Marin County to expand involuntary medication of inmates

Marin County plans to expand a program to administer drugs to inmates against their will.

Last fall, the Oversight Board authorized court-ordered medications to be administered to inmates deemed unfit to stand trial without their consent, if necessary. Before this authorization, detainees had to stay in prison for months until a bed was available in a public hospital.

Involuntary medication has been permitted since the passage of Senate Bill 568 in 2007. When Marin supervisors gave approval, several other Northern California counties, Contra Costa, Sonoma, Solano and Napa, were already using the law.

On Tuesday, supervisors received a report from Behavioral Health and Recovery Services, a division of the Marin County Department of Health and Human Services, on how the first year of implementation has gone. Michelle Funez Arteaga, division director, briefed supervisors on plans to expand the program beyond inmates deemed incompetent to stand trial.

Arteaga said state law allows the county to give medication to inmates in two additional situations. The first occurs when a psychiatrist or psychologist has determined that the inmate is severely disabled due to a mental disorder or poses a danger to himself or others. The Marin County Public Defenders Office represents inmates in legal proceedings when authorities seek a court order for the involuntary administration of medication.

The other case is where the detainee was legally detained. A mental health guardianship gives an adult the legal authority to make certain decisions for a seriously mentally ill person. In these cases, the medication would be administered at the request of the patient’s conservator.

We wanted to start with the incompetent to be judged, Arteaga said. But now that things are going well, we plan to expand this program to these other populations while they are in prison.

Arteaga said that in the first year of implementation, fewer than 10 inmates received medication against their will. Arteaga said she couldn’t give the exact figure because the Marin County Department of Health and Human Services has a policy of not releasing population numbers under 10 to protect anonymity members of the group.

Supervisor Katie Rice asked Arteaga how many additional inmates would be likely to receive medication involuntarily with the expansion of the program.

Arteaga said that of the three categories, the group found incompetent to stand trial was the largest.

Although I don’t have an estimate for these other two populations, they will be even smaller,” she said. “We could go an entire year without a single person being incarcerated and falling into the guardianship category.

Arteaga said that since the program began, no inmate or staff member has been injured while administering medication.

When we started the conversation about involuntary medication, some people were concerned that it could lead to injury, Arteaga said. We found that it was actually safer.

Arteaga said all inmates who were initially given drugs against their will consented within one to three administrations.

If inmates are found competent after receiving medication, they can then stand trial or, in some cases, be eligible for a mental health diversion program.

AB 1810, which was signed into law in July 2018, authorizes pretrial diversion programs for crime suspects with certain mental disorders. To be eligible, however, inmates must have one of three diagnoses: schizophrenia, schizoaffective disorder, or bipolar disorder.

Medications are ordered by a licensed psychiatrist or psychiatric nurse practitioner. They are administered by a registered nurse or other licensed healthcare professional with the assistance of corrections officers.

I’m sure it’s traumatic for the individual, Rice said, but I’m just wondering about the impact on you as human beings on a staff level.

Arteaga said, “I think it was even more traumatic to see people incarcerated and untreated for months without having tools to be able to help them. »

These were people in dire psychiatric conditions, unable to meet their basic needs, Arteaga said. There were often problems with eating, hygiene and sleeping, simply without any stability. It didn’t seem human to see people in this state for so long.

Supervisor Stephanie Moulton-Peters said, “I know of a constituent in my district who had been languishing in prison for quite a long time and his family was very concerned. He was finally able to receive treatment thanks to your program. He is now home and his family is very happy.

During the public comment portion of the meeting, Jennifer Carter said, “I’m actually one of those people. I was a person in prison with no insight, I couldn’t take care of myself, and I couldn’t take medicine. I always wished there was a way someone could give me medicine.

“I ended up in jail for about a month due to psychosis and I had no idea where I was,” Carter said. I finally had to say yes to medication to get better.