Here's what LA county is doing—and not doing—to move people with mental illness out of jail

This story was originally published in The Appeal with support from the 2022 Data Fellowship.

This piece is part of a series of stories on the increasing number of people with mental illness imprisoned in Los Angeles County jails. To read the others, click here.

In recent years, Los Angeles County has voted to close one of its largest jails and invested in alternatives to incarceration, including diverting people with mental health needs out of jail and into treatment. The county is well aware of the problems inside its jails, yet conditions in the jails remain an ongoing crisis and the number of people with mental illnesses inside the jails has surged.

Advocates, mental health professionals, and attorneys who spoke with The Appeal said they were frustrated at the lack of progress and questioned the county’s commitment to change.

“We know the solutions,” said Brian Kaneda, deputy director of Californians United for a Responsible Budget, an advocacy organization pushing the state to move prison funding to social services. “The solution to homelessness is permanent supportive housing. We know harm reduction strategies must be fully embraced and implemented to address substance use disorders. We know we must build out a community-based care system capable of supporting the needs of LA County residents. And we know you can’t get well in a jail cell.”

In an effort to provide clarity on the county’s various commitments over the years to improve jail conditions and reduce the number of people the county incarcerates, The Appeal put together a guide highlighting some of the county’s initiatives—and noting how they have or haven’t been implemented.

Mandates From the Department of Justice

In 2015, the Department of Justice (DOJ) put the Los Angeles jail system under a legal settlement intended to address inadequate mental health care and excessive force by guards inside the jails. The agreement requires the county to implement a variety of reforms under the supervision of the DOJ and submit to independent monitoring.

The most recent report from the person overseeing the DOJ reforms stated that the county has successfully implemented some of the required reforms, but it has failed to implement others.

The county is required to provide people incarcerated in the jail system’s high-observation housing with 10 hours of out-of-cell time per week and 10 hours of therapeutic programming per week. High-observation housing is reserved for people who are considered so significantly mentally ill that they must be checked on every 15 minutes and are given suicide-resistant blankets and gowns. The monitor stated in September 2022 that the county was not providing meaningful group therapy and that people were not getting required out-of-cell time.

In February, the county asked to push deadlines for meeting these requirements to 2026. A federal judge has not yet decided whether to grant that request.

In a statement previously shared with The Appeal, spokespeople for Los Angeles County said that officials are committed to reducing the jail population, improving conditions inside the jails, and providing a higher quality of care for incarcerated people.

The Office of Diversion and Reentry

Los Angeles County created an Office of Diversion and Reentry (ODR) in 2015 to keep people with mental and physical health needs out of the county’s jails. One of ODR’s programs connects pretrial defendants who are experiencing homelessness and mental illness with permanent supportive housing, case management services, and treatment. Other programs move people who have been found incompetent to stand trial out of jail and into community-based care, which can include acute inpatient treatment or open residential services.

In October of last year, ODR said it has diverted more than 8,500 people from jail since 2015. Community members who spoke with The Appeal said ODR has been extremely successful, but diversion needs to be expanded. Despite this success, the average daily number of people with mental illness incarcerated in county jails has increased significantly—from more than 3,700 in 2015 to nearly 5,700 in 2022.

The office’s housing program filled to its maximum capacity of 2,200 beds in 2021. Since then, the county agreed to fund an additional 750 beds—significantly less than the 3,700 beds the county itself said it needs in order to comply with DOJ mandates.

“ODR has yet to be funded at the rate of the issue,” said Megan Castillo, a manager of policy and advocacy with La Defensa, an intersectional feminist organization pushing the county to divert funding from prisons to social services. Castillo is also a coalition coordinator with the Re-Imagine L.A. Coalition, which in 2020 helped pass a measure to reallocate money from jails and prisons to community-based care and alternatives to incarceration.

“We’ve been pushing for full funding so they can scale up the permanent supportive housing programs,” Castillo said. “The county refuses to do so.” She added: “Rather than address the root causes, they’d rather turn a blind eye and disappear people from their communities.”

A spokesperson for Los Angeles County previously told The Appeal the county has invested significant resources in ODR and increased the office’s budget by nearly $110 million last year.

Alternatives to Incarceration

In an attempt to reduce its reliance on jails, the county adopted a “care first, jail last” approach to public safety in 2019. That year, the county established the Alternatives to Incarceration Work Group, which was tasked with brainstorming ways to reduce the county’s reliance on the criminal legal system. In 2020, the group published a report with 114 recommendations.

That report recommended that the county expand community-based care—such as violence prevention efforts, family reunification services, safe consumption sites, and supportive housing—to reduce the number of people who come into contact with the criminal legal system. The group also recommended that the county send behavioral health responders to people experiencing mental health crises, substance use disorders, or homelessness. Those experts would connect people with the care they need, rather than arresting or imprisoning them.

To assist people who do end up being arrested, the report recommended that the county institute meaningful pretrial release and diversion services. According to a 2022 report from the sheriff’s department, almost half of all people incarcerated in Los Angeles County jails are held pretrial. The report also recommended diverting more people from jail and into treatment programs, reevaluating the county’s release program for people with medical needs, and identifying alternative forms of community supervision that may not rely on the probation department.

