Mental health advocates agree with Moore. But jails and prisons are often filled with people who would likely benefit more from professional treatment instead of incarceration.

The issue is coming to the forefront locally after Malcolm James, a 27-year-old who reportedly called police for help on May 28 after setting fire to his own apartment during an apparent mental health crisis, died in the Racine County Jail on Tuesday, the second of two deaths in the jail in five days.

According to the Racine County Sheriff’s Office, which operates the jail, James was on suicide watch. On Saturday, he allegedly began hurting himself by violently smashing his head against a concrete wall, was hospitalized, but then began doing the same thing Tuesday; the RCSO reported that he then experienced “a medical event which led him to becoming unresponsive” and he died soon after.

The family says James was tased and maced before his death, but that has not been publicly addressed by authorities. Other than initial releases regarding the deaths of James and 22-year-old Ronquale Ditello-Scott, who died May 29 of unconfirmed causes, the Sheriff’s Office has not released information or answered questions regarding the deaths. On Friday, RCSO issued a statement saying it doesn’t plan to release any more information regarding what happened. The deaths are being investigated by the Kenosha County Sheriff’s Department, in accordance with state law.

Criminal matters usually lead to jail

Moore said that if an officer believes a crime has been committed — such as in James’ case, having allegedly set fire to an occupied building, leading to 15 felony charges that were dropped following his death — the individual is almost certainly going be jailed, Moore said. “If it was a criminal matter … they (the officers) most likely would decide to take them to jail.”

It is possible for someone who is arrested to be transferred to a mental health facility rather than being jailed. This process follows a law referred to as “Chapter 51.” For this reason, the process of sending someone to a mental health facility against their will rather than a jail is often referred to as “chaptering” someone.

When someone is “chaptered,” the decision is often made by the local behavioral health services department after consulting with the arresting law enforcement agency — i.e., the police department, State Patrol, county sheriff’s office, etc.

According to a statement from the Racine Police Department, which declined to comment on James’ situation directly, “Officers frequently encounter people who commit crimes while in a state of mental crisis. This often is accompanied by a suicidal act or threats of such act. Frequently when officers conduct an emergency detention on the individual and write a report to the DA’s (District Attorney's) Office regarding possible/if any criminal charges. Chapter 51.15, not unlike making a custodial arrest on an individual, has a threshold with separate criteria to a specific criminal arrest that has to be met before the hold can be forced on an individual and they be placed in a facility."

Racine County Behavioral Health Services assists in addressing mental health crisis and substance abuse needs of inmates at the jail. Services vary based on individual cases, which can be extremely complex and challenging.”

However, Moore said it is very rare that someone experiencing a mental health crisis and is arrested ends up in a treatment facility rather than a jail.

Nicole Smart, program director at the National Alliance on Mental Illness Racine County, said this is in part because there aren’t nearly enough mental health facilities or staff available in Wisconsin to take care of those who need it.

After his arrest, James was reportedly taken to Ascension All Saints Hospital for a mental and physical evaluation, but was released to be taken to jail; Ascension Health has not confirmed this, citing Health Insurance Portability and Accountability Act regulations that ban it from sharing patient information.

What’s supposed to happen?

The Wisconsin Administrative Code DOC §350.17 outlines the policies and procedures of jails housing inmates with mental health concerns who may be at risk of harming themselves.

According to the state code, as soon as a potentially suicidal inmate is put on suicide watch, qualified mental health professionals should be notified of it within 12 hours. And, as soon as possible, a qualified mental health professional should evaluate the potentially suicidal inmate.

Though the Sheriff’s Office reported James was on suicide close watch and put in a high-visibility cell, it has not disclosed how often he was checked on.

“Usually for suicide attempts, they would be put on watch, put in a particular gown in the jail,” such as a restraining anti-suicide smock. “They wouldn’t necessarily be taken to a hospital,” Moore said.

Moore noted the garment the inmate is to wear is usually padded, and that jail staff “can pad the cell if they feel like that’s necessary,” while adding that she has never seen a cell that has been padded when she’s been in the jail.

