This day at Rockingham County jail, Kenneth Pratt feels neither too high nor too low.
The middle is a good place to be for a person with bipolar disorder. Jail and its 8-by-12 cells is not, he said.
Pratt, 46, is among an estimated 15 percent of the county jail population with severe mental illness. Many others are affected but less debilitated, jail officials say.
And, they add, the number of those with severe mental illness like schizophrenia, bipolar disorder and clinical depression is growing among the 310 inmates at the sprawling block-and-steel complex in Brentwood.
Half of the 310 Rockingham Jail prisoners are being held prior to their trial for charges ranging from shoplifting to murder. The other half, those sentenced by a judge to Rockingham, are serving sentences of one year or less per conviction.
More severely mentally ill inmates at Rockingham mean more disruptions for the 83 corrections officers, more stress for other inmates and hard times for those who are suffering, said Superintendent Al Wright, who sometimes feels like he's running a psychiatric ward.
"I tell people I'm the superintendent of Rockingham County jail, the biggest provider of services for the mentally ill in the county," he said.
Landing in jail
Many mentally ill people arrested on trespassing, alcohol or petty theft charges are brought by police to Brentwood because they can't make bail, according to Helen Watkins, the jail's mental health counselor.
Often they arrive for minor crimes, ineligible for personal recognizance bail because they have no job, family ties or place to live.
Also, there is a shortage of psychiatric beds at the state hospital - down from 3,000 beds in the 1960s to 300 today. This leaves police little choice but to transport mentally ill suspects to jail.
Watkins said many jailings could be avoided if there were peer-support programs or drop-in centers, where someone would recognize when symptoms are worsening.
She pointed to a recent case involving a 23-year-old man committed to the state hospital in early April. He spent three days there before doctors referred him to an outpatient community mental health center, she said. But there he was confronted by a month-long waiting list.