Following an investigation by the Alameda County Civil Grand Jury into the delay of developing a mental health unit at Santa Rita Jail, the onus is now on county leaders to work with the sheriff's office to get the ball rolling on the project once more.
But even though the project has been stalled for about four years since it was originally slated for completion in 2019, advocates against the mental health unit still say the money could be better spent elsewhere.
The plan to improve services at the Dublin jail first started in 2015 when the Alameda County Sheriff's Office recognized the need for better mental health care for inmates. That's when the sheriff's office applied for funding from the Board of State and Community Corrections and was awarded financing through a lease revenue bond agreement for mental health care programs and treatment in a jail.
"The motivation behind the application came about as the ACSO recognized the number of persons in custody suffering from mental health issues, substance abuse and addiction were increasing dramatically," according to the 2022-23 grand jury report, which was released on June 23.
From that funding, the original plan was to remodel two nearby housing units for people with mental illnesses who are incarcerated at Santa Rita Jail to receive medical and mental health treatment and to construct a two-story "Mental Health Program Service Unit" (MHPSU) attached to the housing units.
The designs for the proposed $54 million project were completed in 2016 with the county having agreed to match funds in order to cover the remainder of construction costs, but later that same year the project was scrapped because it was determined that the building site proposed in the application was not suitable for the project.
Without the possibility of building a similar project at the jail due to funding issues, the project had to be put on pause. Then in 2018, a federal lawsuit -- Babu v. Ahern -- challenged the adequacy of mental health care and treatment at the Santa Rita Jail.
Now, after a consent decree -- which is an agreement between involved parties -- was issued by a federal judge last year, the jail is under court supervision to monitor a massive reform program that will begin to remake how mental health care is provided at the jail.
"The consent decree reignited the MHPSU project," according to the report. "As of December 2022, new design plans have been completed and are undergoing approvals with various state agencies."
The scope of the project has now taken a different approach in that it will not build any medical treatment facilities, beds or housing. Instead, the new plans include clinical treatment rooms, classrooms for group therapy and education and office space at a separate and distinct facility on an adjacent land parcel adding up to a total project budget cost of about $81 million.
"The second floor will be utilized for Behavioral Health Care Services staff with a small section reserved for community-based organizational staff," according to the grand jury report. "The MHPSU will not be a 24/7 facility, but day and evening programs will be held. Staff will work split shifts or swing shifts to facilitate programming."
But based on interviews with different stakeholders in the county and sheriff's office who have witnessed the project's lifespan, many are concerned with the new design plans.
"There are no facilities in the new design to house or treat severely mentally ill persons or to stabilize patients in crisis. The additional medical personnel that were originally envisioned are also eliminated," the grand jury report states, adding:
"At the proposed new building site, incarcerated persons will need to be escorted to the MHPSU across the property necessitating further security measures and additional staffing to facilitate the transfers. In light of this, witnesses expressed concern that only the very low-level patients might receive treatment at this facility and those at the higher end of treatment would continue to be treated in their cells."
The report also pointed to a lack of project oversight and management from the county's General Services Agency, which oversees capital improvement projects and construction at a county level.
"Witnesses told the grand jury that until recently, the inter-departmental communications regarding the project often lacked clarity and clear direction," the report read. "These complaints were not new or surprising. The GSA staffing and project management challenges related to the capital projects at Santa Rita Jail had been identified previously by the 2019--2020 Grand Jury."
That's why the report is now pushing for the Alameda County Board of Supervisors to play a more active role in overseeing the project, seeking regular updates from the GSA and conducting a performance audit of the agency, which the board promised to do in the past but failed to follow through.
According to the report, even with the funding there and plans somewhat finalized, the county needs to prioritize finishing the project as it has been stalled for too long. It specifically pointed to the five inmate deaths that occurred at the jail this year, stating that with a completion date expected in 2028, the mental health unit can not be stalled any longer -- especially with inflation only making construction costs increase every year.
Lt. Tya M. Modeste, public information officer for the sheriff's office, told the Weekly that even though the project is in the planning phase, building and modifying Santa Rita to incorporate the new mental health unit is going to be difficult at the jail, which opened in 1989.
"The grand jury's recommendation is challenging, as the Santa Rita Jail's current infrastructure cannot support long-term care and stabilization of seriously mentally ill persons," Modeste said.
While Modeste said that the office and the county still need to establish project initiation and completion dates, the main thing she wants to see is more mental health services in the community so that people with mental illnesses don't have to make it to the jail in order to receive care.
"A disproportionate number of people with current or past mental health problems are incarcerated, so we understand the importance of having a robust behavioral health services program and a suitable facility to meet the needs of those populations," Modeste said. "However, I think that we can all agree the bigger issue of a lack of long-term psychiatric care facilities in the community is a substantial issue that falls on facilities like the Santa Rita Jail."
Alameda County District 4 Supervisor Nate Miley also shares a similar sentiment as he said that while he agrees with the findings of the grand jury report and supports the construction of the $81 million mental health building, he thinks there has to be more of a push for resources in the community.
"I think that universal support for the delivery of mental health services in the community -- I don't know anyone who is not supportive of that," Miley told the Weekly. "The question is getting mental health services in the community, delivered as rapidly and as thoroughly as possible, so that we have fewer people who are ending up in Santa Rita jail."
"We don't want people to have to go to jail to get mental health services," Miley added.
That's why he said he is pushing the county to focus on the full implementation of a community mental health forensic plan, which is being worked on by the Alameda County Behavioral Health Services Department.
He said the plan would allow for residents to easily get treatment and for first responders and law enforcement to be able to take individuals who need mental health treatment to places that offer these services rather than having to take them to jail.
But for Joy George, a healing justice campaigner at Restore Oakland Inc. and a member of the Care First Community Coalition, that push for more mental health services in the community should be the only thing the county looks at -- not the $81 million building.
"Any arguments that are made in favor of building an $80 million facility to provide mental health care to folks incarcerated at SRJ can easily be upended when we question why that same level of investment isn't being supplied to communities prior to their criminalization and arrest," George said.
"The strongest indicator for worsening behavioral health outcomes for folks who are incarcerated is itself their incarceration, which is designed to isolate them, expose them to violence, and deny them of humanity," George added. "When we invest in community-based solutions like funding and expanding access to full-service partnerships, treatment beds, and permanent supportive housing, we inevitably prevent people from being criminalized and incarcerated in the first place."
George also said that a mental health unit at the jail will not address or prevent any concerns on how the jail itself is inhospitable and wanted to make one thing very clear: "there is nothing to be gained by treating folks in cages when the cage is still a cage."
Miley told the Weekly that even though he agrees with advocates like George who say mental health resources should be made available in order to deter folks with mental illnesses from ending up in jail, the world isn't a perfect place and until it becomes so, the need for a mental health facility is necessary.
"I agree with the advocates; I hate to treat people in cages who are mentally ill," Miley said. "I hate for them to be there. I want them to be in the community. But until we can get to a place of perfection on that journey to a more just society, we have to build this facility."