Health knowledge made personal
Join this community!
› Share page:
Search posts:

From homeless, to jail, to......worse?

Posted Oct 22 2008 4:32pm

“Can I stop talking now?”

Yes, Ron was told. You can stop talking.

“Can I hang up?”

Yes, Ron. Go ahead.

So Ron Troche got off the telephone, and went back to his “pod,” a big cell at the Bergen County Jail with no bars. He would go back to the bunk beds that were packed closely together, and sharing space with guys who, he said, “don’t play with a full deck.”

He’d go back to reading some book he’d enjoy - Tom Clancy, Stephen King. But in jail, there weren’t enough of them. So he’d play cards. Or maybe some television, and some boring program.

Or he’d eat. If he wasn’t hungry, he’d pace. He’d go to his closet, and arrange his clothes.

Then the lights would dim, and he’d got to his bunk. The other inmates would sleep, and even snore. Ron? He’d just sit there, in the near-dark, for hours, fussing and fidgeting. When he got anxious, he’d scrape his bottom lip against his teeth.

“My bed is right under the light,” said the 40-year-old, back in October. “And I have to get up in the middle of the night for my medication.”

Sitting there, he could feel his blood pressure rise, and his mind race. Other people called it “demons.” But Ron didn’t think they were “bad” - he thought everybody had them.

But they didn’t. Even the people in his “pod” - the so-called mental health unit at the jail - thought he was weird. Other inmates would poke fun at him, even though they had the same issues.

Ron was an easy target. He’s a short guy - about 5 foot 4. In jail, he was sort of quiet, and often looking scared and nervous. He was always asking for permission to do things.

“They don’t understand,” he said. That made Ron feel lonely.

“I read again and again … my eyes get tired. I read a chapter or two a night,” Ron, who suffers from bipolar and obsessive-compulsive disorders, said in October. “That’s the only way I go to sleep.”

But every night was the same. Eat, drink, get anxious. All because he tried to steal tools from a Jeep. He’d get these feelings that made him sad. He missed the heroin that made him feel “normal.”

And then, by the grace of God, Ron got news that “shocked” him: He was getting out.

And the other inmates heard this, and watched him pack, in amazement. This was a guy who paced and fussed, a lot. This was a guy who talked about how he felt like crying, but had to stop himself.

How did he do it?

Ron’s ticket was “jail diversion,” a program that provides alternatives to jail for inmates with mental illness. With few community resources available to them, the goal is to steer non-violent offenders away from a life of crime, and repeated stints in county jail or state prison.

Under the program, they may get a lighter sentence. They may even get an early release, and transfer to a treatment program. The bottom line, however, is they get something that’s rarely available in a steel-and-concrete prison cell: Help.

“We need to stop the bleeding,” said John Molinelli, BergenCounty prosecutor, who spearheaded the creation of the local program. “It’s just a constant revolving process.”

Years ago, the state awarded a two-year $250,000 grant to BergenCounty officials and a mental health care agency, Care Plus NJ of Paramus, to establish jail diversion, manage the program, and provide guidance to inmates deemed fit to enter it.

And Ron became one of the 1-year-old program’s model prisoners, agreeing to treatment and doing what’s necessary to adjust to life on the outside.

“I’m very anxious. I’ve been here nine to 10 months,” Ron said, in October. “I’ve done everything I possibly can. I’m ready to leave.”

But not everybody can be Ron. The rules for entering the program are strict. Funding is limited, and with few other resources available, the program turns away many more people than it helps.

BergenCounty, N.J. officials, however, see progress. Sure, it may be slow. But they have a simple philosophy: If you can’t save everybody right away, then save one person at a time.

“I think this is something that is going to work,” Molinelli said.

Left: Ron Troche

Nationally, mental health experts - as well as law enforcement - say jail diversion is becoming a more effective and humane way of treating inmates with mental illness than locking them away in jail.

