The SLO County Board of Supervisors voted unanimously on May 1 to allow the SLO County Jail to provide medication to inmates found mentally incompetent to stand trial, even if those inmates refuse the medication.

Jail officials believe that the measure will help prevent mentally ill inmates' conditions from worsening while they wait for transfer to state hospitals to restore their competency.

• File Photo By Jayson Mellom
• MEDICATION The SLO County Jail will now be able to give medication to some mentally ill inmates who have been found incompetent to stand trial, even if they refuse to take the

The new policy would still require a court to find that an inmate is mentally incompetent, meaning they are not capable of understanding or participating in their own defense, and are not capable of giving their informed consent to be medicated. In addition, the medications must be prescribed by a psychiatrist and administered by authorized medical personnel.

When an inmate is found incompetent to stand trial, they are supposed to be transferred to either the county's psychiatric unit or a state hospital, depending on their crime. But a lack of available beds at the state hospitals often leaves inmates waiting for months in the jail for a transfer. Prior to the board's vote, the SLO County Jail could not provide medication to inmates awaiting transfer who refused to take medication.

"Our hands have been tied in treating these patients because all we can do is wait for them to get a bed, and it's been taking a long time, and they deteriorate while they're in jail," SLO County Jail Chief Medical Officer Christy Mulkerin said.

Concerns over lengthy waits for inmates found incompetent to stand trial surfaced after the Jan. 22, 2017, death of Andrew Holland, a schizophrenic inmate who had been waiting for a transfer to the county's psychiatric unit for 12 days when he collapsed shortly after being strapped into a restraint chair for 46 hours. Holland's death lead to a $5 million settlement from the county and promises by both the Board of Supervisors and SLO County Sheriff Ian Parkinson to reform services and treatment for the mentally ill at the jail, which is currently under FBI investigation for possible civil rights violations.

While Mulkerin said the county's psychiatric facility has since been taking jail transfers "very quickly," the issues with transfers to state hospitals remains. A county staff report estimated that the jail typically houses between eight and 10 inmates awaiting transfer to a state hospital, with at least one currently waiting as long as 100 days.

Mulkerin said the board's vote is also a step toward implementing a program that would allow inmates to get treatment to restore them to competency within the SLO County Jail. In order for that program to work, the jail would need to provide treatment space and develop an agreement with the California Department of State Hospitals. Δ