Crouched by the steel toilet, bundled in a blanket and clutching a trash can, he vomited and shivered through his most severe drug withdrawal in 20 years as an addict.
"I can't keep doing this," Isbell thought as he reflected on how he got to that point in 2015. He smoked weed in his teens before being diagnosed in his early 20s with bipolar disorder, depression, anxiety and ADHD. At 23, he was introduced to heroin — and finally, just days earlier, Isbell had forged a $650 check to buy more heroin.
He wanted to get clean. His girlfriend was pregnant with their first son. Isbell wanted to be there for the birth, but he would have to find his way to sobriety alone. For 17 days, he fought to kick heroin. But he didn't have access to Buprenorphine or any other medication to help with the withdrawal. He didn't receive counseling. He didn't have a recovery coach or the support of family and friends.
In short, Isbell was missing out on all of the things that are widely recognized as necessary for someone in recovery.
Just weeks after being released on bond paid by his parents, Isbell injected heroin again. And it wasn't long before he was back in jail.
Isbell's story illustrates just how ineffective revolving-door incarceration is for those driven to commit crimes due, in large part, to their addiction. It is an approach, an IndyStar investigation found, that has proven to be both costly and deadly in Indiana.
Since 2000, the state's jail population has grown by 60 percent, according to 2019 federal data — more than five times the state's overall population growth. But it's not like Indiana has been overrun by hardened criminals.
Indiana's jails are largely filled with people arrested on relatively minor charges and often related to drugs, mental illness, the inability to afford bail or a failure to follow rules of probation. They are complicated, sometimes overlapping issues, exacerbated by a drastic shortage of state psychiatric hospital beds and the transfer of thousands of state prisoners into already crowded local jails since 2014.
The rapid growth has led to overcrowding, which occurs once a jail begins surging past 80 percent of its capacity. The fallout is deadly.
IndyStar's yearslong "Death Sentence" investigation, which has identified more than 300 jail deaths since 2010, found that 69 percent of the deaths happened in facilities that were understaffed or overcrowded — two issues that go hand-in-hand.
But there are solutions: More community mental health funding. The reduction or elimination of cash bail. Expanded access to drug treatment. A less punitive approach to non-violent crimes and status violations, such as a missed court hearing or failed drug test.
They all come with a steep price. But none may be as high — or as misguided — as maintaining the status quo.
In Indiana, though, the default approach remains the same as it has always been: Building bigger jails, and slapping local taxpayers with the bills.
Without directions and support from the state, that's about all counties can do. And as a result, the cycle is flooding jails with Hoosiers struggling with addiction and mental illness. And taxpayers are shelling out more money than ever for new jails that are, in effect, monuments to the state's failure to address the widespread social issues driving the jail-crowding crisis.
New and planned jail construction in just the past eight years, IndyStar's investigation found, has affected more than a third of Indiana's counties and added up to a price tag of more than $1 billion.
"To me it's fool's gold to be building new jails, unless they just are so old or so lacking in the ability to meet basic health and safety standards," said State Rep. Matt Pierce, a Bloomington Democrat who serves on the House Courts and Criminal Code committee.
"Imagine if those billions of dollars were going into constructing facilities that provided mental health and addiction treatment. I'm pretty certain that you would have a much better outcome and lower crime."
How Lawmakers Drove Jail Overcrowding
Ask just about any Indiana sheriff about their crowded jails and they will point to the same major policy decisions, made by the state Legislature in 2014 and 2015, as the underlying cause.
That's when state lawmakers, pledging to pursue criminal justice reform, started transferring some Indiana Department of Correction prisoners to local county jails. Under the new law, nearly every person convicted of a Level 6 felony — the lowest level — whose sentence is less than a year must serve it in a county jail.
The law is so infamous among sheriffs and other county officials that it's been shorthanded. (Simply "ten-oh-six," short for House Enrolled Act 1006.)
Jails, which were originally built to briefly hold people accused of a crime before their trial, were forced to accept a new role. With 1006, they became small prisons — and took on the challenges of the new prisoners.
Carroll County Sheriff Tobe Leazenby runs one of the smallest jails, which has a capacity for 34 people.
"Prior to 1006, we kept it well below that 34 mark," Leazenby said. "Post-1006 was where we started seeing the 75 and 80 numbers."
