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The Legislature's special Jail Study Committee, examining capacity issues at the Tompkins County Jail, today continued to hear about services offered in the jail—much of today's focus on behavioral health issues.

Tompkins County Deputy Commissioner of Mental Health Sharon MacDougall talked about the societal factors affecting the need for behavioral health services (encompassing mental health and substance use services), why such treatment is important, and how behavioral health services in the jail can be enhanced.

MacDougall noted that in the general population, 20% of people have a mental health diagnosis and 20% a substance abuse diagnosis, percentages that are two-to-three times higher in the incarcerated population, where the environment itself exacerbates such issues. She noted that the number of behavioral health clients has increased over the past three decades, due to factors such as deinstitutionalization and a lack of support for communities. She described substance use trends as unpredictable and very difficult for communities to deal with. Often, she said, behavioral health issues are associated with minor crime, because people are hungry or without a place to stay.

Regarding what Tompkins County can do, MacDougall said it's critical to have a full spectrum of services for the behavioral health population. Important factors include diversion from incarceration whenever possible; behavioral support services for those in the jail, with the goal of getting people out of jail quickly; and outpatient services in the community, to serve them once they're released. She said that her department, by adjusting schedules of its three forensic-trained social workers, is prepared to enhance behavioral health services in the jail, providing 20 hours of coverage per week—including universal screening for behavioral and substance use; expanding behavioral health support services to help and engage people while in jail; and supporting discharge planning to link jail residents to outpatient services in the community. Commissioner MacDougall said that a program to offer medically-assisted treatment in the jail, through the anti-dependence drug Vivtrol and associated counseling, is being explored in discussions with New York State. She stressed that the goal is to keep people out of jail whenever possible, with the Mental Health Department offering both immediate access to treatment and a mobile crisis team for after-hours critical situations.

Jail Nurse Evelyn Goldsberry also briefed the committee on the range of the 40-hour-per-week services she provides—coordinating medical care for all inmates, managing all medications, and maintaining all medical records. Goldsberry told the committee that there are very few inmates who don't have medical needs, and that both additional nursing hours and additional medical space at the jail would be very helpful.

Legislators again heard comments from the public related to the Jail and the jail study process. Nine people addressed the committee during a half-hour of public comment, speaking out against any expansion of the jail, urging initiatives such as bail reform and a focus on community services that would keep people out of jail. Committee members thanked the speakers for their ongoing input, several saying that this issue should not be viewed in an adversarial way. Legislator Anna Kelles was one who said she would like to achieve the sense that all sides are working toward a common vision. Committee Chair Rich John said that the County needs to address New York State in a viable way on the jail capacity issue, but would never have a "build in and fill it" attitude regarding the jail.

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