For the mentally ill, the best place to have a brush with the police is Memphis.
There, a Crisis Intervention Team (CIT) staffed by specially trained police officers usher people in the throes of a mental episode into a facility called the Med. Instead of winding up in jail, these people receive immediate counseling, medication, and a link to aftercare services when discharged.
"They are diverting an awful lot of people on the front end," says Ben Dishman, deputy commissioner of the Tennessee Department of Mental Health and Mental Retardation. But as Dishman notes, Shelby County is paying for the CIT program, a luxury most counties can't afford.
In Knox County, TennCare Partners—the managed mental health care program set up for Tennessee's uninsured—does fund the Mobile Crisis team, based at a Covenant Health facility in West Knoxville. Seventeen times last month, social workers with the Mobile Crisis team went into the Knox County Jail to counsel inmates and diffuse psychotic episodes. Mobile Crisis also responds to calls at private homes, in the emergency room, and "by the side of the road," says clinical leader Priscilla Jenkins.
Jenkins, who has been repeatedly confused for Elvis' wife by patients in a psychotic state, says Mobile Crisis tries to link the mentally ill with appropriate care. But unlike the CIT program, it doesn't have its own psych ward.
Mobile Crisis was created in 1991, and is now working closely with case managers to try and divert people with a mental illness away from situations that could lead to a crisis and possibly an arrest.
Still, Jenkins' team is not set up to fully monitor the mentally ill before their situations fishtail into crisis. Describing a typical person in need of Mobile Crisis, Jenkins says, "They don't follow up on their care. They run out of medication. So Mobile Crisis goes out again."
And again, and again, as the revolving door continues to spin at the Knox County Jail. Brushing against the parade of mentally ill inmates are people like Det. Harry Carroll with the Knox County Sheriff's Department. In the interview room where Carroll normally interrogates suspects, the detective has found himself cast as an armchair psychologist. His most demanding patient: A repeat offender named Richard Settle, who has logged a lot of couch time with Carroll.
Earlier this summer, after spray painting a star of David, half moons, and a swastika on the sidewalk near a Church of Latter Day Saints on Grigsby Chapel Road, Settle confessed to Carroll as if the detective were his analyst.
"He said, 'It's like my mind just melts and I see things that need to be done,'" recalls Carroll. Over the past several years, Settle has struggled with mental problems reportedly brought on by a head injury suffered during a traffic accident. He's lived on $334 a month in disability, and driven his late-model Gremlin all over the country, blazing a bizarre trail of vandalism.
At the Mormon Church headquarters in Salt Lake City, Settle allegedly left two Mountain Dew bottles filled with urine and a Jolly Roger flag. At the courthouse in Marion, Va., he left two crosses marked with the words "never again" because his ex-wife's name is Marian. She was the person who brought Settle into the Latter Day Saints Church for a time. It was an experience the 44-year-old apparently resents.
But Settle doesn't seem to mind being arrested. TennCare Partners can try to contain and treat his behavior. Still, the incorrigible vandal continues to treat the Knox County Jail like a mental institution. Settle has repeatedly come and gone, confessing to several acts of vandalism, including an incident at the Washington Monument, during his lengthy sessions with Det. Carroll.
So far, all charges against Settle in Knox County have been dismissed. Like doctors taking notes, judges have diagnosed his actions as unpunishable symptoms of a mental illness.
—David Madison
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