In July of 2014, a homeless, schizophrenic man smuggled three Peppermint Patty candies from a Philadelphia-area dollar store. Criminally charged with retail theft and deemed “incompetent to stand trial” by the city’s court system, J.H. was sent to Norristown State Hospital to undergo “competency restoration treatment” — care that would, at best, render him ready to take the stand.
But J.H. never made it to treatment. He’s still waiting in county jail – without access to medication or therapy – where he’s been for over 11 months. And given the messy current state of Pennsylvania’s mental health system, it’s likely he’ll be there for a while longer.
Competency restoration treatment is an amalgam of medication, therapy, and coaching about the legal system. The idea is that it can prepare patients to communicate effectively when they get their day in court.
According to a class-action federal lawsuit filed yesterday by the ACLU of Pennsylvania on behalf of J.H. and 10 other plaintiffs, there are at least 200 people awaiting competency restoration treatment in Pennsylvania jails. The lawsuit claims that, on average, pre-hospitalization sentences run 391 days, and that one patient was stuck in jail for almost two years. The suit further claims that two patients have died in jails awaiting competency restoration treatment – one by suicide, and one by murder.
“Federal courts have ruled that delays of more than seven days from the court’s commitment order to hospitalization for treatment are unconstitutional,” the lawsuit says, naming Pennsylvania Department of Human Services secretary Ted Dallas, along with the CEOs of the only two hospitals licensed to provide competency restoration treatment, as defendants.
The suit follows a 15-month ACLU investigation into what co-lead counsel on the case, Witold Walczak, calls the “black box” of the state’s competency treatment program. “DHS hasn’t been very forthcoming with information thus far,” he told us, adding that the upcoming discovery process will probably reveal more.
The problem as it stands is that between the two hospitals, there just aren’t enough beds to accommodate the patients who need them. And the wait lists appear to be growing at an alarming rate: records obtained by the ACLU show that, at Norristown, the wait list has jumped from 121 on August 21st to 174 yesterday.
Alyssa Schatz, director of advocacy and policy at the Mental Health Association of Southeastern Pennsylvania, believes that efforts to reduce overcrowding should be preventative and come much earlier in the street-to-jail pipeline, long before the vulnerable commit crimes.
She points to the negative impact of community-based services cuts made in 2012 under the Corbett administration, like the elimination of the state’s general assistance program, which gave $205 a month to those in drug and alcohol treatment programs, those with disabilities, and others. From 2014 to 2015, soon after those cuts were implemented, Philadelphia saw a 179 percent increase in its street-residing homeless population, according to data collected by the Mental Health Association.
“It has this ripple effect in our community,” Schatz says, adding that Governor Wolf has proposed the restoration of such funding. Thus far though, his efforts haven’t made substantial progress within the General Assembly.
Although news articles, court challenges, and interviews with experts have led Walczak to believe that Pennsylvania, and Philadelphia in particular, have some of the longest delays in the country, protracted wait times at competency restoration treatment programs due to overcrowding probably aren’t unique to our state. According to the Washington Post, in 2012, over 350,000 mentally ill patients resided in American prisons – that’s more than the population of Pittsburgh.
Kait Gillis, press secretary at the Pennsylvania Department of Human Services, told the Inquirer yesterday that since Gov. Wolf took office in January, his administration has had its eye on the state’s “long-standing issues regarding forensic services.”
“While we cannot comment on pending litigation, the department has been working with the courts and other stakeholders to improve services at our forensic units since that time,” she said.
When we pressed Gillis for details about the efforts, she emailed us what amounted to a mere revision of her earlier statement: “Every day we work with all stakeholders, including the courts, district attorneys, and public defenders, to help ensure that the entire system effectively provides the services that these individuals require,” she said. “Every day we work toward enhancing the services we provide.”
Walczak guesses that the issue at hand will turn out to be – as it so often is – resources. “But saying we don’t have enough money is not a defense to a constitutional violation.”