Some groups and individuals have correctly pointed out that mental health and substance use disorders appear to contribute to criminal behavior and recidivism. This is partially based on a study conducted in the Haywood County Detention Center showing high prevalence rates for these conditions and associations with recidivism.
In full disclosure, I need to acknowledge that, in concert with Sheriff Christopher and his staff, I designed that study and oversaw the day-to-day operation of the project. I have also just assisted in writing up a similar report for a county in Florida. There, a treatment counselor from a local treatment provider administered the same structured interview used in Haywood County. Of the inmates with a substantial alcohol and/or drug use disorder about one in three actually entered a treatment program.
The logical conclusion from the two studies is that effective treatment for alcohol and drug conditions could help reduce criminal behavior and recidivism. The other implication is that providing treatment for substance use disorders would also contribute to public health by reducing injecting drug use and risk for overdoses. The problem with the conclusions is that in Western North Carolina such needs are partially irrelevant to the issue of a new jail. This is true for three reasons.
The first reason is that I personally know of no provider in Haywood, Jackson, or Transylvania counties currently staffed to provide behavioral health services for those leaving a jail. Over the past decade or two we have seen a reduction in treatment providers in the area.
Secondly, even if there were providers able to provide services there is no way to pay for them. Unlike the situation in Florida, counties in our area do not have a reliable funding source to pay for clinical services for this population. This is exacerbated by the fact that North Carolina has not expanded Medicaid. In all likelihood, few people leaving the detention center in Waynesville would have coverage or be able to pay for the services they need.
The final considerations may trump all other reasons. The overriding factor is the current condition, size and capability of the jail to meet current and future needs. Given the ever-increasing population, it is unlikely that we will see any substantial reduction in the number of people requiring incarceration. Another factor is that the General Assembly has shifted the responsibility for incarcerating inmates with short sentences to counties instead of providing incarceration in the prison system of the state. This adds to space requirements.
The bottom line is that I would need to defer to Sheriff Christopher and Chief Deputy Jeff Haynes concerning the need for a new detention facility. As to addressing the behavioral health needs of those arrested as well as the rest of the community, I would be pleased to work with commissioners and the courts to explore pragmatic strategies.