Cuts to mental health will drive up county jail expenses

The Houston Chronicle editorial board joins the chorus criticizing plans to cut mental health services in a way that would strand mentally ill inmates and associated expenses in local jails. The editorial opens:

What's wrong with this picture? The largest administrator of mental health services in Harris County is the county jail. It's a symptom of a national problem: There are now more than three times more seriously mentally ill individuals in jails and prisons in this country than in hospitals.

But in Texas, that ratio is almost eight to one. In the Harris County Jail, the third largest in the country, on any given day 20 to 25 percent of the 10,000 or so inmates are receiving psychotropic medications. And jailing these inmates isn't cheap: According to the National Alliance on Mental Illness of Texas, each costs taxpayers between $30,000 and $50,000 a year, compared with $22,000 for those without mental illness. And the mentally ill tend to stay in jail or prison two to five times longer.

It's not the jail's own funding, however, that is precipitating the crisis: It is the fact that county Sheriff Adrian Garcia's office contracts with the Harris County Mental Health and Mental Retardation Authority to provide its mental health services, and MHMRA, already struggling financially, is facing severe budget cuts.

When the Department of State Health Services announced major cuts earlier this year, much of it from MHMRA, Dr. Steven Schnee, MHMRA's executive director, told KHOU TV, "It's really tragic how we are treating these conditions …. People with these serious conditions don't go away. They will resurface someplace and we will pay as a community." He said that would mean higher emergency room costs and higher crime.

In reality, cuts to mental health services - particularly competency restoration - don't really save a lot of money; they just shift costs to counties and local hospitals in an unfunded mandate that arguably ends up costing taxpayers more.