Shortage of competency restoration beds a sudden, longstanding crisis

Texas' failure to finance mental-health services to sufficiently supply the vast volumes demanded by the justice system - in particular "forensic" beds for competency restoration at state mental hospitals - belatedly is receiving attention. Edgar Walters at the Texas Tribune has a fine story detailing the quandary state officials find themselves in regarding funding for criminal defendants' competency restoration at state mental hospitals. Here's an excerpt, which will ring familiar to long-time Grits readers:

State public health officials say there were 388 people on waiting lists for state hospitals as of April 1.

“Almost all of our state hospitals are currently at capacity, and we are admitting patients as soon as other patients are discharged,” said Christine Mann, a spokeswoman for the Department of State Health Services.

Meanwhile, more than half of state hospital beds go to people who have been ordered there under a “forensic” commitment through the criminal justice system. Texans who were found by a court to be not guilty of a crime by reason of insanity or who were considered incompetent to stand trial currently fill about 1,200 state hospital beds.

That leaves only about 1,100 beds available at any given time for people, like Contreras’ son, who seek treatment outside of the criminal justice system.

At the Houston Press Meagan Flynn had another recent story on the topic.

Grits is pleased the issue is receiving attention and that legislators have pledged to address the problem (though in the coming budget environment, one wonders whether that's possible). I'm puzzled, however, at commentary portraying this as some new problem that legislators just discovered. My theory is that Sen. Robert Duncan attempted to manage the situation for years and, when he left, the Lege lost important institutional memory on the topic.

Regardless, long waiting lists for forensic commitments to state mental hospitals have been a problem for years, as highlighted in this 2012 story from Eric Dexheimer at the Austin Statesman. And though I know that meager blogs seem to be falling out of fashion in the era of social media, this humble opuscule has been beating the drums on the topic nearly since its inception. For those interested, here's a sampling of Grits' writing on competency restoration topics over the last decade:

• Lege focused on least-bad band aids on mental health, competency and jails
• Band-aid bills no substitute for competency restoration funding
• Incompetent Waco defendants in legal limbo
• Incompetent defendants may wait decades pretrial with no rights, options
• State sending some defendants big bills for competency restoration costs 
• Man deemed incompetent held 20 years without trial for attempted murder, may be released
• Showdown brewing between Travis judge, state health agency on competency restoration
• BSG (Broke State Government) seeking forensic mental health beds
• Grits commenter played role initiating lawsuit over timely competency restoration
• Judge: State mental hospitals must take incompetent inmates within 21 days
• 'Neither punished nor treated, just jailed'
• Growth in forensic commitments exacerbates shortage of state mental hospital beds
• Judge orders state hospital to take more competency restoration patients
• Competency restoration process sounds crazy to columnist
• Few bills proposed at Lege to remedy statewide crisis in competency restoration
• Harris County pleads case for mental health, probation/diversion funds in state budget
• Jail deaths implicate state oversight, competency restoration funding
• Mental health cuts by state would shift costs to local jails, emergency rooms
• '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
• Unfunded mandate: Counties struggle to pay for mentally incompetent defendants' care
• More counties grumbling at backlog of incompetent defendants in county jails
• Chincy state hospital funding leaves mentally incompetent defendants stranded