Few people who are fired from the police are arrested

Many others simply walk out the door and sometimes do not come into contact with the police again until hours later.

“They’re often back in our communities before the paperwork is completed. Within two hours, three hours. We’re asking these questions. How can this happen?” Doug Jerome, president of the Montgomery County Association of Police Chiefs, said in May. “We don’t get many answers.”

Our research found that people with severe mental health problems are more likely to end up in prison. Nearly half of the more than 800 inmates at the Montgomery County Jail take medication for mental illness.

“When we talk to county sheriffs across the state, they say, ‘We have people in our jail who really don’t belong there,'” said Luke Russell, executive director of Ohio’s National Alliance of Mental Illness (NAMI).

And some recent examples show that people whom police and neighbors tried to get into psychiatric treatment ultimately became a threat to the community.

Tragic consequences

The man who shot and killed four people at a Beavercreek Walmart on Nov. 20 bought his gun just two days before the shooting. Reporting by the Dayton Daily News showed how Benjamin Charles Jones, 20, of Dayton was able to buy the gun after being fired twice in 2022 for suicidal thoughts.

Because of medical privacy laws, it’s unclear what happened during Jones’s evaluation when he twice said he was suicidal. But he never made it to the probate court-mandated supervision, according to missing records in local county probate courts. That might have prevented Jones from purchasing his gun, or at least given him the opportunity for additional, more intensive treatment.

Mental illness is not a predictor of gun violence, mental health advocates say. But in some cases, mental health advocates question whether people would have ended up in certain situations if they had received help sooner.

On May 5 of this year, 57-year-old Michael Bagley was arrested and later charged with panic-mongering following a reported disturbance around midnight that continued into the morning hours and involved a heavy police presence in the 600 block of Kings Cross in West Carrollton.

A neighbor said Bagley had been suffering from mental health problems for years, but had become increasingly unpredictable and aggressive and had refused help.

Police and neighbors have been trying to figure out what to do for three years, she said.

“The law says there’s nothing anyone can do to help him,” Karen Korn said in May. “…It’s a tragedy because we need a different system. We just need something different to stop it from getting to this point.”

Only a few make it to the probate court

Pink slips are forms printed on pink paper that can be filled out by police officers and other qualified individuals to refer a person for examination by a physician to determine whether the person poses an immediate danger to themselves or others.

The person can voluntarily undergo treatment and be released. Or the doctor can have them taken into custody – usually in a mental health facility – and compel them to begin treatment. Because the person is being held against their will, the process is overseen by probate courts, which ensure that the committed person’s rights are protected and monitor compliance with the treatment plan.

The Montgomery County Probate Court recently began tracking dismissals and determining how many are forwarded to probate court. The Dayton Police Department filed 87 dismissals in January, five of which were forwarded to probate court, the court said.

In February, 67 terminations were issued to Dayton police, none of which were referred to probate court. In March, 101 terminations were issued by Dayton police, resulting in four people being referred to probate court and one case being expunged, according to the court.

This means that in the first three months of the year, only about 4% of people fired by the Dayton police made it to Montgomery County Probate Court.

“Our officers in particular recognize that mental health issues are complex in nature and are trained to treat people humanely, regardless of how often they come into contact with the same person,” Dayton police said in a statement.

More people in prison than in psychiatric beds

Law enforcement has become the first front line of mental illness crisis response, while prisons and detention centers are the new asylums, mental health experts say. Local and state authorities in Ohio are trying to correct decades of failed mental health policies.

This policy also included the deinstitutionalisation movement of the 1960s and 1970s, which was actually intended to be addressed by the Community Mental Health Act of 1963.

The Dayton Daily News reported that people with severe mental illnesses became homeless due to a lack of alternatives to institutional care and thus were more likely to end up in prison.

According to the Treatment Advocacy Center, a national policy and scientific organization, there are 10 times more people with serious mental illnesses—such as schizophrenia spectrum disorders, severe bipolar disorder, and/or major depression with psychotic features—living in prisons or jails than in state psychiatric hospitals.

Almost half of the inmates suffer from a mental illness

According to the Montgomery County Sheriff’s Office, as of July 1, approximately 43% of people incarcerated in the Montgomery County Jail were receiving psychotropic medications.

“Our prison and local justice system is under comparable strain to any other prison and justice system across the country,” said Teresa Russell, chief of the Criminal Justice Division of the Montgomery County Sheriff’s Office.

Not only do they detain people before their alleged crimes have been tried, but prison staff must also deal with mental health care.

“This includes providing effective care for people in correctional facilities, particularly those who refuse such care, and what judges and probation officers should do in finding alternatives to probation placement for people with serious mental illness,” said Teresa Russell.

Nowhere else

For some seriously ill people, emergency rooms and the justice system can become revolving doors if there are not enough psychiatric beds or other facilities to provide them with services that they cannot access themselves because of their mental state.

“While it is frustrating for police to encounter a resident they have taken to the hospital a second or third time, these individuals are now going to jail because they committed a crime that warranted their arrest,” said Teresa Russell.

“Sometimes these are minor offenses, and unfortunately, in prisons across the country – not just the Montgomery County Jail – mentally ill people are often arrested because there is no way to directly transfer them to an appropriate program for which they may be eligible,” she said.

According to the Treatment Advocacy Center, nearly 80 percent of beds in state psychiatric hospitals are occupied by forensic patients, that is, people who are in the care of the criminal justice system.

Inmates waiting for a bed in a state mental hospital typically have to wait a month for a bed to become available, according to the center. The center also notes that this may put these individuals at risk of worsening their psychiatric symptoms.

Ohio has allocated $10 million for a new psychiatric hospital in Dayton. That sum was included in the capital budget that Governor Mike DeWine signed last month. Construction will take years and the total cost of the hospital is estimated to be around $273 million, according to initial estimates from the Ohio Department of Mental Health and Addiction Services (OMHAS).

OMHAS currently operates six regional psychiatric hospitals and spends more than $300 million of its annual budget on hospital services, the largest portion of its budget. Its total budget is $1.2 billion for fiscal year 2024 and $1.1 billion for next year.

Experts: More needs to be done

Even though the new mental health hospital will add more than 200 beds to Dayton—a move welcomed by mental health advocates, providers and police—continuity of care for people with serious mental illness still needs to be improved.

Among the things needed are inpatient beds to stabilize people, as well as psychiatric rehabilitation facilities for short-term accommodation and long-term accommodation, such as assisted living communities, says Luke Russell of NAMI Ohio.

“We need more residential communities for the mentally ill where they can live and receive support,” he said.

Recovery support with treatment has a greater chance of success, he said.

“Right now we have some people who could get treatment but have no place to live,” he said. “Then they become hard to find, coordination of treatment becomes difficult and they become non-compliant with medication. They don’t take their medication and then we get into these situations. It’s like these revolving doors.”

NAMI Ohio was among the groups that said the new mental health hospital in Dayton was urgently needed, but that more work needed to be done to build the community-wide network of care required by the Community Mental Health Act of 1963.

“The system didn’t fail. It was just never rebuilt after there was a movement toward community-based mental health treatment in the 1960s,” said Luke Russell.

Sydney Dawes and London Bishop contributed to this story.