EDITOR’S NOTE: This is part 1 of a 2-part series on mental health services in the Mahoning County justice system.

YOUNGSTOWN — A great deal of conversation about Mahoning County’s justice system in recent months has focused on its role in providing mental health services.

On Thursday, legal experts and mental health professionals from across the county and state met on a three-and-a-half-hour Zoom call to discuss what is being done and what can and should be done better.

Led by retired Ohio Supreme Court Justice Evelyn Stratton, director of The Ohio Project — a subsidiary of the national Stepping Up program — county and municipal judges joined Sheriff Jerry Greene, Mental Health and Recovery Board Executive Director Duane Piccirilli, state agency leaders, educators and nonprofit organization representatives to assess the mental health and addiction recovery services being provided to those who end up in court or in jail.

Perhaps the most profound issue is the Mahoning County jail remains the county’s de facto mental health hospital. Greene said his office has made a lot of progress since his career began in 1991, but he knows how far Mahoning County and Ohio still have to go.

“You just wanted them out or wanted to have them sent to a penitentiary. Well, the root problem there is they are not going away, addiction is not going away, mental health is not going away, and it’s a revolving door in and out of our facility,” he said. “Obviously, we’ve grown in our maturity with what we know about how you have to tackle these situations, and over the years we’ve put together things to help treat them.”

Greene said the jail houses 127 inmates who are on some form of psychotropic medication.

“Most of those people are OK, they deserve to be in jail, and they can make good decisions. It’s the smaller percentage of those individuals within our facility that have absolutely no business being in jail and it’s just wrong, but there’s nowhere for them to go,” he said. “Of those 127 mental health patients, among them is a small number that don’t need to be here at all…Those few, those five or 10, 15, those are the individuals that tie up all of our time…. Sometimes, we finally get a bed for them and they are too rough for that hospital to handle them and they come back to jail.”

Greene said the county and his office have made progress in finding mental health professionals to address some of the issues. When Greene started, the jail had one full-time psychiatrist that would visit in person or via Zoom once a week, with a backlog of 30 to 60 days, and two part-time counselors. Now the jail keeps three full-time professionals on staff, and deputies and corrections officers regularly undergo training to better manage inmates with mental health challenges.

The county also will invest in hiring a forensic mental health navigator. The Ohio Department of Behavioral Health is funding the position as part of a program that emerged from the Competency Restoration and Diversion Work Group that Gov. Mike DeWine had the department assemble two years ago.

These professionals largely help to move high-need individuals to Ohio’s regional psychiatric hospitals, which are most commonly used for competency restoration. They also partner with jails to provide support and necessary external resources to individuals while they remain in jail throughout the referral and transition process, and to keep the courts updated on their progress.

There are six regional psychiatric hospitals across the state. Mahoning County is served by Northcoast Behavioral Care, based in Cuyahoga County, which operates eight facilities in Cuyahoga and Lake counties.

Programs like the Navigator Grant Program and Stepping Up/The Ohio Project give Greene and other county officials hope.

“The best way to do this is for everybody to collaborate and know what your resources are,” Greene said. “Because, many times, there are resources that are just undiscovered, we don’t even know are out there, and hopefully this will open some eyes for all of us here.”

The problem is not lost on either state or local officials. Locally, county, municipal and juvenile courts all operate special dockets to try to intercept troubled residents before they become part of the criminal justice system, or at least try to minimize its impact on their recovery and get them the help they need most.

And Christopher Nicastro, Deputy Director for Criminal Justice and Recovery Services at the Ohio Department of Behavioral Health, said the department runs a specialized docket subsidy program that provides $11 million in support annually for 225 specialized dockets in 64 counties. Statewide, Ohio has 104 drug courts, 42 mental health courts, 31 family drug courts, 24 veteran courts and 24 human trafficking, OVI, reentry and domestic violence courts. These specialized dockets serve 8,000 Ohioans annually.

In Mahoning County, the DBH provides funding for seven of the county’s eight specialized dockets. It also offers addiction treatment program special docket support worth $5 million for 154 specialized dockets in 65 counties, serving more than 6,400 Ohioans annually.

Thursday’s Zoom call gave considerable time to several of Mahoning County’s judges to speak about the programs they run to help citizens with extreme mental health and addiction challenges. These programs help everyone from children to veterans and victims of human trafficking.

Read part 2 of this story in Wednesday’s newspaper.