Opinion Columns & Blogs

Dan Morain: Mental health system a safety net in name only

Matthew Herrera has revolved in and out of locked psychiatric wards, jails and prisons for 13 years, ever since he was 15.

Karen Herrera, who struggled to raise a troubled son on her own, had reason to hope this time would be different. It wasn’t.

Herrera spent 128 days in the Sacramento County jail and another 10 days at the Sacramento County Mental Health Treatment Center.

Jailers released Herrera at 1 a.m. Oct. 9. Not 40 hours later, he lay on a gurney at UC Davis Medical Center, mumbling. He had been deemed a danger to himself or others, again.

That Sacramento County jailers dumped Herrera in downtown Sacramento at 1 a.m. shows that while many mentally ill people slip through gaps in the safety net, others are shoved.

“They’re setting him up for failure,” Karen Herrera told me.

I met Matthew Herrera at the end of February, the day he was released from an earlier jail term. During that stretch and this one, jailers isolated him on a tier reserved for severely mentally ill inmates. He is schizophrenic.

In February, jailers released him on the Saturday morning of President’s Day weekend, when social-services agencies that might have provided assistance were closed. Karen took him back to her tract home in Elk Grove. The next day, he took the keys to her car, sped off, totaled it and was arrested. He made it 31 hours that time.

He remained in jail until May 7, and was released to a board and care home in Fruitridge, where he deteriorated again, probably because he used illicit drugs. Back at the treatment center on May 24, he assaulted two emergency medical technicians, the crime that landed him back in jail for this most recent term.

Senate President Pro Tem Darrell Steinberg read what I wrote about Herrera in February, and was moved to intervene, imploring case workers from the state-funded nonprofit Turning Point Community Programs to help in any way they could.

They did for a short while he was out of jail in May, but couldn’t gain access to him when he returned to jail. Karen hoped Turning Point would assist him again when he got out earlier this month. But as Karen learned in an email exchange with a Turning Point caseworker on Sept. 30, nine days before Matthew’s latest release, he needed a referral from the Sacramento County Mental Health Treatment Center. That didn’t happen. Without a referral, the caseworker told Karen, “I technically can’t be in communication with you or with him, or offer any assistance.”

Karen knows her son is not blameless. He makes bad choices. When he takes anti-psychotic medication, he can be rational. He generally refuses drugs that can clear his mind. He has his rights.

When he gets out of jail or locked wards, he uses street drugs, which let loose his demons. On the gurney, he told his mother he had smoked marijuana that day and contemplated suicide.

“It’s no different than letting a 3-year-old run out to the street,” Karen said. Adults should intervene. But they don’t until mentally ill people commit crimes. Even when they are in custody, authorities are solicitous of their rights.

Court records show that in July and August, Matthew refused to meet with a psychiatrist and a psychologist who tried to assess his ability to assist in his defense. Judge John Winn declared him incompetent to stand trial but did not order that he take anti-psychotic medication, in deference to his rights.

Herrera’s attorney, Chief Deputy Public Defender Steve Lewis, did manage to persuade Herrera to take medication in September. Herrera returned to court on Oct. 8, apparently stabilized. Winn concluded he had served his time, and ordered him released.

Sacramento County jailers obliged, kicking him loose at 1 a.m. Oct. 9. The jail used to have a discharge planner, but that position was eliminated a few years ago. There was a time when jailers would give mentally ill inmates a month’s supply of meds upon their release. Now, they hand them a prescription, as if Herrera would go to a pharmacy, even if one were open at 1 a.m.

I asked to speak to Sheriff Scott Jones, who oversees the jail, about why Herrera was released as he was. He did not get back to me.

Anticipating his release, Karen, acting as caseworker and discharge planner, had found Matthew a room at Pete’s Place, a row of three boardinghouses on 27th Avenue off Broadway. She also left him $25, which he used to pay for a cab to Pete’s, arriving at 2 a.m.

Once the sun came up, a Pete’s Place staffer drove Herrera to a Social Security office to get his disability payment reinstated. The paperwork wasn’t in order, and the federal government was in partial shutdown, which complicated matters and frustrated Matthew.

The next morning, Oct. 10, less than 30 hours after jailer dumped him, Herrera became agitated and bolted from Pete’s Place, and made his way to the UC Davis emergency room.

When his mother arrived at about 5 p.m., he mumbled unintelligibly, stared into space, and nervously asked why nurses were talking about him. She assured him they weren’t.

The next day, he was at the Sacramento County Mental Health Treatment Center, on anti-psychotic meds, and lucid enough to play cards with his mother.

“There are different Matthews as the medication kicks in,” she said.

I write about Herrera not because he has some amazing talent masked by his illness, or comes from a rich or famous family. His father may or may not be alive. His mom, the one person in the world who cares for him, works in the state bureaucracy. He is part of that small segment of mentally ill people who can’t care for themselves and become our responsibility. We don’t do well by them.

“Nobody is satisfied with the status quo,” Sacramento County Health and Human Services Director Sherri Heller told me.

In January, Sacramento County will begin a new program called Community Alternatives for Recovery and Engagement. Two public guardians with caseloads of no more than 10 each will provide oversight of hard cases like Herrera, cajoling them to get therapy and take medication, trying to stop the door from revolving.

Let’s all hope it works.