New project gets aid to Missoula's sick and jailed 

Captain Jason Kowalski is in charge of the Missoula County Detention Center, which is not an easy job. Guards aren't trained social workers, yet they're charged with safely managing a stream of incoherent and violent individuals and addicts going through the emotional and physical pains of withdrawal.

"We deal with inmates that want to kill themselves," Kowalski says. "We deal with inmates that just want to hurt themselves. We deal with a lot of people who don't want to be here."

Kowalski's worked at the jail for 19 years. In that time, he's had plenty of opportunities to see issues that arise from trying to house mentally ill people in a secure setting. "The one part of inmates' incarceration that we really struggle with out here is dealing with the mentally ill, or somebody going through a crisis," he says. "While jails aren't set up for handling the mentally ill, we do get them in our population all the time. ... It's not a problem that's getting any better."

click to enlarge Missoula news
  • Photo by Chad Harder
  • University of Montana social work students Kate Hahn, left, and Ashley Egan are helping mentally ill inmates cope.

That problem stems at least in part from a dearth of funding for community mental health services, which leaves jail the place of last resort for the mentally ill. "What routinely happens is, somebody gets released from our jail, they've been sobered up. They've been through detox. They get put back into the community, and there's nothing there for them," Kowalski says. "They just start self-medicating again, get back in the same situation, and they're back in our community."

Now, Kowalski and his detention center staff are working with the University of Montana School of Social Work to help change that. Last fall, the detention center partnered with UM assistant professor of social work Catherine O'Day and her students to launch Project C.A.R.E., an acronym for "crisis intervention, assessment, referral to resources and education." A pilot project funded from a $20,000 Montana Mental Health Settlement Trust grant, it helps assess the risk of suicide, provides coping strategies for detainees and educates detention- center staffers about ways to ease inmate anxieties rather than exacerbating them.

Kate Hahn, who is earning her master's degree in social work at UM, helped launch C.A.R.E. and brings an unusual perspective to the project after working as a military police officer for the Air Force. During her 10-year military tenure, Hahn routinely encountered people with brain injuries, post-traumatic stress disorder and other forms of mental dysfunction. It pained her to send them to jail. "I had to step back and look at the big picture and say, 'I need to [help] before people get to this situation,'" she says.

Since the project began, Hahn and Ashley Egan, who's completing her undergraduate requirements at UM's School of Social Work, have counseled and advocated on behalf of more than 70 Detention Facility detainees, advocacy that entails tracking down elusive psychological and social services for inmates when they're released. It can be painstaking trying to cut through layers of bureaucracy. Hahn and Egan also coordinate with families to help bolster safety nets and better keep people from re-offending.

Hahn says sometimes detainees just need someone to talk to. Others benefit from new ways of coping. That was the case with a recently incarcerated Marine Corps veteran who has PTSD. Hahn recognized that the veteran was still deeply connected to his military training. She drew from her own background to reach him, telling him, she recalls, "Your mission is, whenever you find yourself getting upset or anxious or claustrophobic, you know, your heart is starting to beat heavily and the room is closing in—your mission is to find your center. ... Your mission is to find that place and to help yourself calm down."

It worked, O'Day says; the veteran got into the habit of asking detention staffers to remind him of his mission.

Hahn's background also gives her insight into the stresses detention officers face. "The men and women that work in corrections are also doing time," she says. "They are in the facility in the same environment, without the windows, having to go through doors that are operated by other people, dealing with this day in and day out, 12 hours a day. In a way, they've volunteered to do that time, kind of side by side with the inmates. Having the ability to walk out at the end of the day is nice, but you still go back."

O'Day says Project C.A.R.E. is unusual because social work students are working in it as part of their degree requirements. The program's grant through the Mental Health Settlement Trust runs out in December, however. O' Day is seeking funding to continue it. "Our goal is to get a full-time ... social worker at the detention center," she says, who could supervise as many students as that social worker could handle.

She's pleased with the project's success thus far, O'Day says, but she also cautions that communities need to make a larger commitments to fill gaps in mental health care. "It's like we're in this rock-and-hard-place," she says. "What's it going to take for our society to address and look at mental health issues before they get to the point of getting arrested?"

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