Marin County plans to expand a program that allows prison inmates to be drugged against their will.
Last fall, the Board of Supervisors authorized inmates deemed incompetent to stand trial to be given court-ordered medications without their consent, if necessary. Prior to authorization, inmates had to remain in prison for several months until a state hospital bed became available.
Involuntary medication administration has been allowed since Senate Bill 568 was passed in 2007. Several other Northern California counties (Contra Costa, Sonoma, Solano and Napa) were already taking advantage of the law when Marin supervisors approved it.
On Tuesday, supervisors received a report from Behavioral Health Recovery Services, a division of the Marin County Health and Human Services Department, on how the first year of implementation has gone. Department Director Michel Funes Arteaga briefed regulators on plans to expand the program beyond inmates deemed incompetent to stand trial.
Arteaga said state law allows counties to administer drugs to inmates in two additional situations. One is when a psychiatrist or psychologist determines that the inmate is severely impaired by a mental illness or may pose a danger to themselves or others. The Marin County Public Defender’s Office represents inmates in legal proceedings when authorities seek a court order for involuntary administration of drugs.
Another example is when prisoners are legally “protected.” A mental health conservatorship provides one adult with legal authority to make certain decisions for a severely mentally ill person. In such cases, the drug is administered at the request of the patient’s guardian.
“We wanted to start with people who are incompetent to stand trial,” Arteaga said. “But things are now well underway and we plan to expand to other people in prison.”
Arteaga said fewer than 10 inmates were given drugs against their will in the first year of implementation. Arteaga said he could not give an exact number because the Marin County Health and Human Services Department has a policy of not disclosing population counts of less than 10 people to protect the anonymity of group members.
Superintendent Katie Rice asked Arteaga how many more inmates could be involuntarily medicated with the expansion of the program.
Arteaga said that of the three categories, the group deemed incompetent to stand trial was the largest.
“We don’t have estimates for the other two populations, but they’re probably even lower,” she said. “It’s possible to spend a whole year not putting a single person in prison under the conservatorship system.”
Arteaga said since the program’s inception, no inmates or staff have been injured while administering medication.
“When we started talking about involuntary medication, some were worried that it could lead to injury,” Arteaga said. “We’ve found that it’s actually safer.”
Arteaga said all inmates who were initially given the drug against their will agreed to one to three doses.
If an inmate is determined to be competent after receiving medication, he or she can stand trial and possibly qualify for a mental health diversion program.
AB 1810, signed in July 2018, authorized pretrial diversion programs for certain mentally ill criminal suspects. However, to qualify, inmates must have one of three diagnoses: schizophrenia, schizoaffective disorder, or bipolar disorder.
Medication orders are placed by a licensed psychiatrist or psychiatric nurse. They are administered by registered nurses or other qualified health professionals with the assistance of prison staff.
“It’s definitely traumatic for him,” Rice said. “But what I’m concerned about is the impact on you as people at the staff level.”
“I think it was more traumatic to see people incarcerated for months without treatment and without any resources to help them,” Arteaga said.
“These were people who were unable to meet their basic needs and were in dire mental states,” Arteaga said. “They often had problems with eating, hygiene, and sleep, and were never stable at all. It didn’t seem humane to see people in such conditions for so long.”
Supervisor Stephanie Moulton Peters said, “I know that one of my constituents in my district has been languishing in prison for a long time, and his family was very concerned. He was able to receive treatment through the program. He is now home and his family is very happy.”
During the public comment portion of the meeting, Jennifer Carter said: I was in prison, without insight, unable to take care of myself, unable to take medication. I always wished there was a way for someone to give me medication. ”
“I was in jail for about a month because of mental illness and I had no idea where I was,” Carter said. “It took me a while to finally say yes to medication in order for my symptoms to get better.”