About 16 percent of the nation’s jail population suffers from a severe mental illness, according to the federal Justice Department. But that number is growing. Ron Honberg, legal director for the National Alliance on Mental Illness, pointed to surveys that show as many as 30 percent of the nation’s jails hold people with mental illness who have not been charged with a crime. The reason, he said, is there is no place else to put them.

“The folks who are, by and large, served by the jail diversion programs - they’ve committed low level crimes,” Honberg said. “These are, by and large, not hardened criminals. These are people who attract the attention of the police for whatever reason.”

With judicial systems burdened by heavy caseloads, law enforcement is desperately searching for ways to reduce the population of prison inmates with mental illness.

Hundreds of jail diversion programs, as a result, are popping up across the United States. Law enforcement boasts it as a way to reduce overcrowding in the courts, probation offices, and prisons that are over capacity.

In San Antonio, Florida, and Atlanta, public officials, judges, and police officers are bragging about the success of programs that have steered hundreds of people into treatment programs and other services.

Some critics deride such programs as “get-out-of-jail-free cards” that don’t effectively deter crime. But jail diversion advocates say they’re limiting - and, in some regions, reducing - the number of repeat offenders returning to prison. The main goal, they say, is to treat people before they do something worse.

“The point of jail diversion is to stop the cycle of having them return to jail,” said Michelle Naples, whose organization, the TAPACenter for Jail Division, coordinates jail-related mental health services across the country. “There are lots of people with mental illness in jail who don’t need to be in jail, and they need a program that allows them to link with the right services in the community.”

When he served as chairman of Care Plus’ Board of Trustees several years ago, Molinelli said, he became sensitive to the plight of prisoners with mental illness. He heard stories from people who struggled to survive in lock-ups that lack the counseling, medical, and rehabilitation services of the outside.

As prosecutor, he has had no interest in “locking up” people with mental illness if they can be treated elsewhere, he said.

In 2002, Molinelli formed a task force that consists of local representatives of the judicial, law enforcement, and criminal defense fields. Their brainchild was jail diversion, even though Molinelli knew it came with some risk.

As prosecutor, Molinelli’s sworn duty is to prosecute criminals and punish them for their crimes. But his support was critical, he said. Without the backing of law enforcement, the program wouldn’t work.

Besides reducing the caseload for law enforcement, Molinelli views it something that’s simply the right thing to do.

“My ass is on the line if we make the wrong decision,” Molinelli said. “If one of those people in the program pushes somebody into a railroad train, then that’s the last you’ll hear of me. I’m done.”

Right now, it’s a pilot program, receiving about 10 percent of the funding that San Antonio and other regions have received. The state grant, which expires in July, also helps pay for mental-health awareness training for probation officers and judiciary officials.

Next year, Molinelli hopes to obtain a federal grant - perhaps as much as a $1 million - to expand the program. Until the county gets more money, however, the program will be small, progress will be slow, and the rules for entering will be strict.

“We just took a baby step,” Molinelli said. “I will never see the benefits of this program. This is 10- to 20-year program. I’d like to think by then it [jail diversion] will be the norm.”

Other jail diversion programs serve hundreds of inmates at a time; Care Plus, on the other hand, had about 17 active cases by the end of December. Many more inquire about the program, but they fail to qualify.

Only non-violent offenders can participate, and they must be BergenCounty residents. While other programs assist inmates at the point of their arrest, Care Plus intervenes when they’re within a few months of their release.

Since the Bergen County Jail is a temporary holding cell for prisoners before they’re sentenced, the program helps some inmates steer clear of a stiffer penalty - such as a transfer to state prison. The goal is readjusting to society, and avoiding a return to jail.

“Our goal was to provide a level of service,” said Gary Dock, manager of the Care Plus program. “It is a level of service that’s effective so they don’t end up back in jail.”

Mostly, Care Plus provides an “infrastructure” to inmates with mental illness that’s not normally available to them, Dock said. Case managers drive them to the doctor, help pay their fines, accompany them to court, and serve as a liaison to their families and lawyers.

