MIAMI COUNTY, Ohio (Miami Valley Today) — In response to the increase of suicide attempts at both the downtown jail and the Incarceration Facility, Miami County Sheriff’s Office recently initiated an on-site mental health specialist four days of the week.

Tri-County Board of Mental Health’s Recovery and Wellness division appointed David Clem, of Port Jefferson, who splits his time with inmates at both facilities to counsel and support inmates in crisis.

A pastor for 20 years, Clem serves as a mobile crisis therapist to address the needs of inmates in hopes to de-escalate their problems before they harm themselves or others.

“I’m not an authority figure, but a therapist and therapy figure to maybe allow us to deescalate situations. We can work out treatment for those who do have mental illness, provide some counseling for those who are here and get them set up so when they transition from jail, they are already in the system and can transition right out to outpatient therapy…it’s a continuity of care thing,” Clem said.

The Tri-County Board of Mental Health provides the service to the jail at no cost to the county. TCBMH serves Darke, Shelby, and Miami counties through the support of a local tax levy for mental health support services.

Miami County Sheriff Dave Duchak said each year mental health issues seem to increase in both facilities, but in 2020 he said “it just exploded.”

Duchak said he’s not sure if it is attributed to the pandemic, civil unrest or other factors.

The evening before the interview, an inmate attempted suicide for a third time, to which Duchak said, “so why is he still in jail?”

Duchak explained if an inmate is suicidal and in crisis, a mobile crisis team is dispatched to the jail to perform an assessment. If “pink-slipped,” deputies would transport the inmate to the behavioral health department on Upper Valley Medical Center’s campus. A doctor will then assess the inmate who will either be admitted or released back to the jail.

“Many times they are released back to us and placed on suicide watch. Which again, doesn’t make sense to us, because if we transport for a physical ailment, they’ll be admitted, but if they are saying they aren’t suicidal they send them back to us. It’s very labor-intensive, we have to do more cell checks, more staffing,” Duchak said.“I’m not the only sheriff dealing with this. We are not equipped to be a mental health facility, but that’s what happens when you defund all the mental health facilities —they end up in jail.”

Ohio’s mental health system was defunded in the 1980s.

Tri-County Board of Mental Health Director Terri Becker said at the time, funds were to be distributed from the savings of the mental health hospital closures to communities to provide services, “but that never happened.”

“Jails are the biggest housers of mental health individuals in the nation,” Becker said. Becker said if the inmate has calmed down, no longer wants to complete suicide, the hospital can’t hold them and they are sent back to jail.

“It’s a horrible cycle for individuals who then get back in jail and the situation is still horrible and it starts over again,” Becker said.

Sheriff Duchak said he hopes the on-site mental health specialist will reduce the demand for crisis team calls, which could take hours as an inmate is placed in solitary confinement, and prevent suicide attempts. Duchak also said the administration hopes it will reduce the burden on correction officers, who are there to protect them from harm — from other inmates and themselves.

Miami County Sheriff’s Office Jail Administrator Capt. Mike Marion said Clem’s services are a welcome attempt to not only help inmates but allow correction staff to focus on their tasks of keeping inmates safe — a proactive measure rather than reactive.

“I’m glad we have someone in-house,” Marion said. “Even with our population cut in half right now, the number of mental health cases we see are a lot higher percentage-wise.”

Marion said correction officers participate in crisis intervention training to help de-escalation, but having Clem on staff provides support from someone who doesn’t wear a badge.

“I think a lot of it is the uniform; he’s not an authority figure…I think once you take away the black shirt and the badge, it already helps de-escalation,” Marion said.

Marion said having an in-house therapist speeds up the process for crisis intervention rather than waiting on paperwork, dispatch and waiting for the team to arrive based on urgency among the three counties it serves. Sometimes the wait from overnight crisis calls can be addressed by Clem the following morning, which he said, “is a perfect fit having him coming in here seamlessly.”

Marion said while some attempts are faked to get out behind bars, even those “fakers” could injure themselves in their attempts.

Marion shared a case of a female inmate who almost hanged herself with a pair of headphones in a failed attempt of suicide.

“As far as having David here four days a week, it’s definitely a peace of mind for us and hopefully for the rest of the correctional staff,” Marion said.

Clem said while crisis therapy can’t get the numbers down to zero, specialists like himself hope to lower hospitalizations and decrease the logistics and expense of mental health services for inmates.

“I hope it’s successful,” Clem said. “It’s ramping up slowly.”

The cost of Clem’s services from the Tri-County Board of Mental Health was not available as of press time.

  • In 2019, with an average daily population of 224 (with a high of 256 inmates), MCSO recorded 11 suicide attempts and one suicide death.
  • In 2020, amid the Coronavirus pandemic, the average daily population of 162, there were 24 suicide attempts with zero reports of suicide-related deaths.
  • County-wide, with reports from all cities and village patrol logs, in 2019 there were 494 suicide/no injury calls; 110 suicide with squad response for injury or death calls; and 469 mental health issue reports.
  • As of Dec. 22, in 2020, there were 392 suicide/no injury calls; 114 suicide with squad response for injury or death; 499 mental health issue reports.