POPLAR, Mont. — When Maria Vega was a senior in high school in 2015, she found the body of one of her closest friends, who had died by suicide. A few days later, devastated by the loss, Vega tried to take her own life.
Harvard University political scientist Daniel Carpenter, the project’s leader.
In May, the group presented a plan to the Fort Peck Tribal Council, which has yet to act on its recommendations. A spokesperson for the Fort Peck Tribes said the tribes are looking into the policy but declined to comment further.
Yet tribal leaders say that unless they can attract mental health workers to remote northeastern Montana, the jailings will likely continue. “We can propose all we want,” said Jestin Dupree, a tribal legislator and chairman of the law and justice committee. “We’re not getting the doctors, the qualified people.”
The Fort Peck reservation, a windswept cluster of small towns surrounded by 2 million acres of rolling farmland, has a suicide rate that in some years has topped six times the national average. Native American adolescents are twice as likely to die by suicide as their white peers.
The 2010 policy that put Vega in jail followed a cluster of more than 150 suicide attempts and the deaths of at least six teenagers. Overwhelmed by the crisis, Fort Peck’s tribal government created the “aggravated disorderly conduct” charge.
“It came from desperation,” said FourStar, who was chief tribal prosecutor at the time. “Families weren’t able to handle the needs of their loved ones and they didn’t want them to hurt themselves.”
People charged with aggravated disorderly conduct are held until they can undergo a mental health evaluation and attend a court hearing, where they may receive a court-ordered treatment plan. If they comply with the plans, the charge is dropped. They usually don’t end up with a public criminal record, but the court system can still track them.
Nontribal members are never put in jail, because the tribe lacks jurisdictional authority over them. Instead, a police officer ends up sitting with them in the hospital — sometimes for days — until they can be evaluated.
Not every suicide threat or attempt ends in an aggravated disorderly conduct charge. Ideally, a person in crisis is immediately evaluated by a mental health professional at the Indian Health Service or a telemedicine provider who can refer them to emergency care, if needed.
“Even though there’s difficulties in trying to get care for them, we still persevere,” said Sylvia Longknife, an IHS mental health specialist in Poplar. Longknife is IHS’ only mental health worker on the Fort Peck reservation since two other providers quit this year, meaning she can’t always immediately see somebody in crisis.
Longknife said she sees between two and five emergency cases a week. If the situation is deemed an emergency, the patient is referred to a facility four hours away in Billings. IHS doesn’t have its own transportation, so it either asks family members to drive the patient or requests transportation funds from the tribe.
If a suicide attempt occurs on a weekend, after hours or when a mental health worker is unavailable, police officers who respond may end up taking the person to a hospital for medical treatment, if necessary, and then to jail.
Lisa Dailey, executive director of the Treatment Advocacy Center, a national nonprofit that pushes for access to mental health treatment, said jailing people for attempting suicide criminalizes mental illness. “Prison or jail are the worst settings you can possibly be because you’re in a psychiatric crisis,” she said. Even if the care is good, she said, “being incarcerated is a traumatizing experience.”
Studies have shown that the risk of self-harm in prison increases if someone has been held in solitary confinement or has previously attempted suicide.
The Fort Peck reservation isn’t the only jurisdiction where people can be jailed after a suicide attempt. In New Hampshire, suicidal people often end up in the state’s only secure facility: the men’s prison.
After the Fort Peck tribes approached Carpenter’s Native American politics class last year for ideas, he and his undergraduate students began consulting with tribal members and others in Montana and working to research potential alternatives to jail.
The Flathead tribe in western Montana, for instance, specifies that people should be held in the “least restrictive environment” possible to protect their well-being, short of a jail cell. Carpenter said this could take the form of a “safe house” that separates a person from weapons.
Other potential fixes include requiring that a mental health worker accompany police during interactions with a suicidal person to ensure that jail is the last resort, and creating a new “mental health code” that would treat suicidal people differently from those who pose a threat to others.
The state of Colorado put $9.5 million toward community-based health treatment in 2017, then made it illegal to jail people awaiting mental health evaluations who hadn’t been charged with a crime.
But places like reservations may have no choice. “With no resources, there’s very little you can do about any of those issues,” Dailey said.
@Sara_Reardon