Rational Psychiatric Care of Jail Inmates: It Happened in Monterey

This column describes a civil rights lawsuit over the conditions in the Monterey County, California, jail that resulted in a court order to make substantial reforms. The remarkable feature of the case was the parties’ willingness to use neutral experts to assess the facility’s deficiencies in general medical and mental health care, safety, and disability access. The authors outline areas in which the 2015 settlement affects matters such as drug abuse and withdrawal screening, suicide assessment, continuation of medications, and psychic harm caused by isolation. The elements of the court order could serve as a template for improvements in other jurisdictions.