Portrait of Sheriff Jeff Easter. Easter is wearing his uniform and the background is blue.
Sedgwick County Sheriff Jeff Easter said it’s a constant challenge to provide mental health services to people held in the county jail. The jail’s mental health pod can accomodate 50 people, but an estimated 400 people in the jail have a mental illness. (Fernando Salazar/The Beacon)

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Update: On Aug. 24, Sedgwick County Jail saw its fourth person this year die while in custody. A 38-year-old male was found unresponsive and EMS pronounced him dead at the scene. A preliminary investigation determined the death a result of natural causes; an autopsy is pending.

Content warning: This story contains references to and descriptions of suicide.

The Sedgwick County Jail is on track to see a record number of suicide attempts this year. Five people have died from suicide in the jail since 2018, and at least one lawsuit has been filed against the jail’s staff alleging negligence leading to a suicide death.

“It’s overwhelming,” said Sedgwick County Sheriff Jeff Easter. “With the population we’re dealing with, the rates of mental illness and their addiction problems are a lot higher than what you’re going to see in the general community.”  

Easter estimates one-third of the jail population is affected by a mental illness, a number disproportionate to the general population. Nearly one-fifth of all Americans live with a mental illness, according to The National Institutes of Health.

Eight years ago, a section of the Sedgwick County Jail was renovated to serve incarcerated people with mental illnesses. The resulting mental health management unit — often called the mental health pod — has been considered a success by county officials. But because the pod only accommodates 50 people, the majority of those who require these services don’t have access to it. 

The county jail is designed to house 1,200 people, Easter said. If the jail operates at capacity — which it often does — then roughly 400 people in the jail could be expected to have a mental illness. That’s eight times what the mental health pod can accommodate. 

In-custody suicide local and statewide

For every suicide death in the Sedgwick County Jail, there are several suicide attempts. Currently, the highest number of attempts in one year is 65 in 2020. This year is on track to beat that number. As of early August, 63 suicide attempts have already been made in the county jail, Easter said. 

Suicide is the leading cause of death among those held in U.S. jails. The number of suicide deaths in local jails has risen by 13% over the past two decades, according to data from the Bureau of Justice Statistics. In 2019, 355 people died by suicide in local jails nationwide. 

Kansas jails follow similar trends. Since 2011, suicide has killed 64 people in county-run facilities, according to in-custody death reports from the Kansas Bureau of Investigations. KBI investigates in-custody deaths where the cause of death is unknown, unexpected or from unnatural causes. Of the deaths investigated by KBI, suicide far outnumbers other manners of death. 

The number of in-custody deaths reported annually in Kansas jails has also increased over time. In 2011, four deaths were reported, whereas 15 deaths were reported last year. Of the 15 people who died in Kansas county jails last year, eight of them died by suicide — a number that has remained mostly consistent over the past several years. 

What happens if someone attempts suicide in the Sedgwick County Jail?

To prevent suicides in jail, deputies are told to look for signs that someone held in the jail may be feeling suicidal, Easter said. Indications of suicidal thoughts include acting withdrawn and socially isolating from others. There are also certain populations, such as those who recently received a life sentence, that commonly attempt suicide, Easter added. 

“If they get convicted and they’re going to serve a lot of time in prison, we pay a little bit closer attention to them,” he said. “We try to identify them as quickly as we can to start giving them mental health services.”

High-risk individuals or those who have already attempted suicide are placed on suicide watch, where they are monitored 24 hours a day. Due to understaffing at the jail, this observation is often done via camera.

Individuals on suicide watch wear yellow jumpsuits that make them easily identifiable and are held in cells without items like bedsheets that could be used for self-harm. Appointments with one of the mental health nurses are also made as soon as possible. 

Sedgwick County Jail mental health pod lacks required space

Due to limited space, only the most severely and persistently mentally ill individuals are housed in the mental health pod, Lorelei Ammons, the chief operating officer of clinical services at VitalCore Health Strategies, wrote in an email to The Wichita Beacon. The Sedgwick County Jail contracts with VitalCore Health Strategies to provide behavioral health services to the jail. 

“It may be difficult to house them with others in a jail setting as they can be aggressive, or conversely, they can be taken advantage of by other incarcerated individuals,” Ammons said.

Once an individual enters the mental health pod, they are enrolled in a step-down program designed to stabilize their symptoms. This program, which began five years ago, offers three steps. At the highest step, the individual is assessed by a behavioral health professional at least daily and watched more closely by correctional staff, Ammons said. At lower levels, correctional staff monitor the individual less frequently, and they are allowed more freedom to socialize with others in the pod. 

Licensed behavioral health staff determine whether to move an individual down a step in the program. “The incarcerated person’s safety is paramount, but a crucial determination is that they are safe and are not at a point that they have suicidal thoughts, plans or intentions,” Ammons said. 

The mental health pod’s step-down program appears to effectively decrease the severity of a participant’s symptoms, Easter said. Issues arise when it comes time to reintroduce them into the general population. 

“A lot of the time, they start falling away from compliance with their medication,” Easter said. “And so, once that happens, they regress, and we have to start all over with them again.” 

Many people who enter the mental health pod remain there the entire time they’re held in the jail, Easter added.

Sheriff’s deputies are ‘trained in combat,’ not mental health services

An additional challenge comes in providing mental health care to those who can’t fit inside the mental health pod, Easter said. 

Anyone held in the county jail can request to speak with behavioral health staff, Ammons said. These requests are prioritized based on symptom severity, though staff works to reach all individuals in a timely manner.

