Grand Jury

MARIN COUNTY CIVIL GRAND JURY FINAL REPORT SUMMARIES 3 MARIN COUNTY CIVIL GRAND JURY 2017-2018 • OCTOBER 2018 Photo Credit: iStockPhoto FOLLOW-UP REPORT ON MENTAL HEALTH CARE IN MARIN COUNTY JAIL e previous Grand Jury con- cluded in its 2016-17 "Care of Mentally Ill Inmates in Marin County Jail" report: Although identifying and committing ad- equate resources to provide ap- propriate mental health care in Marin County Jail may be difficult for the County, there are important reasons that a significant enhance- ment of mental health care in the Jail should be a high priority. Current staffing and organization of mental health care in the Jail is inadequate, and appears not to conform to California law and code nor to court rulings regarding the care that should be provided to incarcerated persons. In particular, delays in assessment and treat- ment of recently booked mentally ill inmates, lack of adequate local processes to address emergency mental health crises, inadequate 24/7 clinical coverage, and the use of safety cells for acute mental ill- ness episodes need to be addressed as soon as possible. ere appear to be clear violations of the rights of inmates to adequate care based on, and equivalent to, "community standard" care. is Grand Jury was unsatisfied with the responses of the Marin County Sheriff and the Board of Supervisors to the previous report. is report explores the adequacy of the previous re- sponses and recommends that the respondents take further action. is report concludes that Marin County may be vulner- able to lawsuits that could lead to costly legal fees and onerous judg- ments, as has occurred in some other California jurisdictions. In addition, last year's report pointed to certain practices as violating the Constitutional prohibition against cruel and unusual pun- ishment. It is the opinion of this Grand Jury that the recommen- dations in the 2016-17 report be implemented. 2017-2018 MARIN COUNTY CIVIL GRAND JURY FINAL REPORT SUMMARIES RECOMMENDATIONS R1. Mentally ill inmates should not be kept in safety cells for more than 24 consecutive hours. R2. Safety cells should never be used as a substitute for adequate psychiatric treatment. R3. Any inmate placed in a safety cell should be evaluated by mental health staff within 4 hours for the appropriateness of the placement and the evaluation of possible alternatives. R4. e Board of Supervisors should establish or contract with a local facility where sentenced inmates can receive involuntary administration of psychiatric medication. R5. Mentally ill inmates should be provided with 10 hours each of unstructured and structured out-of-cell time per week. R6. A psychiatrist should be available at the Jail 8 hours a day, 5 days a week, and available by phone 24/7. R7. A Mental Health Crisis Specialist or psychiatric nurse should be available at the Jail 24/7. R8. Programs should be cre- ated to provide appropriate non-pharmacological mental health therapy to all mentally ill inmates. R9. Classification of inmates as mentally ill should be reviewed by a member of the mental health staff within 4 hours of booking. R10. All policies and procedures in the Sheriff 's Manual related to the care of inmates should be reviewed and updated.

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