QUINCY -- Bipolar disorder, schizophrenia and depression. They're just a few of the diagnoses some inmates at the Adams County Jail have received.
With no elevator up to the booking area on the fourth floor, inmates must walk -- or at times be carried -- up the stairs to get booked, putting staff and the inmate at risk, especially if a mental health illness makes them uncooperative.
Mental health illness is nothing new in the Adams County Jail or at other facilities in the United States.
A report from the Vera Institute notes that about 14.5 percent of men and 31 percent of women in jails have a serious mental illness, compared to 3.2 percent of men and 4.9 percent of women in the general population.
Going by that estimate, it means with a capacity of 118, 21 inmates -- 15 men and six woman -- in the Adams County Jail could be expected to have a serious mental health illness.
However, the Adams County Jail has exceeded its capacity in recent years, with recent populations of more than 140.
Construction continues next to the Adams County Courthouse on a new larger facility.
Increased training is one way that jails are working to address mental health.
New hires for the jail automatically go through crisis intervention training when completing Basic Correctional Officer Training.
The crisis intervention team training provides ways to deal with individuals who suffer from mental health illness.
Jail Administrator Chad Downs said four or five corrections officers recently completed the crisis intervention team training.
Another option used in the jail is bringing a provider who can offer inmates assistance.
Every Monday, a representative from Clarity Healthcare based in Hannibal, Mo., visits the jail to offer mental health visits to inmates. Through video communications, they can speak with a psychiatrist who can prescribe medications and assist with any issues they have with the medications.
"If we feel that Clarity needs to (help) somebody, we will definitely get them hooked up with it," said Adams County Sheriff Brian VonderHaar. "From there's up to the individual."
Counseling is not offered in the jail, unless it is court-ordered.
With the new jail set to open before the end of the year, VonderHaar said it is possible that more services could be offered, including counseling, but more discussions are needed for that.
Downs said after an inmate leaves, they might stop taking their medication and then end up getting sent back to the jail after getting arrested. After they get back on their medications, he says they're fine.
"It's when they leave here that they might get off track," he said, adding aftercare is an area that needs to be addressed.
The Quincy Police Department also changed how it interacts with those with mental health illness.
Sgt. Erica Scott has been an officer with the Quincy Police Department for 15 years, and she has seen the change in approach when it comes to dealing with individuals suffering from mental health illness. Many officers have taken crisis intervention team training.
"It basically teaches officers not to diagnose, but how to recognize someone in crisis and how to recognize someone who is potentially mentally ill, and then how to handle it -- ways to approach them, things to do, things not to do and a little bit of a de-escalation," Scott said.
The Quincy Police Department also is working with Clarity to provide mental health evaluations as needed. The department contracted Clarity last year for evaluations and to provide services during crisis to crime victims or even officers.
"They are basically on call to us 24 hours a day to provide mental health services, so if we have someone in custody that is suicidal or homicidal and they need to be evaluated prior to being put in jail, they will come and do an assessment and determine whether or not that person really needs to go to the hospital or if they can go to jail," Scott said.
In 2018, officers with the Quincy Police Department responded to about 660 calls for service involving an individual with mental illness.
Scott or another assigned officer along with someone from Clarity will occasionally reach out to individuals with mental illness to make sure they are keeping up with medications and follow-up appointments they may have with an area provider.
"I think law enforcement as a whole has taken a new perspective that jail is not a solution for a lot of these people," she said. "It's getting them follow-up services. A lot of people don't need to be hospitalized. There can be out-patient services that can treat them."
Aftercare is cited by both law enforcement and justice officials as an area lacking in addressing mental health illness in jails.
Adams County launched its Mental Health Court in 2018 to stem issues with aftercare.
State's Attorney Gary Farha said goal of Mental Health Court is to stop a pattern of behavior of repeat offenders who are suffering from mental health illness. Cases can range from multiple counts of retail theft to violation of an order of protection.
The Mental Health Court team includes representatives from Transitions of Western Illinois, Blessing Hospital, Quincy Medical Group, the state's attorney's office, the Adams County public defenders office, the Adams County Probation Department and other representatives from law enforcement.
"You're not only getting treatment providers looking at their cognitive thinking, but they're also looking at their medication and what it might do to them and what not taking their medication might do to them," Farha said. "That's the wonderful thing about the team approach, because you get everything from different prospective. Ultimately, the judge is the arbitrator."
The problem-solving court is a more intensive version of probation for those convicted of crimes who suffer from mental health illness.
However, Farha takes issue a state requirement that sets admission in the program only on objective standards, and with a space for 20 to 25 people, it could limit people who staff believe would be successful from entering the program.
"In a way, the Mental Health Court team cannot use as a standard, ‘This person may not get through because of problems they might have,'" he said. "That's a little bit frustrating when you're trying to start out a program because we've already had an individual that has left the program for not being able to handle it, and there are a couple others that are having difficulty with it."