THE FACE OF A BROKEN SYSTEM; Melissa Ann Jernigan Has Been Arrested about 20 Times since 1999. Instead of Treating Her, Why Do We Keep Putting a Mentally Ill Woman Behind Bars?

By Denton, Frank | The Florida Times Union, February 16, 2014 | Go to article overview

THE FACE OF A BROKEN SYSTEM; Melissa Ann Jernigan Has Been Arrested about 20 Times since 1999. Instead of Treating Her, Why Do We Keep Putting a Mentally Ill Woman Behind Bars?


Denton, Frank, The Florida Times Union


Byline: Frank Denton

Yes, that face to the right is a woman, and no, despite the appearance, it is not a face of anger or evil or meanness. Along with all those other faces of Melissa Ann Jernigan over the years, hers is a face of bewilderment or frustration or desperation.

They are all police mug shots of Jernigan as her mind misfired and deteriorated over the years. Her story tragically and graphically illustrates our virtual abandonment of very many people in our community who are mentally ill. Instead of helping them get well, we lock them up.

The three biggest mental-health providers in the nation today are: the Cook County Jail in Chicago, the Los Angeles County Jail and Rikers Island jail in New York.

The biggest mental-health provider in Duval County is the Duval County jail.

Think about that.

Last week, you read in the Times-Union that Jacksonville Community Council Inc. has launched a major inquiry into community mental health. It will hold weekly meetings and, by summer, develop recommendations on various aspects of a broad issue that affects our quality of life in multitudinous ways - but is too often hidden, suffering in the shadows, underneath our routines, but constantly hurting and often destroying people.

Ever the optimist, I am hoping for substantial progress, but we have stumbled down this road before. As a journalist who has covered it for a long time, I have the historical perspective to see the inquiry as the inevitable and long overdue result of public-policy fits and starts and failures dating back more than 50 years.

Before then, there was little mental-health care, and those most afflicted were locked up in often horrendous warehouses ironically called "asylums" but really meant to protect the rest of us while doing little or nothing for the incarcerated sick people.

Weeks before he was assassinated, President John F. Kennedy signed the Community Mental Health Act of 1963 to create a national network of community mental health centers for every city, so the mentally ill could leave the state hospitals and get treatment in their own towns, ideally supported by family members.

Indeed, the state hospitals eliminated about 90 percent of their beds, and the sick went home for the promised community treatment. As a young reporter in 1971, I covered the development, building and opening of the very nice center in Anniston, Ala.

But again, we chose not to think about the mentally ill, and they left our attention span. Only about half of the planned 1,500 centers were actually built, none was ever fully funded, and in the Reagan years, the appropriations were converted into "block grants" allowing the states to spend the money however they wanted. The community mental health effort melted, and the mentally ill largely were left to their fates on the streets.

Given that many of them suffer from serious, debilitating illnesses, they often get into trouble. A 2010 study by the Treatment Advocacy Center and the National Sheriffs' Association estimated that 40 percent of the seriously mentally ill have been in jail or prison at least once in their lives.

Florida has almost five times more seriously mentally ill people in jails and prisons than in hospitals. "We have now returned to the conditions of the 1840s by putting large numbers of mentally ill persons back into jails and prisons," the 2010 study said.

Tara Wildes, director of the Jacksonville sheriff's Department of Corrections, estimates that up to 80 percent of the jail's average 2,400 population have some sort of mental-health issue, and maybe 10 percent are seriously mentally ill. That's more than 200 at any given time.

There are so many that the jail has had to develop four levels of confinement and care for its mentally ill majority. Some are functional enough that they can be in the general population. Then there are separate mental-health cells for more seriously ill inmates. True psychotics are locked up alone. Then there is the "close-observation dorm," where the suicidal inmates are held, sometimes with a one-on-one watch.

The jail has its own mental-health team, led by a psychiatrist and including a physician's assistant and six counselors. Each mentally ill inmate is assigned to a counselor, but if you do the math, that gives each counselor a caseload of more than 300 people who are constantly rotating in and out of the jail.

"We could use twice that staff," Wildes said, "but compared to other facilities, this is good staffing." Meaning that some jails may have little to no help for their many mentally ill inmates.

Of course, there are other mental-health programs in the community, but it usually is the jail that is trying to provide acute care to people with chronic illnesses that have roots and outcomes defined by years and, usually, decades.

"For those seriously and chronically mentally ill," Wildes said, "this isn't a good place to be."

The 2010 study found that mentally ill offenders are usually "frequent flyers" in the system, they cost half-again to twice as much to incarcerate, they stay longer, they are often "major management problems," they are more likely to commit suicide in jail, and they are more likely to be abused by insensitive corrections officers.

To the contrary, remarkably and pointedly, one of the assets at the Duval jail is Wildes herself, who was also a police officer but chose corrections as a career partly because she grew up with a little sister who was psychotic and diagnosed as bipolar. The sister finally had to leave Florida to get the care she needed and now is working as a nurse in Georgia.

