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Texas' failure to fund mental health treatment leaves hundreds stranded in jails around the state

Photo: Illustration by Chuck Kerr, License: N/A

Illustration by Chuck Kerr

Photo: Courtesy photo, License: N/A

Courtesy photo

Jeremy Weaver

Nearly four years ago, "Sam's" paranoia had grown so intense that he believed spies followed him in the shadows everywhere he went. His house, car, motorcycle, workplace, were all bugged, he believed. "I was in a very bad place, psychologically," said Sam, who asked that his name not be used for this story, by phone from the Kerrville State Hospital last month. "I thought everyone was after me."

After a number of increasingly intense psychotic episodes, those delusions reached a breaking point. In 2008, he set fire to his motorcycle in the driveway of his parents' small San Antonio cleaning business. The fire quickly spread, destroying his parents' shop. It took over a year and a half inside the Bexar County jail, much of it in solitary confinement, and a suicide attempt before Sam was transferred to one of Texas' 10 mental hospitals for intensive treatment for what he later learned was a schizoaffective disorder. "I really thought I would die in that jail cell," he said last month.

Mental health advocates say Texas' mental health care system is failing those like Sam, and that stories like his are far too routine. Defendants with severe mental illness land in the criminal justice system where they're forced to languish for months behind bars while an overburdened state hospital system struggles to find room. The state's mental hospitals have long hovered at or near full capacity, with roughly 2,400 patients at any given time pushing the system to its limit, according to numbers from the Department of State Health Services. And while the state hospital system avoided the budget axe this past legislative session — state hospitals even saw a slight bump, from $778 million to $783 million — according to the University of Texas Hogg Foundation for Mental Health, the 82nd legislative session was anything but a win for mental health care in the state. In its wrap-up report on the session, members note that the state's Health and Human Services deliberately shortchanged itself $4 billion needed for services in the new biennium. And while mental health services faced much smaller cuts than other state services (say, education), the report states: "Long-term community supports and services designed to prevent institutionalization received significant reductions."

Wait times for civil commitments to state hospitals remained relatively low in December, ranging from 24 hours to five days on the outside. However, so-called "forensic commitments," those hundreds of incarcerated criminal defendants who were declared incompetent and unable to participate in their own defense, languish on a growing waiting list that can take months to clear.

"We've got such a long wait list because we just don't have the services in this state for people with severe mental illness. We never have," said Beth Mitchell, an attorney with the advocacy group Disability Rights Texas. "The Legislature has never ponied up enough money to make sure that we can appropriately take care of people needing mental health services. … They end up in jail, and many wait there for months and months." Those suffering inside that institutional limbo, mental health advocates fear, continue to deteriorate behind bars while their conditions make them potentially more vulnerable, victims to the larger jail population. Some attempt to hurt themselves inside city and county lockups ill-equipped to handle severe and complex mental illnesses.

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