she said.

Now, county jail employees and local law enforcement officers are eager to learn how identifying inmates with mental illnesses and ways to help them. Officers screen inmates using the same eight-question form Burleigh County uses. In addition to the questions, jail employees are trained in what to look for and ask additional questions based on the person's answers. Tastad said officers have made a lot more referrals to her and more and more officers are signing up for crisis intervention training.

"It's taken a lot of education and time, but we've come a long way since when I started," she said.

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