"Having that personal experience has meant that my job almost has become a calling," Wildes said. "I want to do something for these people because you see how bad they're suffering. I do feel passionately about these issues." Her son also is a Duval corrections officer, and Wildes thinks the family history "led him to that."

In fact, most people probably have a family or other close connection to mental illness. As we discussed the JCCI study in our editorial board last week, several members talked about afflicted family members, and we agreed that, if we went around the table, probably all of us had such close experiences. Of course, we have resources, family support and health insurance.

Yet, we as a community and society are leaving much of the care and treatment of low-income and uninsured mentally ill to our jails and prisons.

The 2010 study by the Treatment Advocacy Center and National Sheriffs' Association concluded: "Emptying America's mental hospitals without ensuring that the discharged patients received appropriate treatment in the community has been an egregious mistake. For the approximately half of discharged patients who have ended up homeless or in jails and prisons, it has been a personal tragedy. Although deinstitutionalization was well intentioned, the failure to provide for the treatment needs of the patients has turned this policy into one of the greatest social disasters of the 20th century."

That study ended with several recommendations: provide "assisted outpatient treatment" for released mentally ill prisoners, expand mental-health courts to allow offenders to choose between treatment and jail (Wildes said Duval has a "very rudimentary" one for a few patients), fix the state and federal funding systems, and reform treatment laws so interventions can be based on treatment needs rather than on dangerousness, as in Florida's Baker Act.

But those are recommendations for the corrections system; a caring nation, like the one that passed the Community Mental Health Act in 1963, would reform its entire health-care system to include systematic care for those with mental illnesses.

"Society," says Wildes, "needs to start looking at mental illness as brain disease and treat it like any other disease."

Over the next six months, JCCI's inquiry will be looking at all those issues and more, and mental health will be a major area of reporting for the Times-Union this year.

For all my words and numbers, this story is a consummately human one, perhaps told most eloquently by the life and pain of Melissa Ann Jernigan.

We don't know everything that happened to her in her 36 years. Wildes says she was in the foster care system, indicating an abusive or absent family, and she was the "victim of almost any kind of abuse you can think of." Whether the abuse caused her mental illness or vice versa is unclear, but the profundity of her illness is not.

She aged out of the foster care system at 18, and her available adult criminal record began at 21, when she was arrested for possession of cocaine. Since then, she has been arrested about 20 times, mostly for relatively minor crimes like battery, possession of drug paraphernalia, trespassing, criminal mischief, disorderly conduct and parole violations.

Her offenses began escalating in 2001, when she was charged with aggravated battery after she repeatedly kicked a state hospital guard who then suffered a heart attack and died.

In 2003, the Times-Union reported that she was arrested after two men complained to police that they had unprotected sex with her without knowing she was HIV-positive. She told police that she tested positive for the disease in 1999 but continued to have unprotected sex with at least 200 men.

Of course, she pleaded guilty and was sentenced to 23 months in prison, but her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

"Typically, if she's out, we'll have her," Wildes said. "This is her home, between here and prison and the Florida State Hospital.

"She wants jail, so if she's out, she'll go into Walgreen's, pick up a bottle of Tylenol, swallow the whole bottle, then go up and tell the clerk she's stolen the Tylenol and eaten it." The clerk calls police and EMTs, and the cycle begins again.

Wildes describes the occasional "Melissa summits," where representatives of the county jail, the prison system and DCF meet to try to figure out what to do next. "The state will say 'We can't take her, she's too mentally ill,' and DCF will say 'We can't take her, she's too mentally ill.' "

At the moment, Jernigan is in the State Hospital, but Wildes knows she'll show up at the jail in handcuffs again soon, as the client of a system that may have helped create her and now doesn't know what to do with her.

Go back to Page F-1 and look at those photographs of Melissa Ann Jernigan again. Will we allow our neighbor to live like that? Will we create more faces with those eyes? Do we really want a child who is abandoned and thrown into the foster care system to end up like that? Do we? Do you?

frank.denton@jacksonville.com, (904) 359-4197

GET INVOLVED

To comment or get involved in the JCCI inquiry Unlocking the Pieces: Community Mental Health in Northeast Florida, go to jcci.org and click on "Mental Health." There, you can get more information about the inquiry and register free for future weekly meetings. At the bottom of the page, click Contact to send JCCI your comments and suggestion.

CAPTION(S):

Mug: Melissa Ann Jernigan May 18, 1999

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan July 2, 1999

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan Jan. 7, 2002

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan March 6, 2002

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan June 11, 2002

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan Feb. 8, 2003

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan March 2, 2006

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan Jan. 27, 2008

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan Aug. 13, 2008

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan Dec. 19, 2008

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan Aug. 29, 2013

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

Mug: Melissa Ann Jernigan Most recent

Her adult life has been going from the streets to jail to prison or the hospital then back to the streets, and repeating the cycle.

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THE FACE OF A BROKEN SYSTEM; Melissa Ann Jernigan Has Been Arrested about 20 Times since 1999. Instead of Treating Her, Why Do We Keep Putting a Mentally Ill Woman Behind Bars?
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