Due to Texas’ and Travis County’s painfully inadequate care options for the mentally ill, many are trapped in a cycle of recidivism, only obtaining care when they reach the point that they are “imminently likely to cause serious harm to themselves or others” or when they commit a crime.
Travis County Jail should not be the biggest mental health care provider in the county, but that’s currently the case. When a mentally ill person is arrested, the police officer chooses based on context whether to take them to jail and charge them with a crime or attempt to leave them at a psychiatric care facility if there is no room at an emergency room.
Both options require different procedures, but eventually a judge will use a Physician’s Certificate of Medical Examination in conjunction with observed behaviors to determine whether the person is either eligible for an involuntary commitment or, in criminal cases, incompetent to stand trial or not guilty by reason of insanity.
After that, the person is sent to the Austin State Hospital or another psychiatric care facility. But since 2014, the majority of Texas’s psychiatric care facilities have been at capacity, meaning space is only available after another patient is discharged.
“It’s a question of lack of facilities,” said Dan Prashner, Associate Judge for Travis County Probate Court No. 1. “Texas, I think, is 48th [nationally] in per capita spending on mental health. Other states have the excuse of being poor. Texas simply spends its money elsewhere.”
Unlike other states, that rank includes the money Texas spends on services in jails or prisons, where many people struggling with mental illness end up.
The demand on facilities leads to pressure for doctors to get patients on medication and release them to make room for the next patient, which leads to high rates of recidivism.
“We can order someone to continue on meds, make appointments with their therapists. They can’t do it if they’re living under the bridge, [or] at the arch. [The] lack of services renders the outpatient commitment order meaningless,” Prashner said.
Texas has a long history of shoving care for the mentally ill out of sight and out of mind, but if we won’t listen to humanitarian appeals, you would think we’d hear the economic ones. Texas spends an average of $59 per day per inmate, but that number is estimated to be $140 per day for inmates receiving psychiatric services.
In December of 2015, the Travis County Jail reported having 676 inmates who were dealing with mental health issues. That means the state is estimated to be spending $94,640 daily.
Although not a stranger to dramatic requests, recently the Sheriff’s office asked for $2.4 million from the County Commissioners court to hire 36 more jail officers, in part to deal with a rising population of inmates with mental health diagnoses. This money would be better spent towards prevention rather than incarceration.
Fixing this problem can’t happen in the Commissioners Court alone. The system is so broken that it would take overhaul at multiple levels to fix, but that doesn’t mean we shouldn’t try. The Texas 2017 legislative session, where they could increase funding and the number of beds at state hospitals, would be an excellent place to start.
MacLean is an advertising sophomore from Austin. Follow her on twitter @maclean_josie