2 weeks Ago By Julia Zenkevich
Allegheny County will offer a new way to deliver mental health services to people deemed unfit to stand trial. The county’s Department of Human Services announced the program, called the Mobile Competency Restoration and Support Team (MCRST) on Wednesday. But it began accepting patients in March.
“These are folks who are in need of treatment and care. And with that treatment and care, they do go on to live fulfilling lives,” said DHS director Erin Dalton. The team includes a psychiatrist, mental health nurse, therapist, peer counselor, competency support specialist, and a court liaison.
They will work together to treat patients awaiting trial in Allegheny County Jail — or when possible, in residential treatment facilities or their home communities. When a judge determines a person can’t understand legal proceedings or participate in their own defense due to mental-health issues or cognitive disabilities, they’re deemed “incompetent.” Their case is paused until they receive treatment and education about court processes.
But only two Pennsylvania facilities, Torrance State Hospital and Norristown State Hospital, provide those services. And the demand for beds has kept people with serious mental illnesses in jail for long periods of time, potentially worsening their condition . Though Torrance State Hospital has about 100 beds dedicated to competency restoration, an average of 125 Allegheny County residents are committed there every year.
And that’s just one of the western Pennsylvania counties that rely on the hospital, resulting in a long waitlist. When beds aren’t available, would-be patients charged with low-level crimes — often misdemeanors associated with their mental illness, like retail theft — languish in jails while they wait for a bed to open. It can take more than 80 days before they’re transferred to the hospital — far exceeding the seven-day maximum established in a federal lawsuit on the matter.
“If they're incompetent, they can't be prosecuted. They should not be in a jail,” said Witold Walczak, legal director for the ACLU of Pennsylvania and one of the lawyers in that class-action suit. Pennsylvania did see reductions in wait times after the lawsuit, but those gains evaporated during the COVID19 pandemic.
With this new program, people will be “spending less time in jail, and more of these folks are gonna get into either Torrance faster or be served in a less restrictive setting, which is ultimately the goal,” Walczak said. Debbie Scovill, a deputy health services administration for behavioral health at the county jail, said it will filter out complex mental health cases that the jail’s mental health staff can’t address. “[W]e're really not set up to be a state hospital,” she said.
“But in many ways, we're put in a position to be the state hospital based on the patients that we're providing care to.” Officials also hope the MCRST program will reduce wait times for state hospitals, by shrinking the number of people who must be admitted. Dalton called the program a “slam dunk .
.. for public safety” and a long time coming.
The county attempted a similar program in 2018 as part of a settlement with the ACLU, but the effort never took root. “It's certainly better for the jail. It's better for taxpayers and community [members] who would rather see their dollars spent incarcerating folks who really need to be there,” she said.
She said the new approach would also provide treatment for people who aren’t equipped to stand trial, and speedier case resolutions for minor crimes. Most importantly, she added, it’s better for the people “sitting in jail, potentially decompensating further, not getting the treatment that they need when we could be serving them in the community.” The team plans to continue working with patients after they exit jail or Torrance State Hospital.
It’s “a win-win for everybody,” said Walczak..
