cuts to the system don't translate into cost savings, said Chris Ziebell , director of emergency medicine at University Medical Center Brackenridge . Studies show that people with untreated mental illness are more likely to end up in emergency rooms and jails, where treatment is far more expensive.
"They're not going to save any money, and the people are going to end up suffering," Ziebell said.
The jail system is already dealing with the constraints of a limited mental health system, said Daniel Smith , counseling and education manager for the Travis County sheriff's office.This isn't just a Travis County problem, of course. This recent article out of Midland similarly lamented a surfeit of mentally ill offenders in their local jail. The same is true in virtually every county in the state.
About 20 percent of the approximately 2,400 inmates currently at the Travis County Correctional Complex and Travis County Jail are on psychotropic drugs for a mental illness. Many of those could not get help before their incarceration because of Integral Care's 1,400-person waiting list for adults, he said.
"We do get a bunch of people who really shouldn't be in jail, but the officers find a reason to arrest them so they can come in here and get care," Smith said.
Counties are generally willing to build jail beds for the mentally ill, but nobody wants to build hospital beds. Cuts to community-based mental health treatment will only exacerbate that problem, but they seem unavoidable in Texas' current budget climate.
This is an example why I'd be shocked to see Rep. Burt Solomons pass his proposed constitutional amendment banning unfunded mandates. State and local systems are too tightly intertwined, and virtually any reduction at the state level - particularly on healthcare and education - results in an increased burden on local government. Nowhere is that more evident than on mental health spending.
See prior, related Grits posts:
- 'Harris County jail not the place to treat mental illness'
- The making of an unfunded mandate: Cuts to mental health would dump costs on county jails
- Cuts to state mental hospitals would be massive unfunded mandate for county jails
- Mentally ill languish in Bexar jail awaiting assessment, competency restoration
- Cuts to state mental health treatment would shift costs to local jails
- Cutting state psych hospital budgets could backfire
- Legislature's underspending on competency restoration beds creates havoc
- Priorities: Mentally incompetent inmates languishing in Texas county jails
- 75-year old mentally incompetent grandmother stranded in Lufkin jail most of 2006
- Legislature should prioritize mental health funding that relieves local jails
- Chincy state hospital funding leaves mentally incompetent defendants stranded
- Unfunded mandate: Counties struggle to pay for mentally incompetent defendants' care
- More counties grumbling at backlog of incompetent defendants in county jails
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10 comments:
"We do get a bunch of people who really shouldn't be in jail, but the officers find a reason to arrest them so they can come in here and get care," Smith said.
The first part of that statement is true, the second part about arresting so they can get help is bullshoot.
City police officers continually brought someone with issues to our jail on a BS DOC violation instead of dealing with the real problem.
That left untrained SO employees with the responsibilty to care for those who cannot care for themselves.
Elected officials, district judges and prosecutors don't want to hear about those in jail with mental issues. After all, they are not the ones having to do the babysitting.
Retired LE
I'm not sure the costs aren't already shifted.
The part of the argument that "cuts in mental health will fill up the jails" seems to assume that simple mental health treatment always yields successful treatment. Unhappily it does not. ALL of the "mentally ill" that are in the county jail I supervise are already on treatment--but they are treatment failures.
It's a sad fact that not everyone who is receiving treatment does well--very many especially those severely psychotic or with personality disorders have been tried on all medications known to God and Man and just are not able to function freely in the community.
I guess that just begs the question of whether these chronic offenders should be institutionalized or incarcerated.
So, we will still be paying these costs they will just come from another "pot".
The worst of the situation is not considered in this post. Some portion of those who do not receive their meds will commit offenses and otherwise interact with the public and/or police forces in ways that will sometimes result in harm, either to the mentally ill person, the member of the general public, or an officer. Cutting a program that costs a few dollars per person treated per day, with the idea that those people end up in jail receiving the same meds, at a cost of $50.00 or more a day, is plainly STUPID.
Let the Doc take them home, since he knows all the answers.
Superb blog post, I have book marked this internet site so ideally I’ll see much more on this subject in the foreseeable future!
To anonymous 01:14PM, to say let the Doc take care of them is just out and out wrong! Most of the people in prisons could be treated in State Hospitals, but since the funding for these facilites has been cut drastically over the years, there are not enough facilities to care for them. They are ill, and need care not more abuse and mistreatment. The mind is part of physical health and should not be separated from healthcare. Gone is the notion those persons who suffer from mental illness, a physical condition as the brain is part of the body, are crazy.
Ask not what how others should be treated, and take care of the ill. You are either misinformed or don't the facts.
You are in time out until further notice! The RN
"It's a sad fact that not everyone who is receiving treatment does well--very many especially those severely psychotic or with personality disorders have been tried on all medications known to God and Man and just are not able to function freely in the community.
I guess that just begs the question of whether these chronic offenders should be institutionalized or incarcerated."
Thank you Prison Doc for making that point. Many of the treatments used in psychiatry now are simply not effective. They need to be looking at new, more inovative treatments. While ECT has a bad reputation, it is one of the most safest and effective treatments. It has fewer side effects that most of the medications prescribed. Yet it continues to be availalbe only in limited circumstances or not at all and often as a last resort. I know a few years ago UT Soutwestern was doing some interesting research on using magnets to treat depression. I don't know how that worked out.
One problem is the overeliance on medication and underutilization of therapy. I recall many years ago reading a book by Dr. Peter Breggin. When he was in school he and some other students volunteered at a psychiatric facility. The students would spend time one on one with the patients. That was the time when drugs like Thorazine were just beginnging to be used. The paitiens whom the students worked with did better than the patients who got medication. We need to stop depending so much on pills and really start looking at alternative treatments.
http://www.sciencedaily.com/releases/2010/10/101018165836.htm
The above is a link to an article about using magnets to treat someone with Bipolar Disorder. This appears to be a safe and effective treatment but I'd be that 20 years from now we still won't be using it and will continue to rely on dangerous drugs as the primary form of treatment.
This is how Texas Republicans balance budgets: shift the cost.
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