Mental illness often lands people in jail, hospitals, prison | Idaho Statesman

For the seventh time this year, Katelyn Hodges was booked into jail on June 20. She’d gotten into a tussle with her caregiver after threatening to kill him with a fork, police say.

Hodges is 28, but her mother says her many disabilities, which can make her hard to control, leave her functioning at the level of an 8-year-old.

When she’s not in jail, court or the hospital, Hodges is shuffled from place to place in the Treasure Valley. No housing placement has kept her for long, because her disorders cause violent outbursts.

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Her mother’s greatest fear? “That she’s going to hurt someone so bad that she kills them. Or that she just gets so frustrated she seriously hurts herself or kills herself,” Renee Williams said.

That’s not an isolated case in the Treasure Valley.

The same day Hodges was booked into jail, Melinda Lowe’s son was gone from their backyard.

That’s where he usually lives, in a spacious tent with room for a bed and a clothing rack. He has severe mental illness, and the backyard is a tranquil place for him to sleep, smoke cigarettes, write in a journal or play music.

But on June 20, Lowe’s son was at Saint Alphonsus after cutting his neck in a suicide attempt.

“He had seven deep cuts on his neck and just barely missed an artery,” Lowe said.

These mothers are among many parents who have shared their stories with the Idaho Statesman in the past two years.

Parents say they’re desperate. They fear it’s a matter of time before their children die by suicide, die in a confrontation with police or hurt someone else. They are exhausted, having tried for years to get help in Idaho.

The state lacks the appropriate facilities and programs for their children’s treatment, they say. It feels like they’re fighting an unwinnable battle, and they’re running out of time.

And they wonder: Idaho’s population is booming, so what happens when more people with severe mental illness need treatment from an already overwhelmed system?

“There’s this intense need, and it’s been bottle-necked, and there just aren’t places for people to go,” said Ceci Thunes, health policy specialist for the Idaho Behavioral Health Alliance.

State lawmakers and officials have ordered the creation of special facilities to help these Idahoans. But there has been slow — or no — progress in getting the facilities up and running to help people around the state.

‘It’s making her worse, not better’

Katelyn Hodges has spent the last 10 years in and out of police custody — her whole adult life.

She was booked into the Ada and Canyon county jails nine times since last June. In one week, she was released from jail and booked back in within about 48 hours.

Her mother, Renee Williams, explains that Katelyn, better known as Katie, has a variety of diagnoses. She has autism, schizoaffective disorder — whose symptoms are like a combination of schizophrenia and bipolar disorder — post-traumatic stress disorder, and delayed cognitive development. She also has intermittent explosive disorder, which results in violent outbursts.

She can’t live on her own and needs full-time staff to care for her. But Hodges has assaulted nearly every caregiver she’s had, and multiple residential agencies have turned her away, her mother said. Out-of-state facilities and Idaho’s state hospitals won’t take her, in part because of her behaviors and in part because the hospitals are meant for short-term care.

“This has been a burden that we’ve walked through for many years with Katie,” Jordan Hodges, Katie’s brother, told the Statesman. “You have this tension of not feeling like we can provide care for her in our own homes with our own children and then watching her burn through at least a dozen agencies trying to live in the community.”

More than 20 times in the hospital

Lowe’s son has been hospitalized more than 20 times for psychosis, wanting to kill himself or attempting suicide.

He talked with the Statesman after being discharged from Saint Alphonsus’ behavioral health unit. He said he wanted to share his story to raise awareness, but he didn’t want to use his name.

“What defines my illness is feeling isolated and feeling like no one understands,” he said.

Lowe says her son’s treatment costs the health care system “hundreds of thousands” of dollars a year. There are ICU stays, ER visits and longer-term psychiatric hospitalizations.

“If he had been getting the right care, these hospital stays would not have happened,” she said. “We’d have a healthy young man, instead of an even further tortured and traumatized person from all of these hospital stays.”