The Carroll County Jail has been overcrowded every year since 2011, according to state jail inspections. The worst year was 2018, when the jail was at 158 percent capacity. But even in 2020, when arrests were down nationally because of Covid-19 protocols, the jail stayed above 100 percent capacity. That's even as Leazenby sent people to other jails that had room.
Last year, 10 of 37 people held in that jail on the day of state inspection were convicted of Level 6 felonies. Prior to 1006, they would have been in a state prison. Instead, they took up 27 percent of the jail's capacity.
The trend extends to many other jails, according to an IndyStar analysis of state jail inspections between 2018-20. During that three-year period, IndyStar found, the addition of state prisoners exacerbated already overcrowded jail conditions 54 percent of the time. And jails in 31 counties were pushed into overcrowded status because of the state's additions.
Other Drivers of Overcrowding
To better understand the intent behind HEA 1006, IndyStar requested an interview with State Rep. Greg Steuerwald, the Avon Republican who authored the bill and who is regarded as one of the most in-the-know lawmakers on matters that affect county sheriffs. Steuerwald did not respond to multiple requests through a spokeswoman.
But one of his Democratic colleagues — who also sits on the House Courts and Criminal Code Committee — did. Rep. Pierce told IndyStar that 1006 has basically become everybody's favorite bogeyman when discussing overcrowding in jails.
The reality, he said, is more complicated.
In short, lawmakers saw the transfer of state prisoners into county jails as one part of a larger reform package. Pierce said research shows that people convicted of those low-level felonies would be better served receiving treatment and other services in their home communities, outside of incarceration.
Yet as long as local judges could sentence them to state prisons, they would continue to do so. Keeping people in their home counties meant that local officials would be responsible for their diversion from incarceration or for other rehabilitation programs.
"We wanted to provide the incentive or force them to have to buy in to these programs in the local level," Pierce said.
Still, Pierce said he does not blame sheriffs for feeling frustrated by the overcrowded cells they see every day. Lawmakers have failed, he said, to provide adequate funding to help the counties.
"We've just kind of pawned the problems of addiction and mental health onto them. And we've not given them the resources or the tools to deal with it," Pierce said. "The legislature definitely bears some responsibility for not having gotten the resources that the local counties need to provide mental health and drug treatment services."
Those resources, or tools, would help sheriffs deal with some of the other major contributors of overcrowding.
After the closure of state psychiatric hospitals, jails have become the state's de facto mental health institutions. That means sheriffs — who say that 80 percent of their jail populations have a substance use or other mental health issue — are now serving as mental health providers. Yet they say they are severely under-equipped and undertrained for this task.
Mental health experts and providers who work in Indiana jails suggested that if more addicts and mental illness patients were moved out of jails and into work release facilities, recovery centers and psychiatric hospitals, the jail overcrowding crisis could be mitigated, if not solved.
Other causes of jail crowding are tied to Indiana's acceptance of an increasingly punitive criminal justice system.
Most people in Indiana's jails are being held on low-level, non-violent crimes prior to their court dates. They just can't afford to post bail.
In Carroll County, for example, four of the top five bookings in 2020 were drunken driving, possession of marijuana, possession of paraphernalia and possession of methamphetamine, according to the sheriff's annual report. It's a similar story in most jails.
Indiana's heavy reliance on cash bail also contributes to jail overcrowding, according Larry Landis, former executive director of the Indiana Public Defenders Council. There is little evidence, he said, that the requirement to post bond for a low-level offense has any impact on whether a person shows up for court.
The Brennan Center for Justice, a nonpartisan law and policy institute, said a change away from cash bail in Philadelphia freed more than 1,700 people. An assessment, the center said, "found no negative impact on recidivism or courtroom appearance rates."
Cash bail remains so pervasive in Indiana, Landis said, largely because of the political influence of bail bondsmen and the concerns of some judges.
"Judges are afraid to abolish money bail," Landis said. "Because the one thing they fear is they're going to release somebody, they get out and they commit a high-profile crime, and it's on the judges' back."
Probation violations are also driving overcrowding.
More than 4,200 people were held in Indiana jails on probation violations as of 2019, according to federal data, amounting to almost 21 percent of the state's jail population. Indiana's high percentage trailed only four other states.