They talk to counseling programs and search for space for inmates with a history of substance abuse. They reinstate their benefits that they received on the outside. They make sure they have housing, and that they can pay the rent.

They meet with the inmates on a weekly basis - at a minimum - and learn early who’s ready for the program, and who isn’t.

Every Tuesday, members of Care Plus’ jail diversion staff - which consists of a supervisor, two case managers and an intern - sit in a small, pale room at the jail’s mental health unit, and chat with the prisoners. They’re particularly anxious to talk to Mike Lang, a case manager, and worry when he shows up late.

“The jail has been extremely accommodating,” Dock said. “I have done suicide-awareness seminars at the jail and they [corrections officers] have been extremely receptive.”

Inside the small meeting room, Lang and the inmates set up chairs. A television sits there, turned off. Stacks of books are packed into case, untouched.

As the inmates walk in, Lang assesses who has an interest in helping themselves. If they’re up to it - and they satisfy the rigid conditions - he signs them up.

If they don’t qualify, they’re politely turned away. Inmates with schizophrenia and bipolar disorder get frustrated - even angry - when they hear of the program, but discover that it’s not for them.

Right: Don Cardinali

Take Don Cardinali, a 53-year-old inmate with bipolar disorder. He was arrested after he threatened to rob a Ridgefield bank last July. He also was witnessed using inhalant outside.

In the jail, however, he followed the rules, and attended the weekly group meetings with Care Plus representatives. Initially, he displayed a genuine interest in helping himself. But when Care Plus offered to help get him into a treatment program, Don balked.

Don stayed in jail. Weeks later, he got in a yelling match that landed him in “lockdown,” separating him from his unit. Don said he was “stripped naked” and put in a sleeveless outfit that looks like a blue pleated blanket. He calls it “a chicken suit.”

“I’m in a chicken suit, freezing my ass off,” Don said in December, “and I’m being punished for sticking up for myself.”

For Ron and Don, the process began - in earnest - in the summer and early fall. Ron was arrested in January 2004; Don in July. But every week, they had to sit in the same, small room with 10 other inmates in the BergenCounty jail’s mental health unit, and share their troubles.

Others would walk by, wearing orange jumpsuits, and sandals or high-tops with Velcro straps. They’d walk by the tables with the painted checkerboards that were never used.

They’d quickly glance through the big picture window outside the room where Lang and his group met. Then they would keep walking.

“How are you today?” Lang would say. And then he, and his partner, Jennifer Stratton, would sit and listen.

Usually, Lang and Stratton would only speak when they were asked a question. In some cases, Lang - a former probation officer - knew the answer before he was even asked. The inmates would be impressed.

“I have my ways,” he once quipped.

When the meetings began, the inmates would slouch in their chairs, and fold their arms. A moment of uneasy silence would quickly pass. When the time was right, they would unload - big time.

It usually came in rants and rapid-fire outbursts - usually about the food, their fellow inmates, and their strong desire to get out.

Their lawyers weren’t calling them back, they’d say. They’d call others - including family members - collect. But they wouldn’t accept the charges. They’d complain about not getting their medications - or getting too much.

They’d hear talk that they were heading to a psychiatric facility, when they thought they’d be released. They were being “screwed,” they’d say. They’d get so frustrated, some would talk about how they wanted to “hurt” somebody.

“I had all this anger,” SherodMair, 37, an inmate accused of assaulting a cop, told the group in August. “Marijuana was my thing. But right now, I don’t want to put anything in my body.”

They would ask Lang for help. They wanted to get back on their feet. They wanted to avoid a state prison sentence. Most had been there, they said. They didn’t want to return to the place with the “roaches and the rapists,” they said. They’d rather be in the county jail, the “country club.”

Lang would offer suggestions. Keep trying, he’d say. If you have a complaint, file it. But they wanted more: They’d ask to be a part of the diversion program.

