SACRAMENTO, Calif. — Emerging from solitary confinement after two months, the man with schizophrenia walked from cell to cell, kicked at doors and demanded birthday presents. He stripped naked, stood on a table and put his hands on his hips.
It was not his birthday. But for the mentally ill inmate in Sacramento’s downtown jail, breaking free of his isolation for a brief moment in January may have felt like a gift. He’d been there since October, locked in the most restrictive “total separation” cells of the jail.
Even though a federal judge in 2019 ordered the Sacramento County Sheriff’s Office to stop using such extreme isolation on people with serious mental illnesses, an extreme isolation cell is where staff locked the unkempt, delusional man.
No sunlight. No meaningful treatment. No contact with anyone except the person who occasionally evaluated him through his metal cell door.
The man is one of the hundreds who have been placed in isolation units in Sacramento’s aging Main Jail over the past several years. Limited space for mental health services and soaring demand for help have clogged the pipeline for years, making a difficult situation miserable for both the people in crisis and the employees responsible for them.
It will stay this way for the foreseeable future. Sacramento County elected officials rejected plans in March to add a medical treatment space to the downtown jail, after activists decried the project as an “expansion” and called for a halt to jail funding. Critics of the plan argued that the county could find more immediate ways to bring relief to inmates.
As for the man with schizophrenia, deputies had nowhere else to put him. Mental health staff tried to get the man into the jail’s intensive treatment program, but there were 39 other inmates in line ahead of him. Several had waited for months for help. They’d all keep waiting.
On one day in January, according to a recently filed monitor’s report, the Main Jail housed 37 people in total separation cells called TSEPs. The classification is “fairly unique,” a decrease from years past but still against the federal court agreement. Another 61 were people in “administrative segregation,” a less-restrictive form of housing that gives people limited out-of-cell time and allows them to interact with others.
Experts have long documented how solitary confinement can further harm people locked inside. The extreme isolation worsens the effects of mental illnesses and backtracks on improvements that come from what little treatment does exist in jails.
“This deliberate infliction of severe mental pain or suffering may well amount to psychological torture,” Nils Melzer, an expert on extreme isolation with the United Nations, said last year.
Even after years of meetings, lawsuits and protests about conditions inside the rundown and crowded facility, officials said they were unaware of the array of services in the county they lead and the needs inside its walls.
A majority of county lawmakers — four out five — said they were unwilling to commit more money to the medical annex project until staff considered other ways to comply with the court order.
“When I read the (court monitor’s) compliance report, I am convinced that there are so many things that we could do from an operational standpoint — that’s not to minimize the need for improvements on the physical plant — but we’re not there yet,” said Supervisor Patrick Kennedy.
The medical annex was not intended to jail more people. Instead, it would have provided more space to treat people who commit crimes and have serious mental health problems.
Still, activists celebrated the project’s defeat.
“They told us it couldn’t be done,” activist group Decarcerate Sacramento wrote on Twitter. “That a new ‘mental health jail’ was required to meet a recent class-action lawsuit. We proved them wrong.”
It was the latest in a string of rejections that have left many inmates in limbo as part of a uniquely California problem: What to do with county jails that over the years have been made more like state prisons while running up against local-level political pressure?
After the vote, Sheriff Scott Jones in a statement reiterated that the proposal was for a modification, not expansion. The rejection from the board was without reason, he said. Inmates would suffer and the county would continue failing to comply with the court order.
“At the end of the day, however, this decision is the county’s and the Board of Supervisors who inexplicably voted down the initiative,” Jones said.
Imperfect answers must be part of the path forward, said Keramet Reiter, an associate professor of criminology and law at UC Irvine. Too often, the conversation becomes a “reformist versus an abolitionist agenda,” she said. People inside have the most to lose.
“I also don’t want to see us build new jails,” Reiter said, “but also have nightmares about the circumstances I’ve seen people in those jails and the fact that they need help right now. … It’s just, it’s really tough because we don’t have an infrastructure to help people right now that doesn’t involve kind of funneling more money into a broken system.”
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A law signed in 2011 by Gov. Jerry Brown diverted thousands of people away from state prisons. To lessen the strains in California’s unconstitutionally overcrowded prisons, lower-level offenders would instead serve their sentence in local county jails.
Sheriffs didn’t oppose the plan, in part because lawmakers earmarked hundreds of millions of dollars to improve local lock-ups. Projects ranged from new mental health wards to entirely new facilities.
But as The Sacramento Bee reported in 2019, counties ran up against bureaucratic hurdles and political blowback. Now, counties have walked away from some $202 million in financing to improve or redesign their jails. Sacramento is among them.
Gov. Gavin Newsom this year proposed putting that funding toward new or existing community mental health centers. While experts have long called for more investment in community mental health resources, the budget proposal would likely take years to see results.
Absent incremental change, scores of people in mental health crises will remain locked inside.
“It is unacceptable and unconstitutional to subject people to solitary confinement because of the lack of necessary mental health treatment resources,” said Margot Mendelson, an attorney with the Prison Law Office.
“If the county wants to reduce the cost associated with providing adequate treatment to people with serious mental illness, it should act with urgency to divert them to community treatment settings.”
