Wednesday, July 23, 2008

Locals everywhere struggle to manage mentally ill offenders

Following up on this morning's theme of mental health treatment and jails, I found two items on a brand spanking new blog called Stir Crazy in Texas informing us of new initiatives in mid-sized Texas cities to manage the problem. Welcome to the blogosphere, Stir Crazy!

First, in Lubbock officials received a $400,000 grant to create a public defender for the mentally ill, but with a twist - legal services will be provided by a nonprofit instead of a county office. This isn't an entirely new delivery model in Texas. In Del Rio, Texas Rio Grande Legal Aid staffs a multi-county PD office for all offenders, not just the mentally ill.

In addition, SCIT brings some hometown news from Smith County: "On Monday, July 28 at the meeting of the Smith County Commissioners, there will be a presentation regarding possible Mental Health Court being established in Smith County." Writes Stir Crazy
When approximately 20% of Smith County jail inmates have been treated for mental illness in the past, the potential impact of such an intervention program is substantial not only in terms of dollars saved but also in terms of quality of life for individuals, family members, and other citizens who could be affected by subsequent crimes.

Dr. David Self, chief forensic psychiatrist at Rusk State Hospital, and Ms. Valerie Holcomb, Texas Corrections Office on Medically and Mentally Ill specialist at Andrews Center, will make a presentation to the Commissioners sometime early in the meeting which begins at 9 a.m. (July 28) at the courthouse annex (NE corner from courthouse--where early voting occurs).
Meanwhile, checking in over at Prevention not Punishment, another Texas blog focused on mental health and corrections policy, I noticed this story from the June 2008 issue of Law Enforcement Technology about police Crisis Intervention Teams aimed at the mentally ill and state of the art practices pioneered at the Memphis (TN) Police Department:
The program builds a team of officers available to respond to calls that partner with families, mental health providers and individuals who are diagnosed with mental diseases. The Crisis Intervention Team, or CIT, preserves the individual's dignity, insures greater safety for both responding officers and the mentally ill person — called consumers — and reassures families.
It strikes me that some version of the Crisis Intervention Team concept should be developed by probation departments to provide more pro-active, need-specific supervision for mentally ill people they're supervising. It'd be nice to intervene in some of these crises before somebody gets arrested and locked up instead of only after they've committed a crime or hurt somebody.

10 comments:

  1. Immediately upon taking office the Bush administration began cutting or sharply reducing funding for agencies and privately run local progams that assist the mentally ill. The biggest cuts, by far, were to the Section 8 and Shelter Care Plus programs.

    Not long after that many cities began enacting and aggressively enforcing anti-homeless ordinances prohibiting panhandeling, public camping, loitering, etc.

    In my community there was a one stop walkin operation where the homeless mentally ill could get connected to a range of comprehensive services including psychiatric, housing and employment assistance.

    That funding was shifted to local church groups and other "faith based" initiatives. The walkin clinic closed its doors and the homeless mentally ill now wind up in jail and the emergency rooms and psychiatric departments of public hospitals at far higher costs.

    Meanwhile, we see the free marketers and the anti-regulating crowd rushing to bail out the share holders of the failed investment houses and mortgage companies, with little effort to go after the crooks who begot the mess.

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  2. I sometimes wonder if there is a solution. Granted having more available mental health resources will help, but a number of the mentally ill often reject treatment.

    I wonder what the Europeans are doing on this?

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  3. ron...
    you're only partially correct...
    Often persons with mental illnesses reject traditional clinical interventions and services. Howere', current research is showing a growing willingness for those same persons to engage and actively seek peer supports, and other non-traditional pschy-rehab services...especially those with "wrap-around" as their core....
    There is also a growing body of research on the efficacy of specialized courts to deal with persons arrested with a known or clearly present mental illness....

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  4. Our sadistic district attorney in Smith County is not going to support anything unless the goal of it is to lock people up for as long as possible.

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  5. Under the best conditions that "treatment" consists of (and is limited to) a prescription for a pill that may or may not actually work, and in many cases may make symptoms worse.

