“It is not consistent across all jails and our state that people have access to psychiatric medicines,” said Commissioner Terri White, of the Oklahoma Department of Mental Health and Substance Abuse Services. “In some jails, there is no access. In some jails, there is infrequent access, and in some jails, it's either done well or there's a good partnership between the mental health center and the jail, so it depends on the jail, and unfortunately, it also often depends on the person who's in jail, and whether or not they were already engaged in the mental health system, so the community mental health center can even make the offer to bring medication for them.”

Under Oklahoma state jail standards, jails are required to provide medical and mental health services, but the standards are vaguely written and hard to uphold in court when challenged. There is an effort underway to revise the standards, but that will likely take several more months.

Some jails pay medical companies to provide nurses, physicians and mental health professionals who treat inmates. Others hire nurses and work with local physicians to provide care. And some take inmates to urgent care facilities and emergency rooms as needed.

Leaders say examples like these suggest that every county jail in Oklahoma is operating under a different protocol than the next to deliver medical and mental health care.