Pathway to Stability
Approximately 38 percent of the 2,400-plus inmates in the Travis County Jail have a serious mental health need (i.e., requiring medications), according to Travis County Judge Andy Brown. Of those 2,400, more than two thirds of the individuals have a substance use disorder, Brown estimated.
Determined to lower these statistics, Travis County partnered with local stakeholders to leverage existing programs and crisis facilities to expand community services in order to:
- steer those with mental health issues onto a pathway to stability and community engagement; and
- immediately interrupt the cycle of homelessness, hospitalization, and incarceration of those with mental health challenges.
After two-plus years of careful study, workgroup planning, and community input, the Crisis Care Diversion Pilot Program, a $23 million, three-year initiative, went fully operational in early October. The county invested $6 million, which was pooled with funding from the city of Austin, Central Health, Integral Care, and the State of Texas via a grant awarded to Integral Care.
The project, which includes the expansion of walk-in services and the repurposing of a facility as a diversion/therapeutic respite center, is not for those who are having a severe mental health crisis and require inpatient hospitalization, Brown emphasized. Those with serious mental health concerns will be served by the second phase of the pilot program, which may include involuntary commitment.
Eventually, community partners hope to secure a larger, permanent diversion facility whether through renovation of an existing building or construction of a new central booking facility with a diversion center attached; the target date is 2029-30.
A Starting Point
In 2022, the Travis County Commissioners Court partnered with mental health experts at Dell Medical School at the University of Texas at Austin to study the growing number of individuals living with mental health and substance use disorders who are languishing in jail instead of getting mental health treatment and support. The goal of the study, known as the Travis County Forensic Mental Health Project, was to establish solutions rooted in person-centered and evidence-based care for people stuck at or repeatedly cycling through the intersection of mental health and criminal justice. One of the solutions presented in March 2023 was a jail diversion initiative.
On March 21, 2023, the Travis County Commissioners Court unanimously approved a resolution endorsing “the creation of a jail diversion center and a new central booking facility that will further decriminalize mental illness, reduce the number of people in jail with mental illness, and provide equitable access to health care, housing, the workforce, and legal services.”
“Far too often, those with behavioral and mental health conditions sit in jail, not receiving the treatment they need and taxing our public systems, wasting taxpayer dollars, and exacerbating the terrible outcomes we see in residents who are not treated but are cycled through the criminal justice system,” the county explained in an online update on the county’s website.
“In collaboration with community partners, the Commissioners Court is invested in this cost-effective solution to reduce crime and improve public safety while providing residents suffering from mental health conditions a pathway to stability and community engagement,” the update continued.
On April 20, 2023, the Commissioners Court allocated $6 million of American Rescue Plan Act Local Fiscal Recovery Funds over a three-year funding period to initiate the diversion pilot program with Integral Care, the county’s local mental health authority, as the lead agency with participation from other community funding partners including the city of Austin and Central Health.
Marisa A. Malik, LPC, director of Crisis Services and Justice Initiatives with Integral Care, offered the following description of the pilot program:
A Place to Go
Integral Care’s walk-in urgent Psychiatric Emergency Services (PES) has expanded access to 24/7, added additional peer support services, and expanded the clinical team to include prescribers and add a 23-hour observation service. PES is accepting referrals of individuals experiencing a mental health crisis in Travis County who have a history of, or are at risk of, cycling through the criminal legal system, emergency departments, and/or homelessness.
Program services are voluntary, and referrals deflected from the criminal legal system are focused on non-violent, victimless misdemeanor offenses. Additional referral sources include emergency departments, the Sobering Center, justice personnel, and Integral Care’s jail liaisons.
A Place to Stay
Integral Care’s Geneveive Tarlton Hearon building is now the home of the Therapeutic Diversion Program (TDP), a 25-bed facility for individuals 18 or older. The program combines the current bridge housing model used by the city of Austin with a respite level of supportive and therapeutic care. Wraparound services include intake assessments, psychiatric evaluation and medication management, therapies in multiple modalities, care coordination, peer services, and discharge planning. Outreach specialists are available to help with long-term housing and benefits support.
The TDP provides individuals with care and treatment for up to 90 days to help support stabilization and connection to ongoing services.