In Allen County, for example, about 200 people held in the jail at any given time are there because they violated probation, Sheriff David Gladieux said. The jail is chronically overcrowded and understaffed.
Beth Huebner, a criminal justice professor at the University of Missouri-St. Louis, has been researching jail populations in St. Louis County. Her research shows: People held on probation violations also tend to stay in jail longer than the rest of the jail population.
That clogs valuable bed space in a facility that desperately needs people to go as quickly as they come.
Typically, violations come in the form of people who failed a drug screening or did not check in with an officer when they were supposed to. Or maybe they failed in their recovery, so they didn't bother showing up because they knew they were going to fail a drug test.
Then the justice system really shows its teeth.
"When you talk to judges and other court personnel, oftentimes once someone violates probation, they are given that one chance," Huebner said, "then often people are more harsh because they've given them that one chance."
Indiana's $1 Billion Problem
Across the state, most county officials are following the old path of building bigger jails that amount to what people in the corrections industry classify as "warehouses" to lock up more people.
Absent stronger support for alternatives from state leadership, it is the easiest way to deal with growing jail populations. Yet most of these new jails will do little to address the sources of overcrowding.
In fact, they do not appear to do much of anything at all except hold more people prisoner.
At least 25 counties, IndyStar found, have built or are building jails that do not appear to include any significant space for mental health or addiction programming.
Fulton County, which has a population of just over 20,000, built a new jail for $23 million that added 218 beds, more than doubling its capacity. Tipton County went even further, tripling its capacity in a new jail completed in 2019.
Clay County plans to spend an estimated $20 million to add more than 200 beds, primarily to house more Immigration and Customs Enforcement detainees.
In DeKalb County, the commissioners were so desperate for more bed space that they flirted with sacrificing almost all of their work release and community corrections beds. Eventually, the commissioners settled on a $30 million jail that is set to include a cell block about twice as big as the old one.
Commissioner Bill Hartman, who told IndyStar he believes that being "soft on crime" does not work, said the county has "nothing in the works" to provide mental health or drug addiction programming in the new jail. He said a multi-purpose room could accommodate such programs, though.
Building a bigger jail without considering alternatives to incarceration is a mistake, said Kenneth Ray, a former law enforcement officer who now serves as a jail consultant for many Indiana counties. He said the approach could create a trap for counties that perpetuates the status quo.
"There is no urgency or necessary inclination to develop your community support systems as a means for helping reduce the jail population," Ray said. "If you got the beds, you just use them."
Vigo County was confronted with the dilemma of how to move forward in 2018, when a federal judge decided the county jail was so crowded that it failed to meet constitutional standards. The judge ordered county officials to fix the problem.
The county enlisted Ray's help as a jail consultant. He initially recommended a jail with fewer beds, which would allow the county to invest in alternatives to incarceration that tackle the fundamental causes of crime.
Vigo County did not heed that advice.
Instead, the county opted to build a massive, 505-bed jail that will rival those in counties with double and triple their populations, such as Tippecanoe and Hamilton counties.
The new jail, paid for by a local income tax hike, is projected to provide enough cells to meet the county's growing lockup needs through 2042.
But it does nothing to address the revolving-door issues that ensnare many of the same people year after year.
Mental Health and Drug Treatment
Not every county is following the Hoosier playbook.
A few are trying promising methods to reduce crowding through approaches local officials believe are more humane and holistic, such as providing therapy, peer coaching and medicine to people who are addicted to heroin, pills or methamphetamine. In the long run, the methods also may be more cost effective.
Those counties, though, face an uphill battle. It's one thing to take out a loan to build a bigger jail. It's much harder to scrape together enough money, expertise and community support to treat the problems at their root — person by person, day by day.
To understand the financial challenges, look no further than Boone County. Whereas some Indiana sheriffs do not allow for any mental health treatment inside their jails, Boone County Sheriff Mike Nielsen is taking a different approach.
He provides 182 hours of treatment per week.
The first 30 are what he characterizes as institutional care. They are, more or less, the standard treatment you'd find in a typical Indiana jail, such as hiring a social worker to determine whether someone needs to be monitored on suicide watch. These hours are paid by the county to a private medical contractor.
The other 152 hours, though, are tied to several forms of treatment that are uncommon in Indiana jails. Initial contact with peers who can walk them through what to expect in jail, and how to get help. Individual therapy for people entering jail with significant trauma or severe mental illness. Buprenorphine to help people medically transition away from opioid abuse.
