An audit released June 16 by Auditor Timothy O’Brien’s office of mental health programs in Denver prisons confirms that they are on the right track, Denver Sheriff’s Department officials say.

“We accepted all of the audit recommendations because we know the work we are doing aligns with the audit findings,” said Sheriff Elias Diggins, who had worked for the department for decades before Mayor Michael Hancock will nominate him for the top spot in July 2020.

The Denver Prison System, which covers the Downtown Detention Center and the Denver County Jail, is one of the largest providers of psychiatric services in Colorado and certainly the largest in Denver. According to staff members, between 50 and 60% of people in the prison population have a current or past mental health problem, including delusions, hallucinations and mood disorders; about 75% of people with past or present mental health problems have substance abuse problems.

“If the Sheriff’s Department’s mental health programs and operations do not effectively assist those in need or at high risk, these individuals may not successfully return to the community and may instead return to the prison system,” notes the audit.

As an indication of how seriously the department takes mental health, Diggins points to its January 2021 hiring of Nikki Johnson, a clinical psychologist, as chief of mental health services at the Denver Sheriff’s Department. “I believe we’re above and beyond most prisons in the country,” Johnson says. “I have confidence in the work we do and the services we provide to people with mental illness.”

While the audit is generally positive, he notes that the Denver Sheriff’s Department “needs to develop a strategy and define what success looks like for its mental health programs.”

The Denver Sheriff’s Department has agreed to implement those recommendations by the end of the year, according to Johnson, who adds that work is already underway.

“I think success depends on the program you’re looking at,” Johnson says. “Our definition of success has been preparing individuals to be released into the community, making sure they have that continuity of care…making sure they have medications in place, making sure that they have accommodation.”

Diggins adds, “Ninety-seven percent of the people in our care return to the community, and we want to make sure they receive the best care during their stay, including mental health care.”

Click to enlarge

Nikki Johnson is Chief of Mental Health Services at the Denver Sheriff’s Department.

Courtesy of the Denver Sheriff’s Department

Upon joining the department, Johnson immediately identified a handful of programs she wanted to implement, including establishing an on-site skills restoration program in the Denver County Jail and creating a team of crisis intervention.

The twelve-bed skills recovery program launched in May 2021. Prior to that, Denver prisons typically sent people deemed unfit to stand trial at the Colorado Mental Health Institute in Pueblo. In its first year of operation, the Denver program rehabilitated thirty people.

A total of 35 people were admitted to the program during this year; four of the other five had their charges dropped, while one person was sent to outpatient catering.

The average length of stay at Colorado Mental Health Institute in Pueblo is 263 days. The average for the Denver program was 68 days per person.

“We are hoping to expand our additional beds and are in the process of having these conversations and contracts to make that happen. Additionally, we are in discussions with the state and the Office of Behavioral Health to get female beds in our unit as well. transition for women, as well,” says Johnson.

In February, the Denver Sheriff’s Department also launched a crisis response team with eleven master’s-level clinicians and a supervisor at the downtown detention center.

“We have reviewed some preliminary data and found that there is a strong need for this team, and we have seen deputies and sworn staff using the crisis response team exactly as we intended” , Johnson said. On average, MPs called the crisis response team more than eighteen times a day.

The primary goal of the crisis response team is to “defuse situations before they escalate,” Johnson says. “It could be anything, someone refusing to lock themselves in a unit, and the deputies knowing that person has mental health issues and not necessarily wanting to escalate and be physical in that situation. … It could be something like someone who is actively self-harming, and they need a little more support and encouragement.”

The Crisis Response Team is designed to prevent the type of use of force incidents that have led to tragedies like the death of Michael Marshall, a homeless inmate who died from the use of force by deputies as Marshall went through a mental illness crisis in the downtown detention center in 2015. The city of Denver ended up paying $4.65 million in settlement to Marshall’s family.

According to Diggins, the crisis response team has been popular among MPs.

Denver’s prison system has been a problem for Mayor Michael Hancock’s administration throughout his tenure due to deaths in custody, like Marshall’s, and other use-of-force incidents. Hancock tapped Patrick Firman to lead the Denver Sheriff’s Department in 2015, shortly before Marshall’s death, tasking him with revamping the department. Firman resigned in October 2019 after a series of embarrassing incidents, including a former inmate giving birth in prison without medical supervision. Hancock then appointed Fran Gomez, a career police officer, as acting sheriff; she was eventually replaced by Diggins.

“From a uniform perspective, I saw, personally, this relationship and this interaction between the members of the crisis response team and the deputy sheriffs, and that is exactly what we wanted” , he said. “It’s about collaboration and teamwork for the good of those in our care.” The department is launching a four-person emergency response team, with the same supervisor in charge, at the Denver County Jail in July.

To help deal with substance use issues, the Denver Sheriff’s Department is now offering harm reduction bags that include Narcan, fentanyl test strips, and drug treatment resources to people getting out of jail. The downtown detention center also recently opened a medication-assisted unit “where people with substance use needs can come into this peer-led community environment and receive the treatment they need.” to get sober and achieve their goals as they get ready to release and focus on that reintegration process as well,” Johnson says.

Diggins concludes, “It’s an enormous task to oversee mental health care at the largest mental health provider in the city and county of Denver. We’re up to the task and just keep doing the job.”

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