SYSTEMATIC CHANGE FOR JAILED MENTALLY ILL

Alternative To Prison: Residential Recovery Centers

Cecelia Robles was hearing voices again when she met her
court-appointed attorney in September 1997 in a holding cell at the
Santa Clara County courthouse.

Robles had been arrested four months earlier for stealing two pairs of
Nike athletic shoes worth $139.40 from a Sportmart in Milpitas. She
was 38 years old, seriously mentally ill and addicted to heroin.

With a two-page rap sheet, the chronic offender with severe depression
seemed destined for state prison to rejoin the legions of similar
offenders who have made jails and prisons in California and the nation
the largest warehouses for the mentally ill.

Mental health experts long have maintained the penal system is
ill-equipped to deal with this needy population. Today, with jails and
prisons bursting at the seams, state and local leaders have embarked
on a serious effort to move mentally ill offenders from behind bars.

There are encouraging signs that with the proper care, the mentally
ill can break free of the criminal justice system, saving their lives
and potentially saving taxpayers millions of dollars.

Robles has made it so far. With attorney Chris Beraldo's help, the
tall, shy offender with tattoos splashed across her arms and chest
landed in a residential treatment home in downtown San Jose instead of
a prison cell.

Those who have worked with Robles say her small victories may point
the way to a more progressive approach to helping the mentally ill.

Shielded behind a pair of dark sunglasses, Robles is fidgeting as she
remembers her first steps into the system some three decades ago.

``CC,'' as her friends call her, was diagnosed with severe depression
when she was 7. ``It was terrible,'' she mumbles. Her mother had just
died, and Robles started to hear voices, including a terrifying
message from her mother that she would come back from the dead to take
her daughter.

Robles began to withdraw. While her siblings went to school in rural
South Santa Clara County, Robles would sneak out and wander alone
through the orchards outside San Martin. She stopped talking and
eating, and her hair fell out.

Heroin eased her pain

Before Robles was 14, she had tried heroin, digging up her uncle's
stash in the back yard. Like it does for many with mental illness, the
drug became a form of medication that eased her suffering.

``It was like nothing else I had ever experienced,'' Robles said. ``It
gave me strength. It gave me peace of mind. It made me a lovable person.''

Heroin was also the ticket into a chaotic life that nearly destroyed
her. Robles turned to prostitution. When she was 18, she was arrested
for shoplifting baby clothes. More shoplifting arrests followed in
1984, 1986 and 1987. In 1991, she was arrested for cocaine possession
and sent to prison. Two years later, she was arrested again, this time
for burglary, and sent back to prison for four more years.

Robles' thick mental health file charts her substance abuse and
diagnosis of bipolar disease with psychotic features such as
hallucinations and voices. Prison and jail doctors prescribed
anti-depressants for her, but nothing worked. When she got out, she
sold her medication for illegal drugs and went back to stealing.

``People used to think I was just crazy. And I was. I'd do anything.''
Robles said. ``My heart was black as night. I didn't care about anyone.''

When Beraldo first looked at Robles' case, she was outraged that
authorities could send this mentally ill, petty thief back to prison
when it was so obvious she needed help. But Robles' case was not so
unusual.

Since the massive closings a generation ago of state mental hospitals
such as Agnews in Santa Clara, jails and prisons have been forced to
shoulder the care for the mentally ill.

By some estimates, as many as 20 percent of the inmates in
California's prisons and 15 percent of those in county jails are
mentally ill.

Mental health beds in the state's jails more than doubled between 1996
and 1998, according to the California Board of Corrections.

And the Pacific Research Institute, a San Francisco think tank,
conservatively estimated in 1996 that the mentally ill cost
California's criminal justice system $1.2 billion annually, and
perhaps as much as $1.8 billion.

``Mentally ill inmates are not like typical prisoners. They are very
labor-intensive,'' said Christine Ferry, director of mental health
services at the Santa Clara County Department of Correction. Care is
expensive and, according to Ferry, most inmates do not get the therapy
they need.