Lowe says it’s hard to find mental health providers who can take on new clients, and her son has been dropped by local agencies. This week, she learned his newest agency was dropping him, due to the suicide attempt. He will lose his case management — the backbone of his mental health care — and his community-based rehabilitation services, she said. And each time an agency drops him, it restarts a process that ties up his Social Security disability payments for two months.

Lowe says a trauma-based residential program is the best option for her son. No such facility exists in Idaho. Her son’s psychiatrist recommended a facility on the East Coast, but it has been four months since she began trying to get him into it, she said.

The state does have some options for people like Lowe’s son.

The Idaho Department of Health and Welfare has attempted to launch a program statewide that would offer adults with severe mental illness an option between “group home” and “hospital.” They’re called “Homes with Adult Residential Treatment,” or HART homes.

The department started a pilot in the fall of 2017, with a goal of creating enough HART homes to serve 50 people, officials told the Statesman then.

There were four HART facilities in the state as of the last fiscal year, according to the department. They can serve more than 50 people.

The homes are few, and they aren’t open to everyone. Medicaid eligibility is a requirement to live in HART homes and get the wraparound services they provide.

Police become mental health first responders

When Katie becomes violent, caretakers often have to call the police. Standing at 5-foot-10, she can be a challenge to restrain.

When police arrive, she’s handcuffed and booked into jail, where she’s usually detained in isolation. Sometimes she wears a restraint jacket or a helmet while in jail, her mother says. The helmet is mostly to prevent Katie from hurting herself by smashing her head on the jail wall — something she has done so many times that her retina has detached, causing permanent vision damage.

She’s been tackled by police, restrained in chairs, handcuffed and shackled, and forced to wear restraints for her own safety, her mother said.

“Each time it happens, more and more damage is done,” Jordan Hodges said. “Emotionally and mentally. And it’s destroying her. It’s really difficult to watch, and it’s mind-blowing to us to think that there is not a solution for people like Katie. That there’s not somewhere for them to go.”

In the past, Canyon County Sheriff Kieran Donahue has said Hodges has assaulted nine of his deputies while in custody. She’s been better lately, but the Canyon County jail uses a wrap to restrain her and requires her to wear a helmet.

“I’m so mad I can hardly speak, because I have been a huge advocate for Katie,” Donahue said. “This state and this system have failed (Katie) miserably. We are here to protect the most vulnerable in our society, and she is the most vulnerable.”

Jail staff give her medications she’s been prescribed, and sometimes give her sedatives, Donahue said.

The last time Williams picked her up from the jail, Hodges had marks from the restraints.

“She had bruises all up and down her arm when she got back,” Williams said.

Her mother believes it is just further evidence that a correctional facility is not where someone like her daughter should be.

Idaho secure facility put on back burner

The Idaho Statesman wrote about Hodges’ case in 2017, after state lawmakers passed the Secure Treatment Facility Act. The law was supposed to enable the Southwest Idaho Treatment Center, or SWITC, to create a more secure unit to house up to four patients who pose a threat to the safety of others.

At the time, it gave Williams hope.

But since then, SWITC has come under scrutiny for alleged patient abuse and neglect, chronic understaffing and other problems. Families of SWITC residents filed a class-action lawsuit earlier this month.

A new advisory board recently made recommendations for the future of SWITC. It doesn’t include a secure unit. It does, however, say that “secure features must be built into the model,” according to a department spokeswoman. Those details are still being worked out, she said.

Today, the Department of Health and Welfare cannot legally lock a door at the facility.

Cameron Gilliland, the deputy division administrator for family and community services at Health and Welfare, said he could not comment on Hodges’ case directly, but offered explanations about how the department handles people like her.

Gilliland explained that the department would take a person into its care for several reasons, either a team of professionals and a judge determine the person is not mentally competent to stand trial and they need to be restored to competency, or in rare cases where it is determined that the individual does need a locked door, and a judge would need to commit the person to prison.

The department’s advisory committee has recommended modifying SWITC to include transition beds, stabilization beds and step-down treatment in a homelike environment. These beds would be for people who cannot live in community housing.

