Sunday, August 08, 2010

Mentally ill languish in Bexar jail awaiting assessment, competency restoration

Several notable stories out of San Antonio this week related to mental illness in county jails deserve Grits readers attention:
Last Sunday's story identified a problem that is likely also an issue at most other Texas county jails. It opened:
Bexar County is breaking a state law requiring the swift examination of every mentally ill prisoner in jail, leaving an untold number of inmates languishing without proper psychiatric care.

Local courts are supposed to order psychiatric exams and use the results to route many of the mentally ill offenders toward treatment and away from the jail, where only one part-time and two full-time psychiatrists are employed to treat about 900 inmates a day suffering from some form of mental illness.

The jail is screening inmates when they are booked and providing a daily list of the mentally ill to magistrates.

But the courts at that point drop the ball, saying they are overwhelmed and lack the resources to order the examinations or distribute reports to attorneys. And mental health providers inside the jail say they lack the staff to adequately examine every prisoner who might be mentally ill.

As a result, the jail continues to warehouse mentally ill offenders accused of minor crimes who would be better served in psychiatric hospitals. The courts’ failure to follow the law contributes to crowding at the jail, where an estimated 21 percent of the 4,500 prisoners have a mental illness.
Ironically, Bexar has been widely recognized for its jail diversion program for the mentally ill, where police take some offenders to a "Crisis Care Center" instead of jail. Judge Wolff points out that "Since its inception in 2002, the Jail Diversion Program has prevented 5,600 people from even seeing the inside of a jail cell by law enforcement instead bringing those individuals to the Crisis Care Center." But for those actually taken to the jail, apparently the systems remain an under-resourced mess and magistrates have openly refused to comply with a law requiring mental health evaluations on the front-end of the process.

The latest story focuses particularly on the issue of competency restoration and the declining number of forensic beds available at state hospitals, a subject which this blog has been tracking for several years.
Forensic beds in hospitals are used to treat mentally ill inmates who are deemed not competent because of their illness to proceed to trial.

In Texas, the current wait for a forensic bed is three to six months, and the waiting list numbers about 350 for nonviolent inmates, state officials said.

“I've got 103 in jail right now waiting to go to the state hospital,” said Ron Stretcher, criminal justice director of Dallas County. “About a year ago they started squeezing down on the number of beds, but the state Legislature controls that. The state is pushing costs down to the county.” ...

Associate Probate Judge Oscar Kazen, who presides over hearings to commit those in mental health crises, said further slashing of state hospital beds would only worsen the inequity in how the mentally ill are punished.

“People just disappear into that (competency restoration) hole and sometimes don't come back for months and months and months,” Kazen said.
The competency restoration issue is big sleeper issue that's reaching critical mass, headed quickly once again toward crisis stage. The state began pilot programs to do competency restoration locally in four counties, including Bexar, but their outpatient program only has 50 slots. The story mistakenly quotes a local official saying the Bexar program was unique, but it's one of four legislatively authorized pilots. In general, those pilots have worked well but not operated at a volume sufficient to take pressure off state hospitals. Cuts to state hospital's forensic beds constitute a direct shift of costs to local jails, which are generally ill-equipped for such tasks.

FWIW, this is some of the best original reporting on criminal justice issues out of San Antonio since their paper began sharing content with the Houston Chronicle. And I'd bet the farm that similar stories could be told throughout the state wherever reporters poke their noses into this obscure but critical aspect of the justice system.


Anonymous said...

FWIW, there are other counties doing outpatient competency restoration. The four mentioned received funding, but other counties are doing it with existing funding, along with other approaches, because it just makes a whole lot of sense. Henderson, Smith and Van Zandt, for example, have been doing this.

Gritsforbreakfast said...

Thanks! Now that you mention it I'd heard that Smith was doing that and it slipped my mind when I wrote the post.

Does anybody know of any other jurisdictions performing outpatient competency restoration or doing it in-house at the jail instead of sending people to the state hospitals?

Anonymous said...

So some crazy ass gets arrested, charged and stuck in the MHU and some PA gives them something to knock them out and writes a letter to the judge that they are "now competent to stand trial."

It's just procedural bullshit, they are doing nothing to treat the underlying condition.

The problem is that mental illness is considered as a cause of criminality rather than a correctable illness like diabetes or cancer. You're not allowed to have anything wrong with your brain unless you act like a complete retard or a scan detects a tumor.

If not, you're just a piece of crap worthless person who needs to be caged up like an animal.

Anonymous said...

My son was in the Juvenile detention center. I had all of his mental health records from birth. I have proof that when i let Bryce go live with his father and step mother at age 13. they and a Doctor Patrick Holden from the utsa and long time doctor of the courts, removed all of my sons medications. Serious psychiatric meds he had first been started on at age 5. My son committted a crime. Everyone wanted the crimes against bryce before during and after to remain hidden. Judge Lisa Jarrett did just that. Shut me out of the process because of her ties with the lawyer and this doctor. July 16 2010 bryce vandergrift sentenced 30 yrs. court okayed him to sign a waiver of ever appealing, court sealed his records, put him on staple drugs trazadone and prozac. I have so much documentation it's serious. Serious substancial eveidence also. They still want me to shut up. So does the third party.. not even mrs cantu wanted the public to find out anything. I'm sick with angusih but God gives me hope.
someone will come and help.

Anonymous said...

my friend has been waiting on a doctor to do an evaluation for a month in jail in new orleans. she . she has been on lock down for a week/ the system is broken for the mentally ill. everywhere there just does not seem to be enough doctors willing to help out and the court system doesnt seem to be doing their part.

Anonymous said...

Does ANYONE know how a person can delete their comments and or replies? I was told that there would be a TRASH CAN image, right beside the time date stamp near our comments... Does ANYONE see a trash can near their date/time stamps?
The problem is that I do NOT see the trash can, otherwise I would have removed myself from further posting, and or I would have learned how to NOT post while I was in a Hype Panic Mode as my loved one has been harmed, it was all so fresh and I was still learning.... please leave a reply so I can figure out how to remove my trash.

thank you very much for your considerations.

Gritsforbreakfast said...

Email me the links where the comments are AND the date and time of the offending comment at and I'll take care of it.

welovebryce said...
This comment has been removed by the author.
Gritsforbreakfast said...

I removed the comments from this post because I happened to be on the page. However, as I've explained before, I am constantly bombarded by people wanting comments deleted - often comment spammers who got bitten when Google started dinging them on their search rankings. They're very persistent, too. So if I do it for you I have to do it for them. And I don't want to.

This is a hobby. Nobody is paying me to write this blog and I do not have time to moderate comments. I delete libelous and wildly off-topic comments when I see them. But I make no pretense of even reading every comment, much less moderating, editing, deleting those people come to regret, etc.. Commenters are responsible for their own statements. The lesson here: Think before you write.