If they were qualified, Lang would offer to do an intake, and ask a list of questions that addresses their readiness.

Most of the time, however, they weren’t ready. But Lang would politely listen to them, anyway.

During an August meeting, Don sat, looking frustrated and glum. He was clutching his arm, and slouching in his chair. His blonde hair was long, and needed a comb. He was in a room with 10 other guys, but he looked cold and alone.

For Don, it was the same old story. For some time, he wasn’t hearing from his lawyer, or anybody else he could reach on the outside. That week, somebody threw his underwear behind the washing machine. He was frustrated, angry, confused. He was rambling.

He carried his honeybuns in a pillow sack because an inmate picked on him, and tried to steal his food. He would keep his coffee grounds in a plastic bag, roll it up, and stick it in his sock.

“I lost my job. I lost everything,” Don, a self-described musician who worked in radio and recording studios, told Lang. “I appreciate you coming here, but I feel like I hit a brick wall on a motorcycle going 100 mph … No wonder I’m mentally ill, because I feel like I’ve been beaten to a pulp.”

Then he went silent, and waited for the others to finish. He had to wait a long time. He would raise his head, or his hand, and get ready to speak. But somebody would butt right in. They had similar issues, but they rarely felt compelled to include him.

The others spoke about how they had everything, too. They were ex-stockbrokers who lost money in the 1987 crash, they said. Or they lived in nice houses “near golf courses,” they claimed, and didn’t belong in jail. They wanted out.

“I knew what I was doing when I did it,” said Phillip DeMarco, 44, who was accused of threatening a state Superior Court judge. “I don’t like to take medications, second. I don’t like to be around people with mental health issues.”

Many of them - but not Don - had a history of violent offenses. Or they were non-BergenCounty residents, and had other issues that disqualified them from the diversion program.

Most thought there was nothing wrong with them. They were framed. They were innocent. It was a conspiracy. In that August meeting, they went on and on about it. For two hours, Lang politely listened. Besides offering some advice, that was about all he could do.

“We can’t physically case manage them,” Dock said. “But it’s [the meeting] our opportunity to guide them through the system.”

By the time Don finally got to speak, again, he was tired. He kept apologizing for what he was saying, or what he was about to say. He didn’t want to keep Lang there too long. But it was his only opportunity, he said. He just wanted some attention.

“I just screamed out loud from the other end of the room,” said Don, complaining about the underwear incident. “I just scared the hell out of everybody.”

Then he went silent, again. Five minutes later, he left. Just minutes later, Lang did, too.

Every week, Lang came back. And every week, he got the same crowd. Nevermindthat most of them didn’t qualify for jail diversion. They still attended the meetings, and they were still hopeful they could find a way in.

By mid-September, however, some hurt their chances of ever getting any kind of help. They were arguing with the other inmates. They got into fights, and found themselves in “lockdown.”

When Lang visited on Sept. 14, one inmate stood outside his cell door, pulled his “chicken suit” down to his waist, and waved through the meeting room window. Few were amused by the gesture, and most ignored him.

Inside the meeting room, there was tension. Phil was complaining about how everybody - his attorney, his family - was stealing his money. He was bitter, paranoid. There was nothing wrong with him, he said. Yeah, he used cocaine before. But he was fine. Everybody else was crazy.

“I don’t have any compassion for people going around robbing people,” he said.

Phil was talking quickly, and loudly. Others struggled to get a word in, but Phil would raise his voice, and drown them out.

Bill Lillo, another inmate, told him not to monopolize the time. But Phil kept going, leaning forward in his chair, staring at Lang, gesturing with his hands, and ranting and raving about his sorry life.

“My life has been sh -t,” he said. “I’m sitting here in jail, and it’s not fun. … I really try to write letters on my behalf, but it’s getting nowhere.”

Even Lang had had it. Normally, he let people talk. But he got tired of Phil and his rambling. “Where are we going with this, Phillip?” he said. “Because it’s not going anywhere.”

