Problem Solvers: 90% of Inmates Struggle with Addiction or Mental Illness, Officials Say

BEND, Ore. (KTVZ) — What used to be a place to hold people awaiting court has quietly transformed into something far more complex.

Inside the Deschutes County Jail, staff are now on the front lines of a growing behavioral health crisis, one that’s reshaping how the jail operates, who ends up behind bars, and what happens to them once they’re inside.

Officials say the numbers are staggering. “90% of our population is dealing with a mental illness, and a drug addiction or alcohol challenges,” said Captain Michael Gill, who has worked in the jail for nearly three decades.

That’s a dramatic shift from when he first started, when that number hovered closer to 20%.

For Captain Michael Gill, the changes inside the Deschutes County Jail didn’t happen overnight. But over three decades, they’ve become impossible to ignore.

A Different Kind of Inmate Population

The jail still books 5,000 to 7,000 inmates each year, but who those people are, and what they need, has changed dramatically.

Today, many inmates arrive in crisis.

They may be going through alcohol or drug withdrawal. Some are dealing with severe mental illness. Others are navigating both at once, a combination that makes care significantly more complex. “Those are very, very challenging populations to care for,” Gill said.

Even routine processes can become difficult. Some inmates can’t make it through booking. Others struggle to understand charges against them or communicate with their attorneys, keeping them in custody longer.

In many cases, they’re not facing serious crimes, often low-level offenses like trespassing or disorderly conduct, but their conditions make it harder to move through the system.

More Than a Jail

For staff, the job has evolved far beyond traditional corrections work.

Deputies now act as crisis responders, counselors, and medical first responders, sometimes all in the same shift. “One minute they’re mentoring someone, the next they’re responding to a fight, then a medical emergency,” Gill said.

He described deputies spending nearly an hour talking someone through the booking process, simply trying to get them stable enough to cooperate.

That kind of work adds strain, both operationally and emotionally. “It takes a unique person to work in this building,” Gill said. “It’s challenging work.”

Not Built for Treatment

Despite expanded services, officials on both sides agree: jail is not where people with serious mental illness should be.

“The jail is the absolute worst place a person with a mental health condition should be,” said Holly Harris, who leads Deschutes County’s behavioral health department.

The environment, isolated, controlled, and often stressful, can make symptoms worse. Even with behavioral health specialists, nurses, and medical beds, the facility isn’t designed for long-term treatment.

“It’s a jail cell,” Harris said. “It’s not a hospital. It’s not a treatment facility.”

A System Under Pressure

Harris says the rise in mental illness and addiction is driven by a combination of factors: stronger, more potent drugs, increased social and economic stress, and a growing population without enough resources to support it.

“We’re seeing more severity,” she said. “And more co-occurring conditions, mental health, substance use, trauma, all at once.”

At the same time, capacity hasn’t kept up.

For years, Deschutes County has lacked enough residential treatment beds, meaning people who need intensive care often can’t get it.

“We all know they should be in a residential facility,” Harris said. “There just isn’t one available.” That gap creates a cycle: untreated individuals deteriorate, interact more with law enforcement, and often end up in jail.

The Bottleneck Problem

Even once someone enters the criminal justice system, challenges continue.

Some inmates are too mentally ill to assist in their own defense, a legal requirement for moving forward in court. When that happens, they may need to be transferred to the Oregon State Hospital for treatment. But limited space there creates delays, leaving people stuck in jail longer.

“It becomes a hamster wheel,” Harris said. “There’s a piece of the system that’s broken.”

Searching for Solutions

Both jail officials and behavioral health leaders point to similar solutions, though none are simple.

More treatment beds. More mental health staff. More access to care earlier in the process.

Gill says the jail currently has just six medical beds out of more than 300, far short of what’s needed. “I do think we need more,” he said.

Harris emphasizes prevention, getting people help before they ever enter the system. That includes expanding crisis response teams and strengthening diversion programs, like the county’s stabilization center, where law enforcement can take people in crisis instead of jail.

“From the beginning, we’ve tried to prevent people from ending up in jail,” she said.

A Shift Toward Intervention

One of the most debated solutions is the idea of compelling treatment, allowing authorities to intervene when someone is too ill to make decisions for themselves.

Harris says it’s a delicate balance between protecting civil liberties and preventing harm. "There comes a point where not intervening is more harmful,” she said.

Without that intervention, many individuals cycle through emergency rooms, crisis services, and jail - repeatedly. “It’s incredibly disheartening,” she said. “And costly.”

The Human Toll

Inside the jail, those systemic gaps play out every day.

Staff are managing people in the most vulnerable moments of their lives, often without the tools or space to truly help them recover.

Gill says his team is committed to doing what they can. “We want to keep people safe. We want to treat them humanely,” he said.

But as the numbers grow, so does the pressure. What was once a jail has increasingly become something else, a last stop for a system struggling to keep up.