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Texas County Progress

Texas County Progress

The Official Publication of the County Judges and Commissioners Association of Texas

The Continuing Mental Health Disgrace

March 1, 2022 by Sarah L

For many years, the State of Texas has shamefully neglected its mentally ill citizens. The state allocates $45.23 annually per citizen for mental health services, ranking 46th among the states. Without access to services, the most severely impaired are forced into the criminal justice system for the protection of themselves and others. County jails are the largest mental health facilities in the state. County jails are not designed, equipped, or staffed to provide mental health services. Counties struggle to provide minimal care for these inmates. Unable to post bond, mentally ill jail inmates deteriorate while awaiting disposition of their cases.

Those most seriously ill are declared incompetent to assist in their defense and ordered to receive treatment in a state facility to become eligible for adjudication. Stuck in limbo, these inmates are forced to be held in the county jail for many months awaiting transfer to a state hospital. Those who are violent offenders often are held for two years before being admitted into a state facility. This unconscionable delay results in a continuing danger to the inmates and jail staff and excessive costs to local taxpayers.

For several legislative sessions, the County Judges and Commissioners Association of Texas and the Sheriffs’ Association of Texas have made an increase in mental health funding our legislative priority. Although state funding has increased, it has not translated into an increase in state hospital beds or any decrease in the jail backlog.

In 2001, Rep. Garnet Coleman sponsored legislation to create the Joint Committee on Access and Forensic Services (JCAFS) to make recommendations to the Texas Legislature and Texas Health and Human Services Commission to improve access to mental health services for both civil and forensic patients. County associations have membership on the JCAFS, and it has met quarterly. It has consistently recommended additional staffing and beds at state facilities and improved community services.

Unfortunately, the backlog of jail inmates awaiting transfer to state facilities has continued to increase. Every sheriff and Commissioners Court has watched in dismay as the number of assaults, suicides, and serious mental disorders have increased in our jails. Attending to mentally ill inmates has affected the morale of jail personnel and escalated medical costs. With the advent of COVID, these inmates are particularly difficult to manage and treat.

At its January meeting, the JCAFS received more disheartening news. During the past three months, the state hospital system has removed over 450 beds from its available forensic inventory. At this time, 40 percent of the maximum security beds are offline and not available. Over 30 percent of the total forensic beds are not available. These beds are fully funded and physically available. However, state administration reports that staffing vacancies prevent their use, largely due to COVID and chronic staff vacancies. The result has been a 33 percent increase in the average waiting time for mentally ill jail inmates.

The failure to provide these resources to reduce the jail backlog is inexcusable. These inmates have not been convicted of any crime and cannot be adjudicated until their competency is restored. The county jail cannot release them, and their condition is not improving. The state should immediately activate additional medical personnel, including the National Guard, to staff the state hospitals and accept these patients. Any further delay will be an indelible stain on the reputation of our great state and its leaders.

For additional information, please call me at 1-800-733-0699.

Filed Under: From the General Counsel, Jails

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