In 2020, the county established an Alternatives to Incarceration Office (ATI) to carry out its “care first, jail last” plans. According to ATI’s first impact report from 2021, the county made significant investments in youth development, including in mentoring, housing, and job services. The county is also using the national 988 hotline to connect residents with non-police help for behavioral health emergencies.

In a written statement shared with The Appeal, the county stated that since the Work Group report was submitted in March 2020, the Board of Supervisors has passed a motion to create the the ATI office, “adopted ATI’s five overarching strategies, and directed the CEO to hire an executive to lead this work.”

The ATI office has since been tasked with analyzing the 114 recommendations from the Work Group report and assessing how—or if—the recommendations could be implemented.

According to the county, ATI determined 43 of the Work Group’s recommendations were currently feasible, 56 were partially feasible, and 15 were not feasible.

“Three years after the LA County Board of Supervisors adopted ATI, most of the work group’s recommendations have yet to be fully implemented,” said Kaneda. “This lack of progress has hindered the County’s care first agenda and contributed to the ongoing failures to close Men’s Central Jail.

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People raising hands

Megan Castillo with hands raised in the air alongside other Black Lives Matter activists in May 2020.

La Defensa

Measure J

In 2020, Los Angeles County voters passed Measure J, a ballot initiative requiring the county to invest 10 percent of its unrestricted revenues—estimated in November 2020 to be between $360 million and $900 million—in community-based care. That can include housing, career programs, and health services. The measure also prohibited those funds from being used for jails, prisons, and policing.

But in the years since, that funding stream has been gutted.

In 2021, a county judge ruled that Measure J was unconstitutional because it limited the county’s budget-setting abilities. But there is nothing preventing the county from simply choosing to reallocate its resources on its own. So far, the county has allocated nearly $300 million to programs that Measure J was meant to fund.

To replace Measure J, the county created a Care First Community Investment (CFCI) Budget Policy and advisory committee. The policy sets aside 10 percent of locally generated unrestricted revenues from the general fund annually for alternatives to incarceration. In a September press release, the county said it had apportioned a total of $287.7 million to CFCI initiatives in 2021 and 2022, with plans to allocate more in 2023. Additionally, the county said it allocated $300 million from the federal American Rescue Plan COVID relief program to numerous community based care programs, including $87.7 million directly invested through CFCI.

But community members say they are frustrated the county has not embraced the spirit of Measure J more fully.

“We thought we were going to receive upwards of $900 million to fund these programs,” Castillo said. “The county continues to pass this status quo budget that prioritizes funding law enforcement over what our communities need.”

Los Angeles County’s most recent adopted budget was $44.6 billion. The county allocated more than $3.6 billion to the sheriff’s department—about 8 percent of the entire budget.

In March of last year, the county also created a new department—the Justice, Care, and Opportunities Department (JCOD)—to “centralize the administration of non-clinical services and programs for those who are justice impacted or vulnerable to justice system involvement,” the county said in an email. JCOD began operating in November 2022.

Closing Men’s Central Jail

In June 2021, the county’s board of supervisors voted to close the decrepit and overcrowded Men’s Central Jail (MCJ). The county formed the Jail Closure Implementation Team to develop a plan for how to do so.

The county says closing MCJ requires cutting the total jail population in half—from around 14,000 to 7,160 people. Since the motion to close the jail passed, the county has reduced the total jail population by only about 800 people.

In 2020, the number of people incarcerated in Los Angeles county jails decreased due to multiple factors. But since then, that number has climbed back up, in part because a local judge last year terminated the county’s Emergency Bail Schedule, which set most bail amounts to $0 in order to limit the spread of COVD-19 in jails.

“Since the ending of the Emergency Bail Schedule, the County’s in-custody jail population has increased significantly,” the county said in an email to The Appeal. “Decisions to release individuals from custody (while cases are pending, or as an alternative to serving an entire sentence in jail) to community-based treatment are not made by the County, but by judges, prosecutors and, in some cases, the Sheriff.”

For judges to send people to treatment instead of jail, programs must have space to accept new people. One of the county’s biggest diversion efforts, ODR, reached its capacity in 2021, limiting the number of people judges could send to treatment instead of jail. In 2022, the county increased ODR’s budget and raised its capacity by 750 beds. The county has previously found that it needs at least 3,600 mental health treatment beds to close MCJ. In a statement, the county said it is in the process of building up a robust network of community care to provide alternatives to incarceration.

Mark-Anthony Clayton-Johnson, the executive director of Dignity and Power Now, an organization that supports incarcerated people and their loved ones, told The Appeal that he was frustrated that numerous county agencies submitted a plan to close the jail in 2021, but little action has been taken since.

“We have a commitment from the Board of Supervisors to close our largest jail, Men’s Central Jail, and there’s just been a lack of committing to a timeline to actually get it done,” he said. “There was a plan that was proposed to the Board of Supervisors by county entities, stating that we need $237 million to fund community treatment beds to get enough people out to close MCJ. And that hasn’t happened.”

This story was produced in collaboration with the USC Annenberg Center for Health Journalism.