Phil finally quieted. Then he acknowledged something obvious: His mouth always got him into trouble.

Within minutes, the tension abated. The give-and-take got better. Some inmates even joked. A few started to smile. Phil just sat there, quiet.

Some asked Lang if they could meet with him later. One of them was Bill. He had a laundry list of issues. When the meeting ended, Lang gave him the benefit of his time.

Bill told him everything: He was busted for drugs. He had been in a car accident, and he was still suffering from the lingering effects. His pain felt like a “toothache in my eyeballs. That’s why I started smoking marijuana,” he said.

The 51-year-old had been in therapy with a psychologist. But why would his eyes swell up whenever he stood near a vacuum? Maybe he wasn’t getting the right medicine.

“My body is in atrophy. I’m curling in up into a ball,” he said. “It’s unfair. It’s unfair treatment.”

He and Lang shook hands, and Bill left. Afterward, Lang was asked if he could help him. He shook his head, no. He wasn’t a county resident.

Weeks later, Don was getting ready to leave. The Care Plus people were ready to help him, and spoke of getting him into a treatment program.

Don just wanted out. He still hadn’t heard much from his lawyer. He had fines of more than $4,000. What if he got out, and he couldn’t find a job? He’d go crazy.

Maybe Lang could help him with that. He and others from Care Plus met with him, and talked to him about his options. Don listened politely, but didn’t agree to anything. But to Care Plus, he seemed receptive.

Care Plus offered promise - certainly more than any other program. No other program talked about release. That’s all Don cared about. He didn’t want to consider anything else.

Don looked forward to a new life, even if he didn’t know what it was going to be like. For once, he felt good enough to laugh, and joke a little.

“I’m just praying that everything takes shape,” Don said.

He was to be sentenced on Oct. 12. Prior to that, Care Plus helped him get everything in order. The organization would provide him the safe landing, help him pay his bills, and possibly get him in touch with his family.

His attorney, Diane D’Alessandro, was working on a plea deal: The charge of fourth-degree possession of methadone would be dropped. Fourth-degree public alarm would stick. Maybe he’d get probation, and no additional jail time.

On Oct. 12, around 9 a.m., in Superior Court Judge Eugene Austin’s courtroom, his name was read aloud. Only Don wasn’t there.

There was a snag: The assistant prosecutor, Susan O’Donnell- Voorman, wanted him in treatment, and she needed an answer immediately. Without an agreement, he would stay in jail until the matter was resolved.

Care Plus hadn’t nailed down that end of the bargain yet. In the courtroom, Stratton sat in the audience, talked to D’Alessandro, and tried to work something out. The attorney asked: What about partial hospitalization?

“We could get him into a program, but this may not be what he wants,” Stratton said. “We have to get him somewhere.”

Later that day, Care Plus dispatched Brad Storey, an intern in the program, to talk to Don in jail. He discussed his options. This time, Don didn’t like any of them.

Don had gone through several rehabilitation stints over the past two decades. Forgive him, he said, for being skeptical.

“It’s like - what is it? - checkmate,” Don said later.

After Storey left, Don went back to sleep. Hours later, he rose from his bunk, and looked straight ahead. His stare was blank, and empty. He was angry. He was frustrated.

Seventy-six days in jail, he said. Another 30, 60, 90 in rehab. Hell no. He had it. He wanted out.

“I had my expectations high. They’re dashed … That’s a curveball,” he said, later. “You know what that means? Another institution. I don’t really need to do that again … I’ll go find some dive hotel for $40 a night.

“Right now, I’m 76 days clean. I don’t need to go back to these street drugs,” he said. “We’ve gotten beyond the point of fairness. I can’t allow this to keep going on.”

On Tuesday, Oct. 18, it was raining hard. The sky was dark and gloomy. Inside the meeting room, the mood was worse.

No basketball today at the court with the barbed-wire fence. No sunshine coming through the window. Just darkness and depression.

On this morning, the inmates were peculiarly quiet. This time, they had to be prodded to talk.

