Editor’s note: Reporters from the Topeka Capital-Journal and KHI News Service collaborated for a six-month exploration of how the state’s legal system deals with people with mental illness. This is one of the stories in a four-day series.
Before she moved into a supervisory role, Dawn Shepler would help her clients find housing, make appointments for health care and sign up for benefits like food stamps.
While the job description might sound right for a social worker, Shepler actually worked as a parole officer for the Kansas Department of Corrections, specializing in offenders with serious mental illnesses in Sedgwick County.
Shawnee and Wyandotte counties are the only other areas that have parole officers who specialize in working with inmates with mental illnesses, though Shepler said parole officers across the state receive training on mental health and how to spot someone in crisis. In most parts of Kansas, there aren’t enough cases to warrant a specialized officer, she said.
In Sedgwick County, parole officers and case managers at COMCARE, the community mental health center, work together so they don’t duplicate efforts, Shepler said. They also have a shared emphasis on educating the community about mental illness, she said.
Members of the public “are more apt to work with that individual because they understand what that individual is going through” after learning about mental illness, she said.
KDOC put more emphasis on mental health and re-entry services during the 12 years she worked as a specialized parole officer, said Shepler, who now works as a supervisor doing training and auditing for KDOC. Those changes earned the state some attention from the Council of State Governments Justice Center in 2015 as a model in behavioral health care for parolees.
While parole officers have a primary responsibility to keep the community safe and will return parolees to prison if necessary, they also have increasingly looked at housing, mental health treatment and other supports as ways to reduce the risk that offenders will commit more crimes, Shepler said.
“It’s a case-by-case basis,” she said. “It’s no longer black and white.”
Statistics suggest people with mental illnesses could use the extra support. A 2006 study by the U.S. Department of Justice found about 47 percent of state prison inmates with a mental illness had three or more prior convictions. About 39 percent of those who didn’t have a mental illness had that many prior convictions.
The gap was slightly narrower in Kansas. About 38 percent of inmates with a serious mental health problem returned to prison in fiscal year 2011, which is the most recent year KDOC has provided that information. About 35 percent of all Kansas inmates returned to custody that fiscal year.
Mental health symptoms could cause a parolee to commit a new crime or make it more difficult for the person to complete parole conditions, according to a 2012 report from the Council of State Governments Justice Center, but parolees with mental illnesses also are more likely to have other risk factors for recidivism like problems at home, a low education level or a patchy work history.
The problem isn’t new. Margie Phelps, director of re-entry services for KDOC, told corrections officials from multiple states at a meeting in 2005 that about three-quarters of parolees who returned to KDOC custody had a mental illness.
At the time, Phelps said KDOC had increased the discharge planning staff and started working with community mental health centers to assist with transitions. Still, ex-offenders often struggled to find housing and mental health providers sometimes couldn’t take on more clients, she said during the meeting.
Planning for release
The process of trying to keep an offender with mental illness from heading back to prison starts before release — sometimes as long as 18 months before, depending on the case, Shepler said. A parole officer will work with the KDOC discharge planner and the offender to develop a plan for community supports, and ideally will meet the offender in person to go over his or her needs and the expectations that come with parole, she said.
“It definitely helped on the (offenders’) anxiety,” she said.
Each Kansas prison has at least one discharge planner with experience setting up clinical services. Inmates can stick with the mental health provider they saw in prison for up to 90 days and receive a few days’ worth of medication at a time, said Viola Riggin, director of health care services for KDOC. They don’t give it all at once because of the possibility the inmates or other people could abuse a larger supply of drugs, she said.
The planning process isn’t mandatory, so inmates can decline to receive extended services.
Inmates are considered transferred when they see a mental health provider in the community, though in rare cases they stay with the prison provider if the services aren’t available in their area, Riggin said.
“For years we used to think our services stopped at the door and the community took over,” she said.
“Re-entry and mentoring is one of the best things that has happened to this department. Some of these people haven’t had anyone who would sit with them for five minutes.”- Viola Riggin, director of health care services for the Kansas Department of Corrections
Previously, KDOC followed up with the inmate for 30 days, but that wasn’t enough time to get some people into community services, Riggin said. Too often, their mental health would deteriorate and they would end up back in prison and have to restart their treatment, she said. The state extended the window to 90 days about two years ago.
“That 90 days, it’s just imperative,” she said. “Every time a patient breaks down their mental health treatment, it can cause permanent damage.”
Adam Pfannenstiel, a KDOC spokesman, said Corizon Health, the department’s health services contractor, picked up the cost of medication for the additional 60 days.
It isn’t clear if the extra supports have saved money, but the recidivism rate for parolees with mental illnesses has fallen from about 75 percent in 2006 to 35 percent now, he said.
Inmates with mental illnesses who are nearing release also can participate in a mentoring program.
The program was designed to help inmates without mental illnesses secure work and reduce their risk of reoffending, but the program employees were able to find people who are recovering from mental illnesses and have training to provide peer support, Riggin said.
Having someone who cared enough to work with them without getting paid was a new experience for some of the inmates, she said.
“Re-entry and mentoring is one of the best things that has happened to this department,” she said. “Some of these people haven’t had anyone who would sit with them for five minutes.”
‘Putting your spokes out’
When offenders are released, the parole officer will help them make appointments and complete paperwork for food stamps or disability payments, which sometimes can take four hours or longer, Shepler said. They also can arrange transportation for medical and mental health care, or even to a food or clothing bank, if necessary. Usually, they can get offenders a mental health appointment within a few days of release, she said.
“It’s almost like a wagon wheel. You’re putting your spokes out to every resource,” she said.
Ideally, offenders will have family members or other sources of support who can help with some of those needs, Shepler said, but that is less likely for parolees with mental illnesses. However, the parole officer isn’t intended to be a long-term source of support, she said.
“We don’t want to go out and do everything for them,” she said. “We’re meeting them where they are. This population can burn bridges pretty quickly.”
KDOC doesn’t have a specific set of steps to evaluate whether parolees should return to prison or go to a mental health treatment facility if they violate their parole conditions, Shepler said.
The officer, his or her supervisor and co-workers, and any community providers they work with weigh the person’s current behavior, history, substance use and other factors to determine where the parolee is most likely to be successful and the community will be safe, she said. Even with enhanced services, some people fail to meet parole conditions and return to prison, Shepler said.
“It’s so difficult for somebody releasing from a prison, from a structured environment, where all their needs are taken care of, to (return to) the community where more effort is going to be required of them,” she said.