'Jail navigator' addressing inmate mental health issues

Her title is "jail navigator", but the work Heather Ressel does is a little more complicated and innovative than her title implies.

The first of her kind in Missouri, Ressel is a full-time staff member who provides mental health services to inmates at Cape Girardeau County Jail.

Her job is funded by Missouri Department of Mental Health, working for the Community Counseling Center in Cape Girardeau. She has desk space at the jail, where she provides mental health support and connects inmates to services before they leave the judicial system's confines to rejoin society.

Heather Ressell

Heather Ressell

Ressel has been working in this position for about 14 months.

"We've been flying by the seat of our pants," Ressel said. Her first year was funded by a grant from mental health department, but now it's an established budgetary position. Because her position was new as part of a pilot program with the department, Ressel has spent quite a bit of time assessing needs. Likely her most important role is to listen to inmates who struggle with mental health problems. But she's also gone to work creating packets for inmates to connect them to resources before they are released from jail, such as addiction rehabilitation programs, GED or high school diploma programs and alcoholics anonymous; she provides information about housing and counseling services. She can help some of those connections get started even before an inmate is released.

A study conducted by the American Psychological Association found that 64% of jail inmates, 54% of state prisoners and 45% of federal prisoners reported mental health concerns. Ressel is beginning to collect that type of data locally.

She said she believes the numbers might be higher in the county jail.

The jail has had intake forms to assess inmates' mental health needs. Over the last year, the forms have identified 484 inmates with mental health problems. Yet 541 have requested Ressel's mental health services during that same time period. Ressel said inmates come in with diagnoses of psychosis, schizophrenia, bipolar and major depressive disorders, among others. Some of them are also addicted to substances and dealing with the abstinence of drugs for the first time in a long time.

Sheriff Ruth Ann Dickerson, who ultimately is responsible for a jail that houses between 235 and 265 inmates every day, said the position was needed for multiple reasons. One had to do with medications. The bureaucratic steps needed for the jail to continue medication needs were cumbersome, and Ressel helps by contacting doctors to expedite that. There are a number of prescribed medications that are not allowed in the jail because of their potential abuse. But Ressel is able to help inmates get their allowed prescriptions faster.

Dickerson also said that inmates need someone to talk to about their mental state. Inmates are often not comfortable talking to jailers and deputies about their mental anguish. But they're more willing to talk to Ressel. A large portion of inmates come into jail with mental health problems, but being in jail can cause anxiety in and of itself. Having a way to release some of their mental struggles to Ressel presumably relieves pressure that can be otherwise released in angry outbursts toward other inmates or jailers. The sheriff said violent episodes in the jail have decreased.

Ressel said many inmates express fears of losing their employment and thus their living quarters when released. They often face homelessness, but also fear losing the support of family members, partners or spouses. Plus, they've lost their freedom and are housed among other offenders, some of whom may be violent or threatening. Ressel helps inmates work through those emotions and helps them understand what steps they need to take when they're released.

Inmates also have access to a counselor who comes to the Cape Girardeau County Jail twice a week. She said the mental health needs of the jail far exceed what that counselor provides. That counselor is made available to federal prisoners held at the jail (which is about 30), but Ressel's services are only available to local offenders.

Dickerson said Ressel's position came about through meetings and discussions surrounding Crisis Intervention Training, a relatively new alternative approach to policing. She said Lt. Ed Curtis, a co-chair of the CIT council, was instrumental in helping initiate the program, serving as a liaison with mental health organizations and the sheriff's department. CIT acknowledges mental health problems in many calls to police and meets those situations with de-escalation techniques when possible. Dickerson cited the proactive move by the Cape Girardeau Police Department adding social workers (also through a grant) to respond to certain calls where mental health situations may be involved. Dickerson acknowledged that by the time inmates get to the jail, it's too late for preventive measures, but having mental health resources available almost daily for inmates can help the culture inside the facility. She also said the department's jailers are getting CIT certified as well. Ultimately, she hopes that by providing counseling and substance abuse connections to inmates, the rates of recidivism will drop.

Ressel said safety hasn't been a problem for her. She said in previous jobs, she would meet people in crisis in their homes, and sit on their couches, even more physically vulnerable than she is in the jail. She's met desperate people in alleyways before. At the jail, she meets inmates in conference rooms with cameras, and she has ways to contact jailers while in meetings with the inmates. Generally, she said, the inmates are appreciative of an opportunity to talk to someone willing to listen.

"I like helping people," she said. "I want to give them the chance to help them change their lives."

In addition to having a master's degree as an education specialist in counseling, Ressel also has a bachelor's degree in criminal justice. In the coming weeks, she will also become a licensed counselor.

Dickerson said the mental health work that needs to be done at the jail outpaces what Ressel can provide alone. She hopes and anticipates that the program's success will justify more funding for additional staffers in the future.

Ressel reports to the not-for-profit Community Counseling Center, which is an administrative agent for the Missouri Department of Mental Health.

The CCC is responsible for the green lighting on the Mississippi River Bridge, to acknowledge May as Mental Health Awareness Month.