My Mental Healthcare in County Jail

I was in a county jail from August 2020 to August 2023. What I cover in this blog is what it was like when I was there during that time frame. Things may have changed, as things in life are always changing.

When I first arrived in 2020, the jail was set up with a psychiatric Nurse Practitioner (NP) that worked for a local mental healthcare clinic.

Once a week that NP or anyone that was available that day, saw detainees via a tablet. Us detainees were put on a list once we requested to see one. The list could take weeks. Most detainees were gone, either were OR’d (own recognizance), or bonded out before their turn came to see the NP. If they did see the NP before they left, they’d start medications, then stop taking them upon release. Come back to jail and repeat the process all over again.

It was like they wanted to do better in jail but as soon as they hit the same environment they had just left, they were back at their old bad habits and discontinuing their medications.

The jail sent your medications with us when we were released no matter if we went home or to prison/DOC.

Other detainees just sought meds thinking it would help them sleep their “time” away. The NP used to prescribe melatonin when I first got there. Then that was stopped.

The jail started to sell it on commissary. Other than that, no other sleep medications were available. Not even diphenhydramine (Benadryl).

The last year I was there, the jail outsourced a company instead of using the local clinic as they had for years prior. So, this brought a new psychiatric nurse practitioner.

I did not like the new NP.

She had big, hot pink “Think suicide” signs. The signs were supposed to tell the COs and nurses to think of suicide if they saw or heard certain signs. However, others and I found it to be triggering and inappropriate to be posted inside the exam room. Enough people must have complained because they weren’t in the exam rooms a few months later.

This NP wanted to start me on Effexor as Prozac was not working for my general anxiety. I told her my mother was on Effexor before she took her life. The NP said it was the trauma of my situation that took her life not the meds.

That infuriated me. No one knows that but my mother, and she might not have known that. When you’re in psychosis, you don’t think clearly.

Either way, those opinions were not warranted.

Within the first week of the new NP’s arrival, she completely took me off two medications without my knowledge. The nurse just didn’t have them on the cart at med time one day.

One medication I took for premenstrual dysphoric disorder, but she thought I took it for birth control.

“Ma’am, I’m in jail for over a year, if I get pregnant in here there’s a serious problem.”

Instead of looking at my chart to see the reason, she just saw a birth control pill and cut me off.

Hydroxyzine, I took as needed for anxiety. Instead of explaining to me that she felt that it’s bad to take it on a regular basis, which is what she later told me, she just cut it off. The nurse said we don’t need comfort meds.

We had to buy Tylenol and ibuprofen for fifty cents a pill.

If you had no money, you could charge it to your account but I’m guessing people’s bills got too high and never got paid, so then they forced us to buy it from commissary. Which funds could only be received to the account by having family or friends send it.

We did not have jobs in jail.

The few trustees worked for free. They got hot, fresh, coffee and were out of the pod for most of the day.

That was their “pay”.

No, thank you! I absolutely will not and would not be a willing slave.

No way in Hell I was washing grown ass men’s drawers for a cup of coffee.

Only the men were allowed to work in the kitchen. The women were allowed to do laundry, and that rarely happened. It was mostly men who did both.

The jail didn’t want men and women detainees to be working around each other, for obvious reasons. We still went to court together though so… Plus the men tend to be in jail longer than the women so there were less turnover with men.

We could arrange a NP visit by requesting one from the kiosk. There was a $10 jail fee to see the nurse practitioner.

It would be deducted from our commissary account and if there was no money in our account we’d have debt. When money was applied to the account from an outside source, a percentage went to the debt and not into your account. We found ways around that nonsense though.

If we needed to see a doctor it was a $20 jail fee per visit.

If our meds changed there were times when it would take weeks to come in because the jail used a certain pharmacy that had to order everything. The pharmacy also did not take Medicaid, so we were charged for each medication we took. $5 a month, x2 if you took the same medication twice a day. These fees were like this from the moment I got there in 2020 and continued when I left in 2023.

I had to show out and raise Hell to get therapy once a week.

At this time no one in the jail was having ongoing therapy. I finally ended up being able to see the therapist via tablet in 2021. The visits were originally on a computer, but I got caught using Instagram on it. So, they put me on a table that I could only talk to the therapist on, and it did nothing else.

My appointments were supposed to be weekly, but the CO and/or nurses often forgot my appointments, were too lazy to bring me the tablet, or claimed they didn’t know the password. Just excuse after excuse. For this I was charged $20 a visit. Even if they brought the tablet 45 minutes late out of the 60.

It was nice when I was able to see my therapist though. We did a slice of eye movement desensitization and reprocessing (EMDR). We couldn’t do it fully because it would have desensitized me for the trial and that was not a good idea.

She would help me come back to reality if I dissociated. She would mail me workbook papers to fill out or refer to and give me homework.

I also had someone mail me a dialectal behavior therapy (DBT) workbook. There were things in the workbook I was unable to do like closing my eyes for what I thought was 60 seconds, setting a timer to see how long it really was once I opened my eyes. Things like that.

But there were mindful exercises like visualizing putting your problem on a leaf and watching it flow away downstream in a stream of water.

Other tools I used for my mental health were journaling, walking, and listening to music on tablets that we had to pay for. It costs to breathe in jail.

As far as having a mental health crisis, if you’re suicidal they just put you in solitary confinement in a turtle suit, Velcro thick green coverup, naked underneath. The same material as the suit for the blanket with mat on a concrete slab. The lights stay on 24/7. Cameras above the toilet.

I was not allowed to have anything, not even a toothbrush.

I could only take a shower when the COs had time.

I had 5 showers in 30 days.

I’m not exactly sure how this would make a person stop being suicidal.

When I was in the suicide cell for my first 30 days of jail, I was miserable.

My mom said she could hear it in my voice. As I only got one, five-minute phone call a day.

No visits. No commissary. Nothing but mail and a Bible. I wasn’t even able to write people back because I wasn’t allowed to use an ink pen or pencil. My mom wrote folks back for me.

When I couldn’t take it anymore, I had to request to talk to the psych NP to get cleared to be moved. He told me “If a person wants to kill themselves, they will find a way.”

My reply, “Exactly, I’m still here so get me out of there.”

I was released into general population the next day and $20 later. Normal clothes, sheets, blankets, spoons, people to talk to, access to books and to commissary. Still jail but much better than the suicide cell.

When I was sent to DOC the jail sent all my meds with me. I had to sign a form confirming so.

When I was released from DOC for the half a day I stayed, they forgot to send my meds with me. I had to ask for them on my way out the fence, and when I got them, I only received half of them.

I was forced to call a provider the next day to get them filled asap or risk psychosis.

Mental health care in county jails is minimal, if any.

It starts outside of jail though.

We need more therapists, more groups, more psychiatrists, FREE meds, and FREE programs.

Let’s come together to find ways to make this happen everywhere.

I had to fight for my help, let's fight for yours and everyone's!

The goal is to PREVENT, NOT PUNISH!

Prevent crimes by getting treatment.

This helps us be proactive by putting the focus on prevention of crimes instead of the punishment for them.

Mental health matters!

Prisoner’s rights matter!

Keep fighting!

~Natasha BYTS