Nearly half of the inmates at the Laramie County Detention Center have mental health issues, with approximately 11% being “extremely” mentally ill.
Perry Rockvam, Laramie County Chief Deputy and Detention Administrator, stated that inmates who pose a danger to themselves or others must be isolated in surveillance-equipped cells.
The jail will open Wyoming’s first special management unit after two years and $700,000 in related projects and hires. It is a jail pod designed for inmates with acute mental health issues who require close monitoring and extra care, but it also includes good-behavior incentives as part of its functional design.
On Thursday, Rockvam spoke with Cowboy State Daily, along with Kozak and Donelle Hiltner, the mental health coordinator.
Currently, the isolated cells for potentially dangerous mental health condition patients are artificially lit booking rooms separate from the general population.
It’s not ideal for booking staffers trying to process new inmates in the 12 available booking cells, or for mentally ill inmates whose conditions can deteriorate during prolonged isolation, according to Kozak.
“It’s a struggle every day,” Rockvam explained.
Into the Light
According to Rockvam, many inmates will be able to see a progression of different social recreation areas from their cells. The outermost recreation area is an outdoor patio surrounded by scenic murals.
On the men’s side, Cheyenne artist Jordan Dean’s mural depicts a rooftop view of Cheyenne, including the Wyoming Capitol’s gleaming dome.
On the women’s side, Dean’s mural depicts scenes from Vedauwoo.
The outdoor area cannot be seen from all 26 cells (there are 16 on the men’s side and 10 on the women’s side), but “they’ll know it’s there,” said Rockvam, “because it brings in a lot of daylight.”
He emphasized the importance of daylight.
According to Rockvam, inmates who require observation now have no access to daylight in the booking cells where they are housed separately from the general population. These confinements could last up to six months or more than a year.
He expressed hope that the presence of daylight, as well as the desire to fully enjoy it, will hasten the inmates’ return to a functional, sociable level.
Rockvam expects the special pod to be full almost all of the time. Jail staff have already identified who will take over in the coming days, with an opening scheduled for Friday.
Other distinguishing features of the pod include secure, sand-filled furniture that cannot be used as a weapon or self-harm tool, according to Kozak.
The pod is a far cry from the old movie stereotype of garish padded rooms, Hiltner explained.
But Why This
Though the jail officials did not have pre-COVID figures for the mental health state of inmates in the facility, they said anecdotally that the percentage of condition sufferers, about 48%, is high compared to before the pandemic.
“After COVID there was a huge change in the amount of people who have come — surfaced to the top — in dealing with mental illness,” Rockvam claimed.
Hiltner agreed, stating that she previously worked in a large facility outside of Philadelphia before joining the Laramie County Sheriff’s Office four years ago, and she identified the same fulcrum there.
“Just (in) my observations as a clinician, I think (the pandemic and lockdowns) created a lot of isolation, and had some damaging effects,” says Hiltner.
Jail staff can benefit from this.
“When you look at research on people in jail, and the use of isolation, it’s really damaging to their mental health,” she told me. “COVID as just sort of a large-scale segregation experiment in Wyoming … (which) just brought up a whole bunch of underlying issues for people.”
It’s Gotta Be More Than Just A Jail
Jail is not just jail anymore, officials said.
“Because of the amount of mentally-ill inmates, we feel we have to change how we manage the jail,” Rockvam said. Mental health outbursts bring “a stress on staff. Those inmates are a threat to themselves, a threat to staff, and there’s no place else for them to go.”
The hospital, for example, is not an appropriate place for a jailable criminal defendant having a mental event, Rockvam added.
The result is that the sheriff’s office has been rewriting jail policies, committing to remodels like this one and hiring in-house and contract-based mental health professionals.
“We’re basically running a large psychiatric hospital, in some respects,” said Rockvam.
It’s easier said than done: jail staffers have to balance defendants’ rights alongside court procedures, acute mental illnesses and their own functional limitations.
