Part One: The Patients

THE TREATMENT

chizophrenia is the leading disorder of mental illness treated by Mental Health Assistants, along with a host of others: including bipolar (manic depressive illness), dementia, congenital intellectual disabilities, several anxiety disorders (obsessive compulsive, panic, and drug induced), as well as depression.

We handle some of the most extreme cases in the Los Angeles County jail system. We receive cases from the facilities mental health hospital (Forensic Inpatient Hospital), general population, those who have been arrested or re-offenders, and those who are referred by clinicians. Thus, we experience a wide variety of mental illnesses, symptoms, and behaviors that can vary in different stages depending on the severity of the patient’s illness. This can require different levels of support for each and every individual ranging from intermittent support to pervasive. The treatment also involves patients who suffer from illegal drug abuse, which complicates the treatment process and more importantly can compromise full recovery.

Upwards of eighty percent of our patients are chronic methamphetamine abusers.

Upwards of eighty percent of our patients are chronic methamphetamine abusers. This is a cause for integrated treatment. While focusing on specific mental disorders, simultaneously emphasis is placed on drug abuse, which we believe is a huge factor in failed treatment and recidivism, and in our opinion a possible cause of mental illness and recurring psychotic episodes.

Our patients are administered the following medications according to their diagnosis: Haliperidol (oral, intravenous), Depakote (valporic acid), Trazodone, Cogentin (side effects), Clonopin, Lithium, Clozaril, and several others. However, we do not administer any medication. Our function and focus is to assist the patients to take their medication regularly (everyday). Some patients choose to refuse drug therapy for any number of reasons, so as Mental Health Assistants we provide a level of comfort and trust that enables medication adherence.

We treat patients who have been incarcerated for offenses ranging from trespassing to murder. We treat individuals from all socioeconomic demographics, but predominately the poor and homeless. Most suffer from the most severe disorder of their given illness. So behaviors that are violent, self-destructive, and erratic are not uncommon here. We also treat the elderly which demands intensive care. We care for those who are troubled with grave forms of dementia; who suffer from physical impairments, including those who have had a colostomy; and those who are blind, deaf, and mute. They can range from the extreme (schizophrenia) to men who have banged their faces on the sharp edges of the bunks to quiet the voices that torment them internally, to common anxiety experienced by many who find themselves in high stress situations.

The units we treat are deemed High Observation Housing (H.O.H.) which includes a population of men who have attempted and are recovering from suicidal efforts. Men who demonstrated such behavior are usually sent here before medium observation housing is considered. Those actions can range from a minor verbal claim (“I want to kill myself”) or harming oneself to near successful attempts by actually strangling or cutting themselves with petty things (i.e. plastic cereal bowls and shower towels being tied around the neck).

For example, we encounter cases where individuals will consume their own urine, smear feces throughout the entire room they inhabit, attempt suicide through suffocation.

In all we experience the most severe of the severe in terms of mental illness. For example, we encounter cases where individuals will consume their own urine, smear feces throughout the entire room they inhabit, attempt suicide through suffocation. In addition, many will inflict self-harm by way of intense head banging, cutting, drinking toilet water, assaulting others without sufficient provocation, and several other forms of unexplainable abnormal behaviors. Witnessing and treating these behaviors on an everyday basis is very taxing and be