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PITTSBURGH— A monthslong investigation by Spotlight PA and the Pittsburgh Institute for Nonprofit Journalism found that Pennsylvania’s system for determining whether someone is mentally fit to stand trial often traps them in the very place making them worse — jail.
In “A Criminal Solution,” the newsrooms reported that Pennsylvania laws and policies meant to aid people with severe mental health issues and who have been accused of a crime often do just the opposite.
The system can strand people with serious mental health needs in jail and prolong their detention for low-level crimes that experts say are often a symptom of mental illness.
In conjunction with Point Park University and PINJ, Spotlight PA hosted a panel to discuss this broken system and the story of Rachel Bridgeman, a Georgia woman whose arrest in Pennsylvania led to months in Allegheny County Jail waiting to be restored to “competency” i.e., to be found mentally fit for trial.
Brittany Hailer of PINJ and Danielle Ohl of Spotlight PA moderated the discussion, which was held at the Center for Media Innovation at Point Park in Pittsburgh.
Here are the key takeaways from the September conversation:
Pennsylvania is an especially bad state to need mental health care
When Rachel Bridgeman was first arrested in Pennsylvania, she told jail staff she had a “mental breakdown” earlier in the year and had received treatment for psychosis in her home state of Georgia.
Allegheny County dropped the initial charges against her, but Bridgeman had only a few hours of freedom before police brought her back to jail on charges related to shoplifting in a Rite Aid. Her condition worsened from there.
Repeated incarceration instead of care is common for people with serious mental health issues, said panelist Nev Jones, a researcher and professor of psychology and social work at the University of Pittsburgh. Jones said it also stems from an unfulfilled promise made decades ago that following the closures of public psychiatric hospitals, the United States would significantly invest in community-based mental health services.
“What we see is a very large group of people in American society who are essentially socially abandoned, who end up moving between what has been referred to as the institutional circuit,” Jones said. “ERs, acute services, hospitals, shelters, on the streets, and then, prisons and jails.”
Versions of this path to incarceration exist across the country, Jones said, but some jurisdictions do a better job than Pennsylvania of redirecting people with mental health needs from the criminal justice system.
“I think there’s a particular lack, compared to at least some places I’ve lived and worked, in terms of a really robust continuum of care and ability to really proactively engage and divert folks with what we call serious mental illness in various forms.
“People are often exposed to repeat harm, repeat betrayal, repeat trauma,” Jones said. “So, across this circuit, things are getting worse and worse and trust in the system at a certain point is so fundamentally eroded, that it also takes some really exceptional people and programs to bridge that and reestablish trust.”
Focusing on lived experiences is important in rethinking the mental health system.
Panelist Jeremy Northup’s work as a psychology professor at Point Park University uses a “human science” approach that centers on a person’s experiences living with a mental health condition. He also facilitates Hearing Voices groups that help people verbalize what they go through.
“It’s important to think about what it’s like to be in this situation,” he said. State hospitals are often “cold, alone, difficult places to be,” Northup said. Jails and prisons can be especially isolating because behavior caused by mental illness can have criminal implications.
“You could be held against your will and put into spaces where you lose your agency,” he said. “Because you’re having a hard time, you end up demeaned and degraded.”
Suicidal behavior in an institutional setting like a prison or a state hospital can result in privileges that most people take for granted — like writing implements, shoelaces, clothes, and physical contact — being stripped away for safety reasons.
When she began to self-harm in the Allegheny County Jail, Rachel Bridgeman was moved to solitary confinement, where she wore an anti-suicide smock rather than clothes and had limited ability to interact with others.
“This is at your worst moment when you’re in contact with police officers and psychiatrists and you’re being moved to jails and you have cops and on and on,” Northup said.
It would be a “disordering, disorienting, demeaning experience,” for anyone, he added.
Incarceration can further isolate someone having a mental health crisis.
Panelist Tanisha Long of the Abolitionist Law Center was essential to freeing Bridgeman from the Allegheny County Jail. Through another incarcerated person, ALC learned of Bridgeman’s situation.
Long spent days searching for Bridgeman’s family after meeting her inside the facility and later joined Bridgeman’s sister, Sarah, in the courtroom to advocate for her freedom.
This kind of intervention is familiar to Long because of her time with ALC and because she’s applied it to her own family. Long’s mother, while incarcerated at the Washington County jail, had a mental health episode that prompted the jail to move her to a more restrictive unit.
Long knew something was wrong when her mother’s incessant calls and texts stopped.
“By the time we were able to figure out what was happening, by the time they let us have a video visit, she had lost a significant amount of weight,” Long said. “She was in a deep state of psychosis, where she had no clue what was going on. Her physical health had declined.”
Experiencing a mental health crisis in a carceral setting not only limits your ability to advocate for yourself, Long said, but it also limits your family’s ability to advocate for you.
“Whatever’s happening to you inside that jail, it’s just happening to you,” she said.
Long and her family were able to help her mother, who is now incarcerated at a nursing home.
“I know she's at least safe, even though her mental health has been permanently damaged by that time in solitary confinement,” she said.
Community, not carceral, solutions are key.
Freeing Rachel Bridgeman took the combined efforts of several community members — a fellow incarcerated person, Long, ALC attorney Jaclyn Kurin, and her sister Sarah.
While the criminalization of mental health issues is common, the panelists said, that kind of intervention is rare. But it’s also what’s needed.
“That’s our answer right now,” Long said. “It's a lot of community groups who are getting there, doing the work, who share each other's numbers, who reach out on Signal chats or wherever they're doing it. And that's how we're responding.”
Audience members asked the panelists what they should do if someone in their community seems to be in crisis.
Long said it’s important to treat people as more than their mental illness, or their behavior in a crisis.
“That's like that's my number one,” she said. “We have to start meeting people where they're at.”
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