Jail and Correctional Services

FY 2004 and 2006 Mental Health Services in SC Jail Survey Findings

Chart Overview

 

2004

2006

Number of Questionnaires Returned

40

44

Rated Capacity

9,666

10,285

Average Daily Census

10,408

12,616

Number of Jails Over Rated Capacity

16

23

Jail and Community Mental Health Service Agreements
   Contracts
   Memorandum of Agreements
   Informal Agreements
   Privatize
   County


7
16
18
2
1


4
20
15
3
2

Housing of Inmates with Mental Illnesses

9

3

Utilization of Formulary

22

14

Most Frequently Used Psychotropic

Anti Depressant

Anti Depressant

Cost of Psychotropic Medication

$827,929

$1,612,962

Forensic Inpatient Utilization

253

111

Narrative Summary of 2004 and 2006 Jail Survey

Number of Administrators Responding:

Twenty-two (22) administrators completed and returned the 2006 survey questionnaire.  Follow-up mail outs and telephone contacts resulted in a 100% response from the administrators.

Twenty-nine (29) of the questionnaires were completed by the jail administrator, seven (7) were completed by a captain, major, or lieutenant, and eight (8) were completed by a medical/mental health professional.

Rated Capacity and Average Daily Census:

In 2004, the rated jail capacity and average daily census for the year was 9,666 and 10,408 respectively.  The 2006 the number of jail beds was at 10,285 and the average daily census was 12,616.  During the 2006 survey period the rated capacity for the forty-four (44) jails on the dates of the survey ranged from 14 to 947 inmate beds. 

In the 2006 Survey twenty-three (23) jails were over their rated capacity from 1% to 300% (Pickens, Allendale Union, Kershaw, Fairfield, Lancaster, Oconee, Berkeley, Dorchester, Georgetown, Laurens, Greenwood, York, Beaufort, Anderson, Orangeburg/Calhoun, Aiken, Horry, Spartanburg, Lexington, Charleston, Richland, and Greenville).  Berkeley and Charleston jails had the highest over rated capacity. 

Jails not exceeding their rated capacity during the 2006 survey period were McCormick, Hampton, Bamberg, Edgefield, Abbeville, Saluda, Marlboro, Marion, Colleton, Chesterfield, Barnwell, Jasper, Newberry, Chester, Williamsburg, Clarendon, Cherokee, Dillon, Darlington, Sumter, Florence.

Jail and Community Mental Health Center’s Service Agreements:

The 2004 Survey reported much confusion regarding service agreements.  Many jail administrators reported formal contracts or agreements with the community mental health centers for inmate services.  Four (4) local county governments (Beaufort, Berkeley, Lexington, and Aiken) contracted directly with the community mental health center to provide mental health services to inmates of the local jail. Charleston County privatized their medical/mental health services and the private entity in turn contracted with the local mental health center for services to inmates. Greenville county government staffed its own mental health unit.  

In 2006 of the 44 jails, four (4) (Aiken, Berkeley, Laurens, and Lexington) contracted with the community mental health centers for mental health services for inmates.  Three (3) of the jails (Charleston, Dorchester and Richland) privatized services and two (2) jails (Greenville and Sumter) had mental health units in house funded by the county.  Fifteen (15) jails had no formal agreements for services and 20 had memorandums of agreements. 

Contracted or privatized services were provided on site at the jail.  Staffing varied with jails offering full and part-time coverage by one or more mental health counselors and/or psychiatrists.  For jails with formal or informal agreements, inmate access to mental health services required that the inmate be transported by the jail staff to the community mental health center and/or local emergency department.  Administrators consistently saw transporting the inmate from the “safety” of the jail to outside as safety issues for the officers and public.

Housing/Separation of Inmates with Mental Illnesses:

In 2004, nine (9) jails (Abbeville, Charleston, Cherokee, Colleton, Fairfield, Greenwood, Union, Horry, and Lexington) reported separate housing for inmates with mental illnesses.  In the 2006 Survey, three (3) jails (Aiken, Charleston, and Greenville) reported separate housing.

Utilization of Formulary for Psychotropic Medications:

In the 2004 survey, twenty-two (22) jails reported utilization of formularies in the purchase of psychotropic medications.   In the 2006 survey, fourteen (14) of the jails (Pickens, Kershaw, Fairfield, Berkeley, Laurens, Greenwood, York, Beaufort, Aiken, Spartanburg, Lexington, Charleston, Richland, and Greenville) responded to the utilization of a formulary for psychotropic medications. 

Most Frequently Used Psychotropic Medication and Cost:

Anti-depressants were still reported as the most frequently used psychotropic medication followed by anti-psychotic and anti-anxiety medications. 

In 2004, the cost of psychotropic medication for 28 jails reporting was approximately $827,929.  The lowest was $700.00 (Hampton) and the highest was $200,000.00 (Greenville).

In the 2006 Survey, several jails did not separate medical and mental health costs (Abbeville, Allendale, Darlington, Dorchester, Edgefield, Greenwood, Hampton, Lancaster, Laurens, McCormick, Newberry, and Saluda) and could not provide information on pharmacology cost.  Jails responding gave annualized cost that ranged from a low of $500.00 (Jasper county which had an inmate population of 60 or 76% over its rated capacity on the date of the survey) to $320,000.00 (Greenville county whose inmate population was 1,305 or 80% over its rated capacity).   The estimated cost of psychotropic medication for the 31 jails responding to the question in 2006 was $1,612,962. 

Of interest in 2006 was a comparison of three jails in rural areas of the state with similar county population and jail size (see chart below).

Jail

County Pop.

Rated Capacity

Daily Census

Psychotropic Used

Formulary

Cost

Inpatient Admissions

Chesterfield

42,768

98

56

Depression

N

$3,000

0

Colleton

38,264

96

272

Depression

Y

$7,000

0

Marion

28,818

96

78

Depress/Psycho

Y

$24,000

0

Marlboro

28,818

94

75

Depress/Anxiety

N

unknown

2

While the four (4) jails were similar in county population and rated capacity there was a big difference in medication cost between the two jails that utilized a formulary.  Colleton was over its rated capacity with a $7,000 annual psychotropic cost as compared to Marion with a daily census under its rated capacity but an annual psychotropic cost of $24,000.00.  Both used a formulary but Marion’s cost, with fewer inmates, was more than triple Colleton’s cost.  Neither had emergency hospitalizations during 2005 and both had informal agreements with their community mental health center.  

Forensic Inpatient Utilization:

In 2004, Richland (12), Greenville (9), and Florence (8) were the most frequent users of inpatient service in terms of admissions to the Forensic Unit (Just Care).  In 2005 Richland (21), Clarendon (10), Darlington (9), Kershaw (8), Lexington (7), and Anderson/Berkeley (6) accounted for most of the emergency admissions to Forensic Services.  Sixteen (16) of the jails had no admissions.  The number of emergency admissions was down more than half between 2004 and 2005.  In 2004, there were 253 emergency admissions and in 2005, there were 111 emergency admissions.