“That’s generally why people end up at SWITC,” he said. “They have behaviors that are beyond the control of what can be handled in the community. Providers have refused to serve folks, and that’s why they are with us.”

Hodges was transferred out of SWITC and back into community when she became more successful, according to her mother. But community housing has never worked for Katie because of her arrests and assaults on staff.

Law enforcement’s response

Sheriff Donahue is angry. He’s angry that the state hasn’t moved forward with the secure housing unit, and he’s angry that Health and Welfare hasn’t taken Hodges into its care.

(Under Idaho law, the department does not make the call on who is committed to its care. That is determined by a judge, after evaluations and recommendations by mental health professionals, some of whom work for the Department of Health and Welfare.)

Donahue knows Katie’s case well. She knows all of his jail deputies by name. In 2017, he lobbied in favor of the Secure Treatment Facility Act, calling it “Katie’s Law.” Two years later, there is still no secure facility for people like Hodges.

Donahue sits on the SWITC advisory board and said he doesn’t agree with the recommendations that don’t include a secure unit.

“I see it as such a travesty, because that would at least protect Katie from herself and from harming others,” Donahue said. “That’s what the whole (law’s) purpose was for.”

Some Idahoans with severe mental illness are being housed in a state prison, which is legal in Idaho. The Idaho Department of Correction can take people who haven’t been charged with a crime, if a court decides they are “both dangerous and mentally ill” and the safest place to house them is a state prison.

Four men at the Idaho Maximum Security Institution south of Boise this month are living there under that law, according to IDOC spokesman Jeff Ray.

It’s a path Katie Hodges knows, too.

She was at the Pocatello Women’s Correctional Center from November 2016 to January 2017 after a Canyon County judge determined she was “dangerously mentally ill.”

Her stay with IDOC was brief, but troublesome.

“We were told she tried to hang herself” at the prison, Jordan Hodges said.

From there, Hodges was released into SWITC’s care, but after a year, she started to get better and was released back into the community. Things went downhill from there. She fell back into old patterns.

• On May 27, Nampa Police say Hodges battered three staff members when they were trying to de-escalate a situation. She grabbed one by the hair and threatened to kill her, and she kicked another staff member several times, according to the police affidavit.

• On June 8, Nampa Police say Hodges walked away from her caregiver and threw rocks at a car window, breaking it. She also threw a rock at one of her caregivers, the police affidavit says.

• On June 16, Nampa Police say Hodges threatened to kill her caregiver with a fork. The caregiver picked up a chair to keep Hodges at bay. According to the police affidavit, there was an altercation between the caregiver and Hodges, they fell to the ground and she wrapped her legs around his body, but he was able to gain control. “(Katelyn) seems to be escalating in her violent behavior,” Nampa Police wrote in the affidavit.

Williams does not believe her daughter can succeed in a standard home and worries what will happen now that her last residential facility refused to take her back.

“She did really good (at SWITC), but that’s the problem,” Williams said. “Whenever she does good, they release her out into the community.”

Some of Katelyn Hodges’ recent arrests stem from interactions with the staff at the residential facility she lived at in Nampa. After her most recent arrest, she’s been told she can’t return to that facility, according to Williams.

“You won’t believe how frustrating it is, as a mom, to know that there’s nowhere for her to go,” Williams said. “Katelyn can’t be the only one in the state (who needs secure housing).”

‘Nowhere else safe for them to go’

Hodges was living at a residential behavioral health home in Ada County in 2018 and early 2019, but was arrested several times for again damaging vehicle windows and personal property.

She spent about four-and-a-half months in the Ada County Jail in 2018.

Williams said some of the deputies would read to her, and others would give her crayons to color with.

The Ada County Sheriff’s Office said that when Hodges was in its custody, she was housed alone in a secure health services unit. That was for her safety and the safety of others, the sheriff’s office said.

She tried to punch deputies and spit on them during an incident in 2019 as they tried to move her. She also intentionally broke a laptop in the jail that’s used by inmates to communicate with people outside the jail, according to the sheriff’s office.