After the dayroom incident, deputies moved the man with schizophrenia to an acute psychiatric unit for actively suicidal and seriously mentally ill inmates. Staff said he was “gravely disabled and posing a danger to himself.”
Eight days later, they moved him back to TSEP. Nowhere else to go, they said. Predictably, his condition worsened again.
A month later, he was admitted again to the psychiatric unit, which functions like a makeshift-yet-lonely residential treatment facility inside the jail. It was another temporary stop in his journey through the county’s disjointed justice system.
After five days, staff bounced him back to total separation. He remains in isolation on the eighth floor of the downtown jail, Mendelson said.
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Sacramento County officials have known upgrades were needed in its jails since at least 2013. Yet the improvements languished for years.
Human rights groups urged the county to correct overdue deficiencies in the jails. Mentally ill people were living in brutal conditions. There was consensus that a crisis was unfolding, people were dying and the county was liable.
Seeing little to no progress, Disability Rights California and the Prison Law Office sued Sacramento County in federal court on behalf of inmates, alleging they were kept in “inhumane” conditions.
The court ultimately agreed. In a 2019 settlement agreement, a judge signed off on a plan that called for improvements to the jail’s treatment of people with mental illness. The settlement also included a new layer of scrutiny from court monitors who would review the county’s missteps as inmate deaths and lawsuits mounted.
“The spirit of the consent decree is absolutely not to create more people in the jail, it’s to reduce the number,” said Don Specter, executive director at the Prison Law Office. Construction was but one option of many, he said at the time.
But in the eyes of some county lawmakers, a new facility seemed to be the only solution to their problem — at least that’s how it was billed to the Board of Supervisors under the leadership of former County Executive Navdeep Gill, who has since retired
The state dangled a carrot, too. Sacramento had been awarded more than $53 million for a project to help replace, renovate or expand the jail or mental health facilities. But in November 2019, the supervisors walked away, leery of the community push-back and the increasing project costs.
“That’s part of our job, to figure out other ways to accomplish things that need to get done,” Supervisor Don Nottoli said at the 2019 meeting. “I’m prepared to say, ‘Thanks but no thanks’ to the state.”
Advocates have long pointed out that county leadership should look for ways to reduce the jail’s population. Although a number of efforts are underway, the number of detainees in both county lockups still hangs above 3,000 people.
Their focus on population reduction is not without reason. A consultant hired by the county concluded that Sacramento County locks up more people per capita than other counties its size when compared with places in the state and nationwide.
The Carey Group compared Sacramento County’s jail admission rates with counties in the state that have populations between 1.1 and 3.3 million, finding that the rate of jail admissions was higher than all but one county — San Bernardino. The firm found a similar pattern when it examined incarceration rates for similarly sized counties nationwide.
For that reason and others, advocates have pushed to lower the number of inmates inside over construction.
“There are hundreds of requirements identified in the Mays consent decree that would provide immediate relief to people that are living inside, including providing constitutionally minimum medical and mental health care,” said Tifanei Ressl-Moyer, a lawyer and co-founder of Decarcerate Sacramento, a coalition of community groups that was formed in opposition to the jail expansion plans.
“Out of those hundreds of requirements, they’re not meeting hardly any of them. So this perception that this construction project is going to address some of the most severe harms that people are experiencing inside is just not true.”
At some point, advocates and lawmakers say, Sacramento County will have to add to the jail in some way. It will likely require tens of millions of dollars.
“To move forward with structural reforms in a way that accepts people as collateral feels disturbing,” Reiter said. “Figuring out how to ameliorate the really terrible conditions seriously mentally ill people, in particular, are in … and treating them humanely, to me is a step in reframing the system.”
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A scaled-back plan that would create a medical “annex” next to the Main Jail was again delayed in January. When it came back before the supervisors in March, the balance had shifted more firmly in opposition to the project. Only Supervisor Sue Frost supported construction.
“The way county administrative leadership was intent on presenting this to the board very early on was here’s your one option,” said Supervisor Phil Serna, adding that expanding the jail was the “product of a previous administration.”
But the county leadership was shaken by a number of public scandals late last year that resulted in Gill being placed on paid administrative leave pending the outcome of a misconduct investigation. Gill retired in February.
While the project was always divisive among supervisors, Gill’s absence created an opening for advocates. Longstanding criticism about the project hit a boiling point recently amid a broader push to “defund” aspects of law enforcement and significantly reduce jail populations.
More than a decade ago, when California began giving jail construction funds to counties, advocates in some places pushed back hard. They traveled to state board meetings in Sacramento to decry millions of dollars going toward jails and pressured some counties to give back the awards.
“They were like the precursors to ‘defund the police,'” said Brandon Martin, a researcher with the Public Policy Institute of California who has studied jail construction programs. Putting more money toward the jail was becoming increasingly unpopular among supervisors, too.
Then, for six hours in March, county staff ticked through the list of ongoing criminal justice work — a dizzying amount of information about the piecemeal programs targeting some of the same people who end up in jail. Supervisors said the grueling presentation was the most thorough assessment they’d ever heard about the jail and local justice system.
The board ultimately told county staff to come back with recommendations on all the other ways to come into compliance with the court order without building a new facility.
It’s unclear what an alternative solution might look like — or when it might come to fruition.