    The general public believes this "magic pill" nonsense. The reality is that psychotropic medications prescribed to patients are often ineffective due to a plethora of circumstances, mostly financial.

    Because of neglect and ignorance there exists a pervasive mindset in our culture about mental illness which places such a stigma on anyone needing help that they just won't go looking for it until they are experiencing serious life trauma.

    By this time they are usually unemployed, homeless and alienated from family and traditional support. Even those with a sound mind would find it difficult to function under such circumstances.

    We are now seeing tens of thousands of Iraq war veterans grappling with the effects of post-traumatic stress disorder because Bush's VA Dept couldn't wrap its head around mental illness. They didn't have to, the Jeebus Saves evangelicals provided the cure with their faith based initiatives.

    Despite the fact that if anyone deserves help it is our combat vets, we see the same narrow-minded attitude of blaming the victim with excuses instead of providing the funding to help them.

    But when the Ivy League geniouses trash our economy with their cynical, self-serving policies just so a few of the ultra rich investors on Wall Street don't have to give up their Lear Jets, Park Avenue homes and wine tasting soirees and then expect the middle class and working poor to bail them out with corporate welfare when their little scam comes to fruition, the lie is exposed.

    Maybe when local governments are forced to raise property and public health hospital taxes so much that the suburbanites who were content to warehouse the mentally ill in county jails wake up, we will see proactive change.

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  6. acerbic,
    a little jaded are we?????
    although you're 'on the money' in much of what you say, fact is that there are pockets of improvment around the country...particularly in psych-rehab....and peer run programs and supports....
    And I think there is a small lessening of the stigma so often associated with M.I.
    I mean folks who are in the throes of a raving psychotic episode are certainly still looked at strangly...but terms like PTSD and depression are getting to be pretty common place...and talking about seeing a therapist or taking an anti-depressant isn't considered any big deal, nowadays....so hopefully, we're on the path to seeing some real reform in more serious areas....
    I do believe that Children's Behavioral Health is getting better...and for adjudicated kids that is a big plus....maybe, just maybe we can catch a few before they have to have a full blown mental health crisis.....or become another suicide statistic...
    Anyway, I'm rambling...it's been a rough day....sorry...

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  7. Jaded indeed...and busted.

    Rough day for me as well.

    Thanks for the reply.

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  8. Grits:

    Just a note that Travis County has an innovative mental health public defenders office for misdemeanants funded by the county and the Texas Task Force on Indigent Defense. It's been operating for about a year and is being evaluated by Texas A&M. It includes case management and service referrals for its clients...

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  9. In the Sunday edition of the Bryan-College Station Eagle appeared a couple of articles about an innovative program instituted by the Brazos County Sheriff's Office in an effort to divert mentally ill minor offenders from jail. Brazos County Sheriff Chris Kirk and his staff are to be commended for creating this program.

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  10. Smith County Commissioners established a mental health court today per the email I've received:
    "We were able today to get Smith County Commissioners Court approval to do a pilot program of Mental Health Court with non-violent misdemeaor offenders. This is a giant step forward due to the efforts of many people, and we have many people to thank. I want to particularly thank David Self and Valerie Holcomb who made an excellent presentation to the Court today--they have agreed to post their power point slides for those who were not there to see them. Watch for them on tv news tonight as well--Channel 56 and another station were there.

    Very instrumental in moving us to this step was Stan Springerley, Assistant DA who works with Commissioners Court, who cleared the way with DA's office and is helping coordinate with other aspects of county government.

    Barbara Hart got a grant from UTTyler to do some background data analysis to help us see what kind of numbers we can use for grant applications. We will have to get grant funding or rely entirely on volunteer resources which will sharply limit what can be done on a continuing basis.

    The commissioners want a plan and organizational outline by September 1, so we have work to do. But it is good work, work which will eventually result in people being released from jail and provided appropriate mental health treatment in the community. Spread the word, thank the commissioners and Judge Baker, and prepare to share the work.
    Paul Andrews."

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