Those on suicide watch who don’t have access to the mental health pod are placed in an isolated cell so they can be monitored by deputies, Easter said. But the jail faces another challenge in ensuring all deputies assigned to watch a patient with a mental illness are properly trained to do so. 

Sedgwick County Commissioner Lacey Cruse, who often advocates for mental health care in the criminal justice system, said the county jail isn’t designed to be a rehabilitative space for those with mental illnesses. 

“Sheriff’s deputies are trained in combat, they’re trained in defending things,” Cruse added. “What are they trained in for community-based services? Do they know who the mental health providers are?” 

In the police academy, deputies work through a two-hour-long mental health course, Easter said. The Sedgwick County Sheriff’s Office also sponsors Crisis Intervention Team training, which teaches law enforcement how to interact with people with mental illnesses.

Due to the pandemic, the county hasn’t held this training in two years. The recent lack of training compounded with a staffing shortage means it isn’t always possible for both of the deputies assigned to the mental health pod to have received CIT training, Easter said. 

In February, the mother of a man who killed himself in the Sedgwick County Jail filed a lawsuit against county officials under claims of negligence by jail staff. Austin Stewart, who died in 2019, had been placed under suicide watch and housed in the mental health pod following a suicide attempt four months prior to his death. 

According to the suit, one of the two deputies assigned to Stewart’s pod was a trainee and had not received CIT training. Stewart was also not equipped with a suicide smock and was instead given regular bedsheets. Using the bedsheets, Stewart hung himself from a handrail that lacked protective fencing. 

The suit alleges that Stewart was not monitored every 15 minutes — as was required by the facility — and that he “hung in POD 2 for nearly 1.5 hours, just feet from the door of the deputy’s booth, before the deputies discovered the body.”

The Sedgwick County Sheriff’s Office does not comment on pending civil litigation involving its employees. 

Community-based services could reduce recidivism and prevent arrests

When an individual gets released from jail, staff currently hand out pamphlets that include information about community mental health services. But they lack the staff or the expertise to coordinate beyond that, Easter said. 

For that reason, the Sedgwick County Jail is looking to replace two unfilled corrections positions with social worker positions, Easter added. The job description for this role is in the process of being written and has yet to be approved by the Sedgwick County Commission.

Providing more robust crisis intervention services during law enforcement calls could divert a person from entering the jail at all, said Risë Haneberg, deputy division director on the behavioral health team for the Council of State Governments Justice Center, a national organization based in New York. Prior to her role at the CSG Justice Center, Haneberg served as the criminal justice coordinator for Johnson County.

One diversion method that has been utilized in some Kansas counties is the co-responder method, Haneberg said. This method pairs a member of law enforcement with a mental health professional who works with them while they’re on the scene. 

“Many times, when they arrive, there’s not necessarily a crime that’s been committed,” Haneberg added. “Honestly, a lot of things can be medicated right there on the scene.” 

Sedgwick County currently offers a Crisis Stabilization Unit provided through Comcare. Staying in a residential mental health center is one alternative to jail, Haneberg said. The Crisis Center is looking to expand its services by building a larger building, but progress has stalled and a location for the building has yet to be decided on. 

Haneberg leads the Stepping Up Initiative, which aims to reduce the number of people with mental illnesses in jails through data-driven alternatives. The initiative works with over 550 counties across the nation and provides training, webinars and other resources to county officials. 

Kansas joined the Stepping Up program last year, a decision motivated by an audit conducted in 2018 by the Kansas Legislative Division of Post Audit, which found that few local jails provided all recommended mental health services.

Sedgwick County adopted the Stepping Up Initiative in February and is in the early stages of developing a validated screening tool that can be used at booking to inform the county on the types of people entering the jail. Once data is collected, jail staff can use it to make informed decisions about how best to improve their mental health services. This method also allows jails to track whether new policies and programs have effectively reduced the number of people in jail with mental illnesses. 

Collaboration between community leaders is necessary to enact change, Haneberg said. “Many different players have to be willing to be open to a lot of policy and practice change,” she added. 

Improving mental health services for incarcerated people doesn’t require building a bigger jail or hiring more corrections staff, Cruse said. Instead, she suggests transitioning the way the jail is operating.  

“Right now, taxpayers are paying to just keep the revolving door greased,” she added. “We’re not moving the needle in any direction. If anything, it’s getting worse.” 

One way to enact change is to set small, measurable goals, Cruse said. For example, the jail could decide that it wants to decrease recidivism and go from there to find a solution. 

Cruse suggests funding programs that are designed to reduce the number of people in jail. Both Cruse and Easter are members of Sedgwick County’s Mental Health and Substance Abuse Coalition, a partnership between community leaders that has developed a strategic plan to improve mental health services in the area. 

One of the coalition’s long-term goals involves building a community resource center in Wichita. This resource center would be designed like a college campus and would house various nonprofits in one place. The coalition has been working on the resource center for two years, and a location is in discussion. 

Right now, resources like housing and mental health are siloed, which makes it hard for someone to gain quick access to multiple services at once, Easter said. Once the resource center is built, Easter envisions someone being released from jail and immediately being transported to the center. By setting up this continuity of care, it may make it easier for someone to continue to receive mental health treatment outside of jail. 

In the meantime, mental health may continue to be a challenge for the Sedgwick County Jail. 

“What’s sad is that we have several people that go into the program, do pretty well and stay on their medication,” Easter said. “Then they get released to Comcare, they don’t have that one-on-one every day. So they quit taking their medications, relapse, commit a crime, and then they’re right back with us.” 

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Gretchen Lenth is The Wichita Beacon’s data intern through the Dow Jones News Fund. Follow her on Twitter @GretchenLenth.