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Clinical Psychologist to Head Cook County Jail, the Nation’s Largest Mental Health Institution

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By Frederick H. Lowe

Dr. Nneka Jones Tapia, a clinical psychologist, has been named executive director of Cook County (Illinois) Jail, the nation’s largest mental health institution, and her appointment supports Sheriff Tom Dart’s view as well as growing national sentiment that the mentally ill don’t belong in jail because it is too costly and because it criminalizes behavior of people who need psychiatric or psychological care.

Dr. Nneka Jones Tapia has been named executive director of Cook County Jail, the biggest mental health facility in the country. Photo by Penny Yi Wang
Dr. Nneka Jones Tapia has been named executive director of Cook County Jail, the biggest mental health facility in the country. Photo by Penny Yi Wang of Northwestern University.

Dr. Jones Tapia was named to her new post from first assistant executive director on Tuesday. She is believed to be the first clinical psychologist to head a major jail or prison in the country, although Winston Moore, the first African American to run Cook County Jail, was a psychologist, but it is not known if he was a clinical psychologist. Moore was the jail’s executive director from 1968 t0 1977.

Cook County Jail houses 9,000 inmates and on any given day 25% to 35% of them suffer from a serious mental illness, Dart said. Most the inmates housed in Division II, the jail’s mental health unit, are black men, which as a Northwestern University Fellow I saw when I visited there while researching mental illness among African-American men. The regular jail’s population is also overwhelmingly black men.

Dr. Jones Tapia’s appointment follows this month’s launch of “Stepping Up: A National Initiative to Reduce the Number of People with Mental Illness in Jails.”

The National Association of Counties, the Council of State Governments Justice Center and American Psychiatric Foundation have formed a partnership to generate awareness and action about the 2 million people—the equivalent of the combined populations of Vermont and New Hampshire— suffering from schizophrenia, bipolar disorder and major depression admitted to jails annually.

The U.S. Department of Justice Bureau of Justice Assistance has given the initiative its financial backing.

Cook County Illinois Sheriff Tom Dart
Cook County Illinois Sheriff Tom Dart. Photo by Northwestern University

Dart does not believe the mentally ill should be jailed and treated as criminals for committing minor crimes, such as petty theft, panhandling, trespassing, prostitution, disorderly conduct and substance abuse.

He said the criminalization of the mentally is a tragic byproduct of widespread cuts to mental health services throughout the country and state over the past decade.

Dart did not mention the Chicago Department of Public Health — at least not in his news release — which in 2012 closed the Woodlawn Clinic and five other mental health clinics because of budget cuts.

The city still operates six mental health clinics, but they are hanging by a thread.

Julie Morita, MD, commissioner of the CDPH, recently told a meeting of the Community Mental Health Board of Chicago, Inc., that she could not say “yes or no” as to whether the remaining clinics would be closed.

Dart has criticized CDPH for closing the six mental health clinics, saying the department did not put forth a compelling argument to close them.  He also refused to sign a news release announcing the closures.

Stepping Up’s backers said that housing the mentally ill in jails comes at a staggering cost to taxpayers. It costs $143 per day to house an inmate at Cook County Jail. Treating an inmate suffering from mental illness is more expensive.

Southside Together Organizing for Power (STOP), a Chicago-based activist mental health group,  plans to launch a petition drive to reopen some of the closed clinics and keep the remaining clinics open.

The closed mental health clinics have pressured Cook County Jail.

“When mentally ill individuals have nowhere to go for treatment, the odds of them going off their medication and committing low-level crimes of survival jumps exponentially; so, yes, the closures have served as a catalyst for the growing mentally ill population in the jail,” said Benjamin Breit, director of the Department of Communications for the Cook County’s Sheriff’s Office.

Cara Smith, Dr. Jones Tapia’s predecessor, explained to Northwestern Fellows that not locking up a mentally ill person for stealing is complicated because it involves the retailer and the police.

Cara Smith
Cara Smith said not locking up a mentally ill person for stealing is complicated. Photo by Northwestern University.

“The store has discretion to hold the thief for the police, and the police have discretion to arrest him, but once he gets to us, we don’t have any discretion in the matter. I have to put them in jail,” said Smith, adding the jail kept a record of the number of inmates arrested for retail theft.” Smith has been promoted to chief strategy officer.

It gets even more complicated when a small number of individuals deliberately commit crimes so they will be arrested and sentenced to jail, where they will receive their medication, a warm place to sleep and three meals a day.

Illinois Gov. Bruce Rauner also has submitted a budget that would further reduce funds for mental health treatment. Dr. Jones Tapia spoke at a rally in Chicago  that opposed the governor’s proposed budget cuts. Some 1,836 Cook County Jail inmates were suffering from some form of mental illness, she told the crowd.

“They’re coming in such a severe state that they really require hospitalization,” Dr. Jones Tapia said.

Dart wants to change attitudes concerning the jail.

“No longer can we view jails and prisons as places that happen to house mentally ill inmates — incarceration and mental health treatment have been infused, they are one in the same, Dart said. “Dr. Jones Tapia is ideally suited to oversee the country’s largest mental health center and to catalyze our efforts to reform the broken criminal justice system.”

Dr. Jones Tapia said, “Sheriff Dart understands that pre-trial detention in jails should be reserved for violent and dangerous offenders, not poor, sick and nonviolent individuals who need treatment. I look forward to furthering our social justice mission in this exciting new capacity.”

Dr. Jones Tapia earned a bachelor’s in psychology from the University of North Carolina, a master’s degree from East Carolina University and a Doctor of Psychology or PsyD from the Virginia Consortium Program in Clinical Psychology.  PsyD is a professional doctorate degree that prepares graduates to practice.

She joined Sheriff Dart’s office in 2013 after serving as chief psychologist at Cermak Health Services, a branch of the Cook County Health & Hospitals System, which serves as the medical provider at Cook County Jail.  Dr. Jones Tapia also helped launch the Sheriff’s Mental Health Transition Center, a first of its kind facility that provides extensive therapy, job skills, training and discharge planning to nonviolent inmates suffering from untreated or undertreated mental illness.


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