Chincy state hospital funding leaves mentally incompent defendants stranded

A frustrated attorney/Grits commenter yesterday turned me on to what I think is a major story about mentally ill defendants who've been declared incompetent but are turned away from state mental hospitals because they're already full.

No room at the inn, baby. Whatcha gonna do?

I looked into it a little and confirmed many of the commenter's assertions with the head of the state mental hospital system, Kenny Dudley. First, though, here's what happened to the lawyer's client that got him or her riled up:

A judge ordered the Sheriff of Bastrop County to deliver my client to the Austin State Hospital for treatment to attempt to attain competency to stand trial. The kid is schizophrenic, in county jail, with jailers alternatively sending him into the pods where the kid is beaten, then into isolation where the kid is suicidal. No meds. No training for dealing with schizophrenic inmates.

The sheriff had 72 hours to deliver the kid to the hospital. He didn't. The sheriff has said, since the 72 hours elapsed, 1) he'll be transported tomorrow, 2) we can't transport him until they allow new 46b intake, 3) we haven't seen an order like that.

The attorney later was told that all state mental hospitals are operating at capacity and can't take new criminal commitments. That leaves those defendants in major bind. The commenter summed up his client's dillemma in stark terms.

The lawyer for the [Department of State Health Services] said that there is a present crisis, and that it's going to get much worse. Imagine being in jail and schizophrenic, needing treatment. Instead of treatment you get beaten up, isolated, and held for longer than a plea deal would have lasted. But you can't plea. Because you are incompetent.

Ugh. How grim. That's not only bad for defendants who definitely won't get adequate medication or mental health services in jail, but also for deputies and jailers who aren't trained or equipped to handle such inmates. It just makes the whole situation a lot bigger headache for everybody.

I'd not heard about this situation before, so I emailed the comments to Hope over at the Appalachian Alumni Association who blogs on Texas health and human services issues. Hope forwarded my email to a friend in the state health bureaucracy who promised to look into it, and the next thing I know I get an email from Kenny Dudley, the head of the state hospital system, inviting me to call him to receive an explanation about what's going on -- now that's service! (Thanks Hope!)

Dudley confirmed that mentally incompetent inmates are waiting around in county jails for space in state hospitals to open up -- about 100 inmates right now are on the waiting list statewide, he said. State hospitals have 642 beds designated for criminal commitments like these, he said, and civil commitments are also overflowing -- the hospital system has been full up for at least 12 months. Dudley said that in theory such folks could ask local community mental health centers for help evaluating competency, but he doubted they were equipped to do the work. There's really no place for them to go.

Harris County is the only exception -- there the community mental health center has been doing contract "competency restoration" work for local agencies.

The Texas Department of State Health Services last year requested but did not receive new funds to add facilities and beds. Texas is seeing more criminal code commitments than ever before, Dudley said. Asked why, he said he didn't know -- there were just "more people being declared incompetent to stand trial" in courts around the state.

Dudley said state hospitals were caught in a bind. On the one hand, he said, "if a court committed a person to us, are we supposed to take them? Most people say 'yes,' you should take them if there's a valid court order." On the other hand, "the state has a legal responsibility to provide people in our care with appropriate services," so facility administrators have a duty not to take in more patients than those for whom state hospitals are able to provide adequate care.

So state hospitals find themselves on the horns of a dilemma -- more judges than ever are declaring defendants incompetent to stand trial, for whatever reason, but the Legislature has not provided adequate resources to meet the state's lawful duty toward those defendants.

This is a serious problem the Texas Legislature failed to solve when it last met. Dudley's told his higher-ups about it and requested money to add more beds. If an emergency budget item to fix it isn't on the Governor's "call" for the next special legislative session, it's evidence the state really doesn't give a damn about providing adequate mental health services to defendants in its care.

RELATED: See this Dallas News coverage on the subject from December.

READER REQUEST: Would the anonymous attorney who entered the comment that spawned this post please contact Lucy at the number below? Advocacy Inc. are exactly the right folks to talk to about this. Let me know what happens, and thanks, Lucy, for following up:

If anyone has any information about the person with mental illness discussed in this article, please call me at 512-454-4816 x322, Lucy Wood, of Advocacy, Inc. I would like to visit the idea of working on this case with criminal defense attorney and/or working directly with the defendant. My agency is a non-profit legal services organization that focuses on the rights of people with disabilities, and we have worked on issues like this in the past. Please contact, and thank you.

Lucy