Surge in inmates with mental health issues spurs the need for more beds at ECMC

BUFFALO, N.Y. (WIVB) -- Correctional facilities have become the largest providers of mental health services in the country, and the Erie County Sheriff's Office is no stranger to this shift away from sending the seriously mentally ill to psychiatric institutions.

The sheriff’s office said about 60% of inmates are treated for some type of mental illness, which is above the national average.

"Jails weren't built to be mental health providers, but we're doing the best we can," said Michael Phillips, superintendent for jail management.

An American Psychiatric Association poll in 2022 found 20% of Americans believe incarcerated people are not getting the mental health care they need. In addition, the poll found 75% believe mental health services should be provided to inmates.

The ECSO has grappled with these challenges for years. More than three dozen inmates have died under the custody of the sheriff's office since 2005.

Until June of last year, the sheriff's office was under federal oversight to comply with medical and mental health policies, which it was under federal order to adopt.

When Sheriff John Garcia was elected in 2021, one subject he wanted to focus on was mental health services in correctional facilities. The sheriff's office is in the process of obtaining accreditation from two independent agencies with mental health and medical care components.

Thomas Diina, the chief of community reintegration for the ECSO, said inmates today have a much higher need for mental health services than when he started his career 23 years ago.

Suicide is the leading cause of death in correctional facilities. However, the sheriff's office is trending downward in the number of suicide attempts in the Erie County Holding Center and the Erie County Correctional Facility.

In 2021, the sheriff's office reported 13 suicide attempts, and they reported 10 attempts the following year. That figure dropped to four attempts in 2023.

"All people that have a mental health condition who are incarcerated deserve quality access to mental health treatment," Phillips said.

The sheriff's office said its intake and screening procedures help them identify inmates with mental illness.

"It's asking them questions about if they have any mental illness, do they have any feelings of shame, or how are their families feeling about their situation," said Sandra Amoia, first deputy superintendent for compliance. "It's a very in-depth screening."

But when inmates' mental health reaches a crisis point, ECMC's behavioral health division is usually where the sheriff's office brings them. The secure ninth-floor unit has two dedicated beds for forensic mental health treatment.

"Many times, there's a waiting list for those two beds," Amoia said.

When there is a waiting list, the sheriff's office said they have to keep inmates in the correctional facilities. That leads to "a lot of therapy, maybe changing their medications and constant observation," according to Amoia.

As a result, the sheriff's office has reached out to ECMC about getting more assigned beds for inmates needing forensic mental health evaluations.

“The Erie County Sheriff’s Office has expressed need for more beds, but right now there’s not any funding or whatever for that,” said Amoia, who estimated they could use up to seven more beds.

ECMC said it is working with Sheriff Garcia to "treat individuals they are holding that become patients."

"We have recently become aware of their desire to expand patient beds in the secure 20-bed unit located on ECMC's 9th floor," said an ECMC spokersperson. "As has been widely reported, all hospitals in Western New York are contending with financial challenges due to the COVID-19 pandemic. ECMC would need additional resources to expand, as well as increase reimbursement, for the level of care these patients require."