Where should they go?

Smart said people experiencing a mental health crisis shouldn’t be jailed. Instead, people like James should be sent to the hospital.

“But hospitals in the area aren’t equipped to work with those that have that criminal aspect,” Smart said. “We need more doctors, more staff, better facilities.”

There are correctional facilities in the state which specialize in caring for mentally ill inmates. For example, Wisconsin Resource Center in Oshkosh is “a leader in the development of innovative treatment methods for state prison residents in need of specialized mental health services,” according to its website.

There’s also the Mendota Juvenile Treatment Center in Madison which, according to the state, “provides comprehensive mental health services to teen boys whose highly disruptive behavior and failure to respond to standard treatment has warranted their transfer to the facility from Wisconsin’s juvenile corrections system.”

Smart said the state needs more of these crisis centers; specifically, at least one should be closer to Racine.

“Many times (mentally ill inmates) are sitting in jail, waiting to be transported,” Smart said.

Jerome Dillard, executive director of EX-incarcerated People Organizing, a Wisconsin-based organization that works to end mass incarceration and advocate on behalf of those who were or are incarcerated, said he spent many years working in the WRC.

“There’s rounds to be made,” Dillard said of how often jail staff monitored inmates at WRC. “Someone will check on that person, every 15 or 20 minutes at the most. Was that taking place (with James) is the question.”

Who is affected: ‘It’s not addressed, it’s not treated’

According to the Department of Corrections, almost half of all adults incarcerated in Wisconsin have at least one mental health condition.

An April 2021 report from Wisconsin’s Division of Adult Institutions says that 39% of male inmates in the state’s correctional facilities have a mental health condition. Of those, 7% have what the DAI classifies as “serious conditions” — like bipolar disorder, schizophrenia, personality disorder or severe depression. In the same report, 92% of female inmates have a mental health condition; of those, 38% have a serious condition.

That’s out of about 19,400 inmates the DIA reports having in its facilities, more than 93% of those incarcerated are men.

According to a report from the U.S. Department of Justice, 37% of people in state and federal prisons have been diagnosed with a mental illness; that number goes up to 44% for those in local jails.

Dillard, who was formerly incarcerated, said he remembered the emotional toll he faced the first time he was “locked up and put into a cell.”

“I myself had traumas dealing with undiagnosed mental health issues and never got help for it,” Dillard said.

“A large portion of our incarcerated population suffer from mental health issues,” he said. “And yet ... it’s not addressed, it’s not treated.”

Recommendations

In the state’s budget recommendations, Gov. Tony Evers recommended an addition of over $5 million to help fund Mendota and the Sand Ridge Secure Treatment Center in Mauston, which houses inmates who have a history of sexual aggression.

But there’s more to do beyond supporting an increase in funding.

Michelle Gehring, executive director for NAMI Racine, said the community should mobilize to speak to legislators and advocate for more mental health resources so others like James don’t end up without the help they need.

The stigma against seeking help for mental illness and the overall lack of access to mental health services are two of the biggest contributions to mental health crises, Smart said.

“We hope it’s a wake-up call for the (Racine) community,” Gehring said.

Smart said local legislators and officials would benefit from reaching out to organizations like NAMI who specialize in offering mental health services for the community, since Racine is so lacking in mental health services.

The county also does not offer mental health court, Smart noted, despite other counties offering it. A mental health court would help mandate defendants to acquire, and follow up with, services to treat their mental illness.

There are other courts in the county, however, which may take mental health into consideration — like the veterans court or the drug court. But no specific court handles mental health.

There should also be advocacy for the 998 bill, Gehring said. The 998 bill, signed in October by then-President Donald Trump, calls for designating “998” as the three-digit number to call for mental health and suicidal crises instead of 911.

“We need to do a better job at diagnosing, intervening and treating individuals with mental illness, because it’s a significant part of our communities,” Dillard said. “Especially in the more impoverished communities, where traumas are just stacked on top of each other.”

UPDATED: A quote in the original version of this story was misattributed to the Racine Police Department. The correct quote now appears above.