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HAMILTON — Jeffrey Knight is one of more than 1,200 Butler County jail inmates — about 10 percent of prisoners — to receive mental health treatment at the jail in the past year.

The thick steel doors and cinder blocks don't make it an ideal place for treatment. However, after multiple stays in a psychiatric ward, years of drug abuse, and his second offense, Knight said the jail is the best place he has found for treatment.

Community Behavioral Health Medical Director Dr. Kenneth Tepe visits the jail every Thursday morning and he has Knight stabilized on Seroquel for his bipolar disorder.

"If I met him in '99, I probably wouldn't have went through all I went through already," said Hamilton resident Knight, 24. "Now, I just wake up everyday with a drive that I want to accomplish something."

The Butler County Jail has become one of the largest mental health treatment facilities in the county, treating prisoners for suicidal threats, anxiety and other issues.

"Sadly, jails are becoming major mental health providers, I think, because of our lack of ability to serve people in the community in a timely manner," said Terry Royer, executive director of the Butler County Mental Health Board, which funds mental health treatment in the jail on Hanover Street.

Cuts to mental health agencies have shrunk the number of people the board can serve. Cuts also have stretched the wait time for an appointment from two to four months.

Many who fall through the cracks land in the jail, where it costs taxpayers up to $30,000 to house one inmate a year, said Richard Jones, Butler County sheriff.

The mental health board seeks to pass a 1-mill levy Nov. 7 to generate $7.5 million annually to save existing services, such as mental health treatment in the jail, and to restore the level of treatment that was available before $3 million in cuts were made over the last five years.

"With this issue failing, it's going to make it more critical," Jones said. "Without the resources in the community, there's going to be less treatment and less follow-up. I feel our intake is going to increase.

"They are going to have to go somewhere, and that's probably going to be my jail, but the jail is not meant to be a mental health treatment facility."

Even in jail, Knight has overcome the odds. He's gone from spending most of his time in the "hole" for aggression, to a complete turnaround on medication, the medical staff said.

Today, he's awaiting judicial approval for entry to the SAMI diversion program for substance-abusing mentally ill offenders. Through that program he'll receive monitoring and support services after his release.

"With people like Jeff, we have a chance to do really life-changing, life-saving work," Tepe said.

Many are not so fortunate. Tepe said 70 percent of the jail population has a diagnosable mental illness, and 75 percent of those have a substance abuse problem because they tend to self-medicate.

Therefore, some go unserved and are released from jail without an appointment, a prescription or even disability benefits because those are suspended while in jail, said Susan Holzberger, a licensed social worker in the jail.

"The problem is when they leave," Holzberger said. "The waiting lists are outrageous. By the time they get on a list to see the doctor, its been three months. They've stopped taking the medicine because there's nowhere to get the medicine."

Contact this reporter at (513) 820-2175 or cbrooks@coxohio.com.