Many simply rotate in and out of the system, alternating between life
behind bars and life on the streets, where many commit crimes, often
under the influence of drugs or alcohol. Overworked attorneys or
judges not attuned to mental illness may never give a case like
Robles' a second look.

``They get in the system, and God help them,'' Ferry said. ``Once you
get in, you're tagged. It's like they're on a conveyer belt, and they
can't get off.''

In 1998, Beraldo found a way off that conveyor belt for Robles. The
defense attorney with experience representing mentally ill defendants
persuaded a judge to give Robles a chance at recovery. Luckily, there
was a spot at Jacobs Center.

With spartan bedrooms jammed into a converted two-story home, Jacobs
Center superficially resembles many residential recovery centers
around San Jose. But the center's exclusive focus on the mentally ill
makes it a rare place.

Professional counselors work closely with residents, ensuring they are
properly diagnosed, taking their medication and progressing through
recovery plans in school or job training.

If the criminal justice system is going to move mentally ill offenders
off its rolls, many say, it will have to be through places like this.

Success at the center

Robles thrived at Jacobs Center. Though she talked little in her first
months there, she has since emerged as a central member of the small
community, said director Donna Day. She is learning to read and write.
She has never failed a drug test. And perhaps for the first time in
her life, Robles is regularly taking medication for her depression and
seizures. Last week, she moved into transitional housing in East San
Jose and is continuing her education.

``We're so proud of her,'' Day said. ``CC has truly shown she can make
the right choices, even when she is confronted with the toughest
circumstances.''

There are encouraging signs that state and local leaders are
interested in creating more alternatives such as Jacobs Center.

Santa Clara County two years ago created a mobile medical team that
accompanies police to calls involving the mentally ill. Instead of
jail, many mentally ill offenders caught committing petty crimes are
taken to a shelter or to the county medical center.

And last year, the county set aside money for more residential beds at
Jacobs Center.

In Sacramento, state legislators created a $25 million grant program
for counties to develop alternatives for mentally ill offenders. San
Mateo County, which won a grant for more than $2 million, plans to
develop residential care homes and to hire specialized case workers to
help mentally ill inmates coming out of jail.

This year, the state added $27 million more to the grant program
because so many counties applied for funding.

Santa Cruz and San Francisco counties received grants in the second
round. Alameda and Santa Clara counties applied, but were not funded.

But even with the grants, rescuing this troubled population from the
criminal justice system will not be easy, many acknowledge.

Alternatives to incarceration are expensive. It can cost more than
$1,000 a month to keep a resident at Jacobs Center, according to the
Alliance for Community Care, the San Jose non-profit organization that
operates the home.

Mental-health funds cut

And so far, the state has not committed a steady stream of money to
move the mentally ill out of the penal system. The governor this year
cut $10 million from the grant program that sent money to San Mateo,
San Francisco and Santa Cruz counties.

The number of beds in rehabilitation homes such as Jacobs Center also
remains extremely limited; the waiting list there is three months. And
once a resident completes treatment, affordable housing -- which
advocates say is critical for those with mental illness -- is almost
non-existent.

``Too often, states create programs to get the mentally ill out of
jail, and then they just drop them without any more care,'' warned
Lindsay Hayes, assistant director of the National Center on
Institutions and Alternatives in Alexandria, Va.

But perhaps the biggest obstacle may be the offenders themselves. As
those in the mental health and criminal justice system point out,
there is no guarantee that every mentally ill offender will make it.

Even Robles acknowledges there are moments of doubt. She spent several
days in a funk recently after her job aptitude exam suggested she get
an assembly-line job. She dreams of working with troubled children.

``I'm scared,'' she confides. ``I've tried this before, but I've never
made it. I want to get more out of life than I've had. I want it to be
a lot nicer.''