Monday, July 28, 2008

Smith County will create pilot mental health court

When conservative Smith County in Deep East Texas decides to implement a mental health court, it's safe to say the trend toward creating courts with specialized probation caseloads is now in full swing everywhere in the state. Reports the Tyler Morning Telegraph ("Pilot program for mental health court approved," July 28):
Smith County commissioners today laid the groundwork for a pilot mental health court, which will seek to divert non-violent mentally ill arrestees from the criminal justice system.

“It’s a crisis every county in Texas is facing now,” said Dr. David Self, chief forensic psychiatrist for the Rusk State Hospital. “Far too many mentally ill people are finding their way into the criminal justice system.”

Budget cuts at the state and federal levels have reduced resources for care for those with serious mental illnesses, he said.

“If they’re not being served in mental health system, they’re finding their way into the criminal justice system,” Self said. “Jail populations are typically 25 to 33 percent persons who are experiencing mental illness. Smith County falls right in there.”

And jails aren’t where the mentally ill should be, he added.

“Jails don’t do a good job of treating the seriously mentally ill, but that’s not their fault,” Self said. “That’s not what they’re designed for.”

Most mentally ill inmates are in jail on non-violent misdemeanor offenses, he said.
Valerie Holcomb, with the Andrews Center, said such inmates are much more expensive to incarcerate.

“It costs twice as much to keep a mentally ill inmate (in jail) and they stay in jail three times longer,” she said.

But a mental health court, which would focus on intensive supervised probation, can save the county money. ...

“We’re all focused on the jail population, and that’s a nice side benefit, but the focus of this is getting these people proper care,” said Commissioner Bill McGinnis. “And that’s what I’d like to see.”
Smith County officials are among a handful of Texas trailblazers regarding specialty courts for the mentally ill. District Judge Marc Carter operates a mental health court in Harris County, and Grayson County officials are also pursuing the idea. Some other jurisdictions have created specialized public defender offices to handle these clients.

In a related story, the Temple Daily Telegraph reports that Bell County officials are similarly struggling with a lack of mental health services and the resulting pressure on the jail to provide those services ("Mentally ill don't belong in the jailhouse," July 27):

A 2003 state budget crunch took more than $100 million out of the community MHMR system. But rather than this being an anomaly, it looks more like a pattern. In 1994, Tietje said his budget was $16.5 million. It was slashed to $12 million in 1995, a 25-percent cut.

“A result of that budget cut, we lost a Fort Hood work program that served 200 people,” Tietje said.

Closely supervised program participants cleaned buildings and restocked the commissary on base.

Budget constraints have also contributed to the closing of a three-quarter-way house in Gatesville that helped get people back on their feet. It had 30 beds and was a place where people could stay and look for work while they stabilized on their medications.

“It was a structured environment that made sure they got meds and food,” Tietje said.

And the Gatesville center has not been the only facility that has been shuttered.

Clinics in Bell, Coryell, Hamilton, Lampasas, and Milam counties have all been closed.

Said District Judge Martha Trudo:

“We do not do a good job of taking care of the mentally ill in Texas. There are tremendous waiting lists, doctors won’t see them unless they get picked up and put in jail. Then we are obligated to do it.

“A lot of people can function and work if they have support.”

Regular readers know I'm a big fan of using stronger probation mechanisms like specialty courts to overcome barriers to success for offenders with addiction or mental illness. Traditional probation sets these offenders up to fail without recognizing the special circumstances and problems that brought them before the court in the first place. But clearly a much better solution would be to provide better mental health care on the front end to keep folks out of jail in the first place.

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