“Every one looks so gloomy,” Stratton said.

“It’s a gloomy day outside,” Perry Jackson, an inmate, said.

Don was there, too. But he showed up very late. At first, he quietly waited for everybody else to talk. But when he spoke, he didn’t stop. This time, he didn’t roll over.

Right off the bat, he kept pointing at his stomach, saying it “it hurts. It hurts!” He didn’t know why. He was still angry, and a bit manic. He felt like he was “screwed,” he said.

He hoped to be on the outside, he said, taking care of his sick mother. Now he’s feeling sick, he complained. He was convinced that he was going to spend the rest of his life behind bars.

“They tell me, ‘In three weeks you’re going home.’ Then they say ‘three more weeks, you’re going home,’ and then ‘three more weeks your going home,’Ÿ ” he told Lang. “I don’t believe it’s fair. I believe I’ve served my time here … If I have to go to a funeral in a jumpsuit, then that’s going to be a very bad thing.”

Lang said he’d try to help, but he didn’t offer much else. Don thanked him, and then apologized. Then he went silent again.

Later, SherodMair spoke. He asked if he was qualified for the program, or a related program. But Mair had a violent offense on his record. This time, Lang didn’t mince words. He looked a little weary himself.

“No,” he said. So Sherod left.

Ron was there, too. He was the one guy who was alert and ready. His eyes were wide open. He sat straight up in his chair, and fiddled with his fingers.

Ron was entering the jail diversion program. His focus was on leaving the jail, and what he planned to do on the outside.

This wasn't supposed to happen. He pushed a guy out of the way while he was robbing a car in Carlstadt. He faced a five-year state prison sentence for his offense.

But Ron has a 21-year-old son, and a mother who was worried sick about him. If that meant he had to swallow his pride, and comply with the terms of jail diversion, so be it.

He admitted he had a problem. While in jail, he didn’t raise his voice. He didn’t complain about the food, or getting beat up. If he kept doing everything right, he was told, he’d get out.

“I’m ready to leave,” said Ron. “I can’t sleep on top of that.”

For Troche, Lang agreed to do an “intake.” On Nov. 3, the day after Election Day, he arrived, holding a stack of papers. This time, no one - other than Ron - would meet with Lang.

Ron sat there, his tattooed arms resting on his thighs. His leg was shaking. Occasionally, he glanced through the window. But mostly, he stared straight ahead, and waited for Lang to guide him along.

Lang handed him one form after the other. Ron glanced briefly at each, and signed what he could.

“If you had some goals,” Lang asked, “what would they be?”

“To get my license back,” Troche said. “My father’s got no tombstone on his grave. I want to put that on.”

They put together a plan that would help map out the next few months of Ron’s life. They talked about treatment programs. They talked about jobs.

If it was agreeable - and for Ron, it usually was -he simply nodded “yes,” signed the form, and moved on.

On the other side of the meeting room window, the other inmates grabbed their food. Don was one. He was carrying his pillow sack, and later, a food tray.

At one point, Don slowed up a little, and made a quick glance through the window. He saw Ron and Lang. His eyes were sad-looking, and he was frowning. Then he picked up his pace and, carrying his tray, disappeared from sight.

Lang kept asking questions. He asked who won the presidential election the day before. “Bush, right?” Ron said.

Lang asked him whether he felt somebody was following him. Ron said he’d heard voices before, but not lately.

Lang then quickly glanced through the windows. Ron kept looking out there, so Lang was curious.

“Are they holding a tray for you?” he asked.

“Yeah,” Ron said. “I hope.”

“Eating OK?” Lang asked.

“I’m not even hungry,” Ron said.

Lang went back to writing. Finally, Ron stopped shaking his leg, and looked right at Lang. His stiff look loosened.

“My mother - I don’t know if she’s helping me,” Ron said. “You’re the only one who is.”

“I’m trying,” Lang said.

Post a comment
Write a comment:

Related Searches