The company who provides all of this treatment? It gets about $6,000 each month in grants.
And the company says it's not enough.
"We are losing money. So we are really taking a hard look at everything," said Lynette Clark, director of Integrative Wellness, the mental health provider. "We love the program, but it's hard with the high cost to us."
Clark did not provide an exact figure that accounted for all of the costs, but Nielsen said he has been trying to piece together more grant funding to pay for treatment.
"We've been through fire and back trying to find funding," Nielsen said.
But Nielsen told IndyStar there's no way the county can afford to shoulder the costs alone.
Now he's worried: Is there enough grant funding in the state? And will it always be available for sheriffs like Nielsen?
For example, Boone County is one of 27 counties that relies on federal funding distributed through the Indiana Sheriffs' Association to fund medicated assisted treatment, which uses medicine like Suboxone to treat opioid dependence.
The grant runs through June 30. Steve Luce, executive director of the sheriffs' association, said he's hopeful that Gov. Eric Holcomb will renew the grant when the time comes.
Such treatment, while expensive, is viewed as a key way to reduce Indiana's jail crowding problem. The sooner a person begins receiving treatment for an opioid addiction, Luce said, the sooner they can enter the road to recovery. Then people who are in recovery are less likely to enter jail again for a drug-related crime, thus reducing overcrowding.
"But man, if we don't have those things in this place," Luce said, "it's just jail overcrowding and a revolving door."
IndyStar requested an interview to discuss jails with Gov. Holcomb, but he declined that request through a spokeswoman.
IndyStar also requested an interview with Douglas Huntsinger, a Holcomb appointee who works as the state's executive director for drug prevention and treatment. Huntsinger, too, declined an interview request through a spokeswoman.
Indiana Department of Correction Commissioner Rob Carter, another Holcomb appointee, also has declined IndyStar's requests for an interview.
While Sheriff Nielsen acknowledges it's expensive to provide 182 hours of treatment, he said it's more costly to do nothing.
The group of people who were given buprenorphine since April 2020, Nielsen said, are showing a 17 percent recidivism rate. For others, he said, it's typically 48 percent.
He recognizes he's citing short-term data, but they are exactly the results he had hoped to see to begin reducing jail crowding. And he's so confident in them that he's pushed county leaders to reconsider their visions for a new jail.
The original plan called for adding 301 new beds, which would have been a 140 percent jump. But the new plan, Nielsen said, would add just 202 beds — enough to handle the kind of population growth you'd expect in a growing community close to Indianapolis — with 70 of those beds specifically tied to community corrections and work release.
But the new plan would also include more rooms for individual and group therapy. Right now, a lack of space has artificially capped the number of people in jail who can attend therapy.
It would also include classroom space for skills classes, such as how to do laundry or open a checking account.
The county is hedging its bets, at least a little. The buildout would include a shell that could hold 48 beds down the road, if needed. Nielsen, though, wants to use the space for more classes on automotive design, welding or other trade skills.
"I mean, those are the things that are going to change people's lives," Nielsen said. "They're going to have a skill when they leave here, when they leave community corrections, that they can go somewhere and make some pretty good money."
A Different Approach
Two years ago, leaders in Tippecanoe County were faced with a difficult choice. A comprehensive study had presented two very different options: Should they follow in the tried-and-tested path of building a new jail at a cost of $35 million? Or should they invest in alternatives to incarceration?
They chose the latter. Instead of building a new jail, they decided to expand the community corrections center for $8 million, as well as expand the administrative building of the current jail for another $8 million. This will free up room in the current jail for life skills classes, job courses and peer recovery programs.
"There is a cycle between generations of substance abuse and subsequent interactions with the criminal justice system," Tippecanoe County Commissioner Tom Murtaugh said. "And we want to break that trend, break that cycle, and see if we can get help to these folks."
Tippecanoe County Sheriff Robert Goldsmith put it in perspective: "If you build a bigger jail, you fill it."
Unlike jails, community corrections programs pay for themselves, said Jason Huber, who runs the county's community corrections program. As much as 73 percent of its operating budget comes from participants. Some work by day and return to the work release center by night; others serve home detention or check in each day. Those with jobs pay a daily fee that is equal to one hour's wage plus a dollar.