“Because jails are dealing with things they’ve never had to deal with before,” Rockvam said.
Hiltner gave an example.
To medicate mentally troubled inmates forcibly, jail staffers have to submit to a mental health confinement law most professionals reference by its section of law, Title 25. Through that, a judge can order someone to be medicated forcibly.
A discussion with the inmate/patient follows, said Hiltner.
“We — myself for one of the counselors — will go and speak to the patient and say, ‘Here’s the deal; we have this order to give you the medication. You can take a pill form of it, but if you refuse the pill form we’re going to have to administer an injectable,’” Hiltner said.
Usually, inmates opt for the pill. If they don’t, deputies may have to hold them down while a nurse administers an injection, said Hiltner.Pilot Program
The Laramie County Detention Center has been running a pilot program funded by the Wyoming Department of Health (WDH) and designed to ease symptoms for inmates subject to considerable wait times to enter the Wyoming State Hospital.
Wyoming State Hospital, a state-run facility in Evanston, is part of the health department and evaluates criminal defendants who have had mental health evaluations ordered by judges. However, the majority of those defendants are evaluated as outpatients.
Other criminal defendants seek treatment at a state hospital.
WDH leaders told a legislative committee in May that the majority of the inmates are not criminal defendants, but rather people who have been court-ordered to the facility due to mental health issues that pose a risk to themselves or others.
The Wyoming Department of Health provides a contract that allows a Wyoming Behavioral Institute (WBI) psychiatrist to serve Laramie County inmates and conduct telehealth visits with them, according to Hiltner.
According to Rockvam, the jail currently employs one psychiatric nurse practitioner and two mental health nurses, and it expects to fill a fourth mental health position soon.
This relieves some of the pressure on people waiting for a bed at Wyoming State Hospital by providing them with medication and treatment in the meantime, according to Hiltner.
Four Months’ Wait
Wyoming Department of Health Director Stefan Johansson told lawmakers at a May 19 Judiciary Committee meeting that the often-long waiting lists for admission to the state hospital are not solely based on the physical bed count (104, including about 25 operating for criminal defendants).
Staffing shortages result in bed shortages when there aren’t enough professionals to care for and evaluate the entire number of patients that the hospital can accommodate. According to Johansson, more than 20 beds that could serve criminal defendants were empty in May due to staffing shortages.
According to Johansson, the average wait time for a defendant court-ordered to receive inpatient treatment at the state hospital is around 120 days, though this figure varies.
Over the last decade, the hospital has seen an increase in the number of criminal defendants receiving mental health commitments.
“There’s no judgement there; we’ve just seen higher volumes. “More orders competing for a static number of beds,” said the director, later adding, “There’s a lot of overlap in folks that might end up in the legal and judicial system…” and frequently end up in state hospitals or correctional facilities.”
The Sheriff Holding The Sign
Kozak and Rockvam discussed additional measures to alleviate the jail’s significant mental health burdens.
They work with community providers to place inmates on a mental health or substance abuse treatment plan prior to their release. Rockvam stated that by providing addiction testing in-house, they have reduced the wait time from about four months to two days.
According to Kozak, Laramie County’s jail is the only one in Wyoming that offers that service on-site, which is an essential component of criminal proceedings.
“(What we do is) encompassing a lot of different disciplines to accomplish a single goal of basically taking care of people, and trying to reduce crime so we don’t have people coming back to jail over and over and over again,” says Rockvam.
Kozak contrasted his jail’s methods with his overall reputation for using tough-guy humor to attract employees and deter crime.
In January, the sheriff made headlines for posting a “vacancy” sign at the jail to inform the public that deputies will book inmates and that the jail has not used a COVID-style release program in years.
“I know I’m the sheriff with the vacancy sign,” says Kozak. “So, I’m fairly conservative, and our deputies go out looking to arrest people and enforce the law. But once they’re in jail, you can see the kinder, gentler side (of how we try to work with people to provide them with the resources they require).
