Tuesday, April 24, 2007

Priorities: Mentally incompetent inmates languishing in Texas county jails

Regular readers know I've been worried about Texas' failure to provide adequate "competency restoration" services for mentally ill and retarded people accused of crimes who are deemed "incompetent" to stand trial by the courts. These folks can wait many months for treatment in local jails and state hospitals before they can stand trial or even enter a plea bargain for their crimes. Often they become trapped in a vicious cycle that can last much longer than the punishment they might receive.

The Dallas News' Michael Grabell wrote an excellent story about the problem in yesterday's paper ("Mentally incompetent inmates stranded in jail," April 23), quoting Advocacy Inc. attorney Beth Mitchell who is suing the state to improve services:
"They don't have the money to build more beds and hire more staff in order to restore these people to competency," Ms. Mitchell said.

The state has 738 beds for mentally disabled inmates, which includes 343 for those arrested for violent offenses. As of the beginning of April, 217 inmates – including 175 considered violent – were on the waiting list.

For the 175, the average wait time is four months.

The nonprofit group, which filed the lawsuit last month in Austin federal court, said the cases of Dallas inmates Michael Fields and Ronald Crawford are typical of the troubled cycle that mentally ill and mentally retarded inmates fall into:

  • A months-long wait for a hearing.
  • A psychiatric ruling of incompetency.
  • A months-long wait for a hospital bed.
  • Treatment and a return to jail.
  • A months-long wait for a trial.
  • Deteriorating condition and another psychiatric ruling of incompetence.
  • Back to the end of the waiting list.

Read the rest of the article for human examples and a good overview on this important and little-discussed topic. Last year the state said the waiting list was about 100, so either they were lowballing the figure then or the waiting list has grown since the Legislative Budget Board authorized emergency funds for competency restoration in 2006.

Grabell didn't mention it, but there's legislation in play at the Texas Legislature aimed at reducing that waiting list, spurred on by Advocacy Inc.'s lawsuit. SB 867 by Lubbock Republican Robert Duncan would make several changes to streamline the process:
  • Allow judges to use a previous competency evaluation if done less than a year prior.
  • Require a competency report in 30 days for a felony and 10 days for a misdemeanor (judges can grant extensions).
  • Allows release on personal or surety bond pending competency restoration.
  • Requires bonding out incompetent misdemeanants to outpatient treatment programs.
  • Disallows incarcerating incompetent defendants pretrial longer than their max sentence would be under law.
The bill passed the Senate unanimously but has yet to get a hearing in the House Criminal Jurisprudence Committee (and it's not on today's agenda). Note to Chairman Aaron Peña: Let's get this sucker moving through the House process so it doesn't get caught up in any end of the year shennanigans!

Here's another example where, with all respect to my friend Chairman Peña, I have to question the House Criminal Jurisprudence Committee's priorities. Sen. Duncan's bill passed on the same Senate calendar as did Sen. Whitmire's SB 823 which expands police wiretapping authrority. Both cleared the Senate on April 12, but the Chair suspended the posting rules to put wiretapping on the very next (April 17) committee agenda.

Somebody tell me, please: Why should expanding wiretapping authority - a seldom used tool with important, controversial, and in this committee mostly ignored implications - merit a suspension of posting rules and a quick "yes" vote in the same meeting, when by comparison this bill, like the mentally incompetent inmates it seeks to protect, languishes? There's still plenty of time, but Peña and the Democrat-dominated committee should move with equal alacrity to hear and vote out this much more important bill so it can pass this session.

See prior, related Grits posts:


Unknown said...

It is at the top of our list for our next hearing. It will be received favorably.

Gritsforbreakfast said...

Hey, now that's service! ;)

Thanks, Rep. That's good news.

Anonymous said...

We truly need to focus on treating the desease - mental illness. The mentally ill need treatment, not punishment!

Mariamariacuchita said...

HA!! Par for the course...and did you see that Jessica's Law passed the Senate today?

nandabean said...

Many drug offenders are self-medicating symptomos of mental illness. Impaired judgment makes them very easy to catch and convict.

Unknown said...

Let's see now:
1] We reduced funding for environmental cleanup since 1981
2] We have had an explosion of diagnoses of ADHD, asthma and autism since 1990.
3] We have had an explosion in the prison population.
4] We have a lot of people using designer drugs on the streets and stealing to bankroll the habit.
5] The decrease in the number of people treated does not fully explain the numbers in prison.
6] Many of these ADHD, asthma and autism cases can be more effectively treated by dealing with environmental causes.
When we do treat the mentally ill they get drugs for free. Cheap drugs! When they use designer drugs on the street they commit crimes to pay for these very expensive drugs. Has anyone seriously considered the possibility that we have these people in prison and medical treatment because we don't seriously enforce environmental protections? I know this goes into the "wacky conspiracy" realm - but maybe the drug war is a diversion from the efforts to clean up the environment and enforce social responsibility on our industries.

texasjailbird said...

Hey, does this mean it's taken care of at this point? Because for us it's an urgent issue. About half the letters we are getting letters from around the state are from desperate family members with relatives who are either mentally ill or disabled—many are not treated, many are in serious depression, some are being harrassed by other inmates and punished by staff on a daily basis. One was deemed "dangerous" because his wife pleaded for him to be moved to a hospital nearby.

Is there anyone we should obby about SB 867?
Scott, thanks for drawing attention to the subject.

Omaha Corrections Guy said...

I work in the administrative confinement mod in our county jail - where the inmates who have shown a willingness to assault officers are housed. I would say, from a layman's perspective, that at least 5 of the 16 inmates in this mod are mentally ill to the point where they will not be able to function in society without a serious, comprehensive program including socialization therapy and drug therapy.

Nebraska needs to review how we treat our mentally ill inmates. Several have been languishing for months in our mod while waiting for a bed in our state mental health center to be evaluated.


Gritsforbreakfast said...

Thanks for the comments, folks.

@Texasjailbird: It's not even close to taken care of, but a good start. If you've got people calling you in that circumstance, you might send them Advocacy Inc.'s way. I don't know what else to tell you in the near term.

This bill is half the solution. It remains to be seen if there's enough funding in the budget to expand forensic beds in the near term. I simply haven't looked yet, but it's a good question. The MH advocacy groups are pushing for more outpatient and community center-based treatment, and I don't know what the Appropriations and Finance Committees decided to do. I'll try to find out, or if somebody knows, shout out! best,

Gritsforbreakfast said...

Oh, on who to lobby, right now SB 867 is in the Criminal Jurisprudence Committee, whose membership is linked in the post. The Chair said above it will be "received favorably," but it can't hurt, especially if you happen to be in the district of one of the committee members.

Anonymous said...

The idea of using a year old evaluation in competency proceedings is really disturbing. Competency can fluctuate over time, and medication changes can totally alter someone's ability to understand the proceedings and liaise with counsel. I share everyone's concern for the mentally ill in jail, but using an evaluation that may not reflect the individual's present competency is not going to assist accurate determinations of this issue. This idea needs urgent re-thinking.

Gritsforbreakfast said...

I think the idea of using old evaluations is for folks who are in and out of the jail system a lot, basically when they go off their meds. Is there some suitable way to streamline the process so they don't wait forever for evaluation and treatment if they're a "regular"? I understand it could be abused, but a small number of folks frequently cycle back and forth through this process. Is there a way to strike a balance here? Anybody?