From LA jail, two inmates pioneer care for mentally ill peers

With more than 5,000 inmates struggling with mental health issues, the Los Angeles County jail is the largest jail system in the United States. It also holds another unofficial title: the nation’s largest mental health institution. That jail population has more than doubled in the past 10 years, with the imposing Twin Towers facility for men in downtown Los Angeles now devoted almost entirely to mental health inmates under “moderate” or “high” observation.

The men in high observation – numbering about 1,000 – reside in Tower 1.

When they are not in their cells, they are handcuffed to metal tables so they can’t harm themselves or others, and many are dressed in quilted robes to prevent self-harm. They live in pods of 16 cells that are often noisy and foul-smelling. As Joan Hubbell, the mental health programming manager for county correctional health services, admits, staff can’t keep up. Indeed, the jail operates under Department of Justice monitors to meet criteria for the treatment of mental-health inmates.

But three pods on the fourth floor hold out