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Monday, August 14, 2017

A New Model for a New Jail

                                        A New Model for a New Jail
By Albert B. Kelly

Over the last couple of years, there’s been considerable thought and discussion on the idea of building a new County Jail. Given the fact that over $800,000 was necessary in repairs and maintenance alone last year, there is an obvious need to replace the current aging facility that serves Cumberland County.

I was part of the effort that wrote the grant to expand the jail back in the early 1980’s, but I would like to consider a new county jail within the context of the addiction epidemic that is overwhelming. This discussion is necessary, because the bulk of the “overwhelming” happens at the local level with the county jail as the point of the spear.

I say that because the further away you get from “local”, whether state capitals or in Washington DC, the more the addiction epidemic looks like just a big mound of statistics. But it’s locally where the enforcement happens, where the care is administered, where inmates are released into the community and it’s locally where too many struggle and fail.

At a time when we’re starting to realize that addiction belongs more in medicine than in the courts- that mental health is part of the equation also- the administration is seeking to cut the guts out of the Affordable Care Act and any number of other programs that might allow for meaningful long term treatment.

But even in the best of times, there were too few options to adequately address addiction crisis or mental health needs, and even if there were more facilities and programs, it is doubtful that the people who need it most would have the insurance to cover treatment or the money to pay for it- which brings us back to the local level and local solutions.

A recent piece by freelance journalist Sam Quinones in the NY Times talked about a unique approach taking place in Kentucky at the Kenton County Detention Center; namely a unit in the jail providing longer term treatment for addiction.

The thinking there is that new treatment centers are more difficult and expensive to build and with insurance and funding for treatment that much harder to come by given the posture of the administration in DC, jails are the point of contact and the intersection for the addicted and the one place where it’s possible to provide a less expensive approach to the crisis.

This thinking makes sense. A significant number of those being arrested are addicts and the idea is to use jail, which is the common landing spot, as the foundation for treatment rather than punishment. This is wall-to-wall treatment, just as it would be in an inpatient setting.

The idea is that this type of intervention, taking place at the jail level, may well be the thing to keep an inmate whose primary issue is addiction, with or without mental health issues, from graduating up to the level of state prison time.

As we get set to embark on building a new county jail facility, why not take this as an opportunity to “design in” this approach to treatment for those whose primary problem is addiction? This opportunity comes just as we’re getting the initial results on bail reform and that has implications.

Recall that statewide, with bail reform in place, the jail population has declined by roughly 20%. Here in the Cumberland-Gloucester-Salem area, jail populations have dropped by 6%, 39% and 45% respectively. Why not use that freed-up capacity in other ways?

In the Kentucky program, there is instruction on criminal-addictive thinking, 12-step programs, overdose resuscitation training, physical exercise, counseling, prayer and meditation, inmate self-governance, extensive writing assignments, GED classes, and beds made military style.

As the article points out, recovery is messy. In follow-up visits one year out on 339 inmates who went through the program, 70% were NOT incarcerated, 68% were employed, 86% had housing, and 50% reported significantly less drug use.

I think we can all agree that with $800k a year in repairs and maintenance on the current jail, we need a new facility. Using this as a springboard, and in light of the 7 suicides that took place in the jail in recent years, baking treatment for addiction and mental health services into this cake is a discussion worth having.

Since we’re not going to arrest our way out of this crisis, let’s try a new model- in a new facility- that appears to work.