Sheriff Gordon Ramsay

file photo

REGIONAL- On any given day, the St. Louis County Jail in Duluth, along with its satellite detention facilities in Virginia and Hibbing, houses dozens of people struggling with mental illness. Many are prescribed psychiatric medications. Some are placed on suicide watch. Others return again and again because they can’t or won’t access community-based services. In practice, the main county jail has become one of the region’s largest mental health facilities, a role it was never designed to play.
“This (jail) is now 30 years old, and a lot has changed with mental health and public safety,” Sheriff Gordon Ramsay said in an extended interview with the Timberjay. “It was a very small part of our job and now it is significant. A 911 call for police has become the de facto response to mental health, and then we become the de facto mental health provider.”
Shifting norms
The transformation of local jails into mental health providers began with Minnesota’s own involvement with a national trend in mental health services.
For much of the 20th century, Minnesota operated a system of large state hospitals for people with mental illness, including facilities in St. Peter, Rochester, Fergus Falls, Anoka, Hastings, and Willmar. By the 1970s and ‘80s, most of these institutions were gradually phased out or repurposed amid a growing national movement toward deinstitutionalization.
While the goal was to replace hospitals with community-based mental health services, those supports often fell short. Many individuals were discharged without adequate treatment or housing, leading to increased encounters with law enforcement.
The Moose Lake State Hospital, for example, closed its doors as a psychiatric facility in 1995. Today, it operates as the Minnesota Correctional Facility–Moose Lake – a striking symbol of how the lines between mental health care and incarceration have blurred.
Fuel on the fire
If deinstitutionalization helped set the stage for today’s mental health crisis in jails, methamphetamine poured gasoline on the fire.
Since the 1980s, when crystal meth emerged as a more potent and easily manufactured version of the drug, meth use has surged across rural Minnesota. Its impact is especially visible in county jails.
“People don’t realize how much meth has changed the game,” said Ramsay. “We’re seeing drug-induced psychosis daily – schizophrenia, paranoia, aggression.”
Jail administrator Jessica Pete agreed.
“Sometimes it’s hard to know,” she said. “Are we dealing with a mental illness or are we dealing with a five-day meth run? Sometimes, it’s both. It’s completely blurred.”
These meth-related cases can be among the most difficult to manage. They tend to be volatile, unpredictable, and often involve co-occurring mental health conditions. Some may stabilize after detox, while others reveal underlying psychiatric disorders that have been worsened by long-term drug use.
“Ten years ago, we would have one or two acute cases on the floor,” Pete said. “Now, there’s ten.”
The population inside the St. Louis County Jail today bears little resemblance to what it looked like a generation ago. In 1995, just before the current facility opened, the Duluth News Tribune talked to then–jail administrator Dave Prachar about the new jail, and reporter Matt Nelson recorded this note: “Relatively harmless inmates like drunk drivers and petty thieves comprise 90 percent of its population.”
Fast forward to Monday, April 28, and the contrast is stark. That morning, the jails held 186 inmates. Of those, 65 were in custody for violent offenses, 15 for drug offenses, and 47 for both. Charges ranged from aggravated assault and domestic violence to meth possession and fentanyl distribution. The remaining 59 were held for non-violent charges like DWI, petty theft, or probation violations.
Pete, who has worked at the jail for over two decades, has watched the shift unfold.
“Back in 2003, we were overcrowded, but we were dealing with people that for the most part were not as serious of charges,” Pete said. “And they didn’t have the behaviors that we see with the mental health today.”
That’s backed by both local experience and national data. A 2006 federal study found that 63 percent of male and 75 percent of female jail inmates reported symptoms or a history of mental health problems. More rigorous studies using clinical criteria still estimate that 6-12 percent of inmates suffer from serious psychiatric disorders – well above the rate in the general population.
In Minnesota, a survey of jail staff estimated that 25 percent to 35 percent of inmates are on psychiatric medications daily, according to a 2016 state Legislative Auditor’s report. Many have co-occurring substance use disorders, making stabilization more complicated and resource-intensive.
Ramsay echoed Pete’s concerns.
“We are one of the largest mental health providers in the county right here,” he said. “That shouldn’t be right. This is not the place for people that are in crisis. Inmate safety is number one and this facility makes it very difficult to provide that.”
A strained system
The St. Louis County Jail, like many others, was never intended to serve as a psychiatric unit. There is no dedicated mental health wing. Suicide watch protocols require staff to monitor high-risk inmates every 15 minutes. That adds to the burden on correctional officers already managing substance withdrawal and rising levels of inmate aggression.
Medication distribution, which once was a minor part of daily operations, has grown into a major task.
“It just got to be too much for our correctional officers to manage, so we had to hire health techs just to handle medications,” Pete said.
Commander Jon Skelton added that the jail regularly houses people waiting for psychiatric evaluation or civil commitment. “Sometimes they sit here for weeks,” he said, “because there’s no bed available at Anoka or St. Peter.”
The jail’s shift toward mental health care isn’t just a problem for the inmates. It puts increasing stress on staff, facilities, and taxpayers.
“We’re expected to maintain the safety and security of the facility, but also to provide care to people that are actively hallucinating or suicidal or just completely disconnected from reality,” Pete said.
Even telehealth, often cited as a solution in rural areas, has limitations.
“It’s a band-aid,” Pete said. “It’s better than nothing, but it doesn’t replace having mental health professionals here in person.”
No quick fix
Ramsay and his team emphasize that the problem didn’t arise overnight, and it won’t be solved overnight either.
The combination of deinstitutionalization, underfunded community treatment, and the criminalization of addiction and homelessness has gradually redefined the role of jails. And while many in law enforcement recognize the mismatch, the system continues to default to what exists.
“We’re not saying people with mental illness shouldn’t be held accountable,” Ramsay said. “But when the only place they can get care is a jail, we’ve already failed them.”
In the second story of this three-part series, we’ll take readers inside the St. Louis County Jail to explore in more detail how mental health issues impact inmates, staff, and jail operations. The third story will look at community resources and possible policy changes to support better mental health in the jails.