But beyond the economics, a rehabilitative and "compassion-based approach" has another benefit: It reduces the likelihood a person will commit another crime and return to jail, Huber said.
There is modest evidence for the success of such therapy programs: Tippecanoe County Jail is one of 29 in Indiana offering the Q360 program, which began in 2020 and is run by a nonprofit group associated with the private medical provider, Quality Correctional Care.
Program participants attend group therapy and Moral Recognition Theory classes, where they discuss how their life choices have affected them and learn to distinguish behaviors that encourage recovery or relapse.
Alexandra Schroll, a counselor, said the therapeutic approach to treating people involved in the criminal justice system comes with its challenges. One of her clients recently escaped the corrections center. He had been doing well in therapy, she said. She does not know if he's been found.
Schroll and co-counselor Norman Henry are not lying to themselves. They know there are risks that come with treating people who have criminal behaviors that are triggered or caused by mental health and addiction. They know not everyone will understand why we should spend money on people labeled as criminals. But they also know, despite all the challenges, this approach is better than locking someone away in a cell.
"Punishment is easy," Henry said. "Changing lives is hard."
Still, early results look promising, according to Dr. Michael Person, who oversees the program as Quality Correctional Care's chief medical officer. In the first year, he said, 70 percent of the participants have not returned to jail for any substance abuse charges or violations.
"We may look back in 10 years and see that we failed," Sheriff Goldsmith said. "If in 10 years, these 17 people didn't come back to jail, we actually succeeded."
'It Is Saving My Life'
Isbell, the man who had struggled with addiction for two decades, started using drugs again in 2015 after being released from the Tippecanoe County Jail.
Just months later, his friend, Joseph McClimans, died in the same jail from a blocked artery. They had done drugs together. Like Isbell, McClimans had been booked on a theft charge.
Isbell was haunted by how his life could have ended like his friend's — yet it wasn't enough to make him stop using drugs. That led to another arrest in 2018.
This time, he was sentenced to two and a half years in prison. He tried and failed to complete a recovery program. But he did get clean, with the support of a longtime friend who was in prison with him.
Still, when he was released from the Miami Correctional Facility in Bunker Hill in March, Isbell was terrified. Every other time he had been released before, he would go back to using drugs.
"But I had it in my mind: 'I'll do this,'" he said. "I'll do whatever it takes to stay clean."
He learned about an addiction recovery class at the Tippecanoe County community corrections center and voluntarily enrolled. Three times a week, Isbell worked with two recovery teachers to identify the grief and other emotions he had tried to mask with drug use.
With time and help, he healed.
"The guilt, shame and embarrassment I felt at how I was living my life — the heroin would cover up those feelings," Isbell said. "That's what community corrections is about now. ... It is saving my life."
It makes a huge difference, Isbell said, to finally realize someone is on his team. But that's not all it took.
Recovery was almost impossible in jail, Isbell said, between the contraband and the peer pressure. His fellow inmates would talk about drugs over card games. They would brag about "the fast life" and "who had the best drugs."
After being released from prison and undergoing the recovery program, he made a conscious choice to cut ties with people he'd used drugs with, wiping them from his phone contacts.
He got a full-time job in construction and a second one in meat packing to pay the bills over the winter. He met someone new who keeps him on track. They moved in together and adopted a puppy and two cats. When he feels the urge to use, he busies himself by sawing down old tree branches and building fires in his backyard.
He is on Suboxone, a medicine to treat opioid dependence, and plans to wean off it in the new year. He goes to therapy every week.
The only time Isbell has slipped up in the past eight months, he said, was when he took a puff of a joint at a backyard bonfire. When he realized his mistake, he broke down sobbing.
"It was the (expletive) stupidest thing I've done," he said.
Crying, he called his probation officer and counselor. Isbell told on himself, fully expecting he might be sent back to jail.
In most Indiana counties, he might have been.
But in Tippecanoe County, where leaders are taking a chance on a new approach to avoid jail overcrowding, it's understood that recovery sometimes comes with a few slip-ups along the way.
"They said, 'You're doing something nobody ever does," Isbell recalled. "'That's a step in the right direction. You got ahold of us, we're very proud of you.' They didn't violate me or do anything. It felt so empowering to admit I had messed up and be OK."
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