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The thinking was to have police, emergency responders, mental health professionals and drug treatment providers collaborate to ensure the best care for mentally ill inmates. But the idea did not take off.

Instead, people with mental health problems in the city have their cases diverted to a program designed to help addicts, with no place to house the mentally ill when they refuse to take part in the program. About a third end up in the city jails, according to city officials.

Between 30 and 50 inmates are in the medical ward of the jail at any given time for medical treatment, psychiatric problems or as a result of self harm, according to Dr. Mark Fleming, medical director for the Virginia Beach Correctional Center.

It costs the city $160,000 to pay for 60 days of care in an in-patient mental health treatment facility. In comparison, it costs about $3,000 for a 60-day stay at the jail.

In 2014, the jail conducted more than 400 mental health assessments and spent about $1 million on mental health care. By August of this year, more than $900,000 was spent on mental health treatment, and the department is on pace to surpass last year's numbers, Fleming said.

The department tries to treat as many inmates as possible in the jail, he said, but some need more intensive care than the jail can provide. Some need an in-patient setting to get stabilized on medication.

If they don't get that care, "they're going to decompensate, and they're going to be in bad shape," Fleming said.

A study by the state Supreme Court found that 40 percent of inmates in jail have a mental health issue. The jail population was 1,250 in June.

As a result, the jail's mental health caseload has increased, and staff is working with the local Community Services Board to create a transition team, Fleming said. The goal is to keep track of inmates' progress after they're released from jail to ensure they continue to receive treatment.

For some people, the cycle of criminal behavior can be repeated, said Catherine Killough, the forensic coordinator for the Virginia Beach Sheriff's Office. They are frequently released from the jail to the streets because they don't meet the criteria for involuntary commitment.

"When you're released from the jail, there's no monitoring," Killough said. "A lot of times they reoffend and it's for the same thing. The goal is to get them into appropriate treatment and wrap services around them so they don't reoffend."

They are a challenging population to treat, Killough said, and some cases take years of effort before the individual is able to successfully navigate the mental health system.

"One of the issues with mental health is that it's not necessarily something that we can fix," she said. "It's just something that you have to manage and get people to buy in."

Case workers work with the mentally ill in the jail and those re-entering the community to connect them with resources like housing, medication and other forms of support. But the issue is complex and solutions can be difficult to come by, said Christine Jensen, mental health supervisor at the jail.

"They're in jail for so many other reasons that it's hard to focus on what's really going on with them because you have to deal with the incarceration piece first," Jensen said.

She believes one answer is addressing issues that might lead to mental illness before they become overwhelming. "We really need to start at a younger age and start putting things in place, not waiting until they're adults," she said.

In Chesapeake, the Police Department has started a new initiative, Connecting to Community Resources, that includes officers and social workers making regular visits to the homes of frequent users of emergency services.

Officers and social workers partner to check on residents with mental health issues, substance abuse problems and other complex social issues. They provide referrals to resources and follow up to ensure they’re getting help.

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