When Hodges is in jail, deputies try to keep her busy when they have time. They use dry-erase markers to play games with her through her cell window. They sing to Hodges to keep her calm. They offer her crayons and let her sit out in the booking area, as long as she isn’t disruptive.

One deputy played cards with her through the meal slot in the door of her jail cell.

“She is very social – but can’t be with other inmates. Our deputies have done several things to alleviate this,” said Patrick Orr, the Ada County Sheriff’s Office spokesman. “For instance, during Thanksgiving in 2018, deputies had other inmates sit outside her cell during dinner so they could all eat and talk. Katelyn could see and hear through the window.”

Meanwhile, Lowe’s son has been arrested and jailed once — for his behavior during a mental health crisis. She says he was sentenced to community service. But his mental health was so poor at the time that he couldn’t do the work, and he was forced to spend time in jail.

Ada County Sheriff Steve Bartlett told the Statesman, through his spokesman, that he hopes to see Idaho work toward a solution for Hodges and other people who need secure care.

“If someone is arrested for committing a crime, and they aren’t able to safely be in our community while their case is being adjudicated, the jail is an appropriate place for whoever that is,” Bartlett said. “That being said, the Ada County Jail is not designed to be a secure medical facility for people with developmental disabilities who struggle to be in society. It’s a jail – which is for people who are charged with crimes or for people who are serving a jail sentence.

“And if someone is committing crimes just to get into custody because there is nowhere else safe for them go, that’s a major problem.”

Donahue is especially frustrated because some prosecutors argue she should stay in custody at the jail, and her latest Health and Welfare worker thinks she will be found competent for trial, despite multiple past charges being dropped because Hodges was incompetent.

“We have failed her,” Donahue said about systemic flaws. “They continue to fail her, and (the sheriff and his deputies) have worked our tails off to protect that woman.”

At Hodges’ June 21 court appearance, Magistrate Judge John Meienhofer asked attorneys where she should stay while Health and Welfare determines if Hodges should be committed to its custody, questioning if jail was appropriate.

“If there were anywhere else, she’d already be there,” Canyon County Chief Deputy Prosecutor Chris Topmiller told the court, according to an audio recording of the hearing. “I don’t want to hold her (in jail) one minute longer than I have to. It’s just right now, there’s no other place. Her mom can’t take her, she doesn’t meet criteria for the state hospital and she’s not a candidate for SWITC without that commitment.”

But on Friday, that changed. The court committed Hodges to the Department of Health and Welfare — and she was to be moved from Canyon County jail to SWITC that day.

“I’m so relieved she’s not going to prison,” Williams told the Statesman in court Friday. “She doesn’t belong there.”

Hodges’ most recent charges in Canyon County are for felony aggravated assault and misdemeanor battery, but the cases were put on hold while she is in SWITC’s care. Her next court appearance is set for Oct. 4. Her family is hopeful Hodges will be safe at SWITC, even if it isn’t a permanent solution.

“I can count at least five times that she’s legitimately tried to take her own life, and that is the biggest concern that I carry,” Jordan Hodges said. “Every human deserves, regardless of disability, to live a meaningful life, and we just want her to do well. Nobody deserves to feel like the world would be better without them because they’re positioned to fail.”

Voice your opinion. Contact those in charge:

• Gov. Brad Little: (208) 334-2100, governor@gov.idaho.gov
• Idaho Department of Health and Welfare Director Dave Jeppesen: (208) 334-5500, send a message
• Senate Health and Welfare Committee chairman, Sen. Fred S. Martin: (208) 447-9000, fmartin@senate.idaho.gov
• House Health and Welfare Committee chairman, Rep. Fred Wood: (208) 312-1056, fwood@house.idaho.gov

Do you or a loved one have mental illness? Are you an expert or advocate in behavioral health? Join our closed Facebook group, Mental Health in Idaho.

Editor’s note: References to Health and Welfare SWITC advisory board recommendations, and Idaho’s mental health commitment process, have been clarified.

This story was originally published June 27, 2019 6:35 PM.