Bridging the Mental Health Gap

Bridging the Mental Health Gap

By Aurora Flores, TAC Legislative Manager

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A workshop on Texas’ growing mental health crisis brought together 100 county officials from across the state July 19-20 in Georgetown. County judges, justices of the peace and sheriffs gathered to hear the latest information from mental health experts, psychiatrists, the Texas Commission on Jail Standards (TCJS) and law enforcement. 

Texas Counties and the Mentally Ill – Bridging the Gap was sponsored by the Texas Association of Counties (TAC) and the Texas Justice Court Training Center and funded by a Judicial and Court Personnel Training Fund Grant administered by the Texas Court of Criminal Appeals. 

Real Numbers, Real Issues

A recent report from the Texas Judicial Council found that approximately one million Texans experience a serious mental health illness in a given year. It also revealed that up to 24 percent of Texas inmates have mental health needs. The responsibility to effectively deal with the rising mental health crisis in Texas, including the financial burden, often falls to the court system. 

Limestone County Sheriff Dennis Wilson pointed out while Texas’ population has nearly tripled from 10.3 million to 28.2 million, the number of inpatient psychiatric beds has plummeted from 14,921 to 3,013. 

Attendees learned about what to expect from different medications and complications during a review of mental illness and substance use disorders. During the session on screening tools for county jails, audience members voiced many concerns and questions for Texas Commission on Jail Standards (TCJS) Director Brandon Woods ranging from what constitutes credible information to the magistrate, and who will collect the information on the new screening form, to issues with funding Local Mental Health Authorities (LMHA). 

Bandera County Justice of the Peace Lynn Holt shared how Bandera County Sheriff Dan Butts uses a telehealth service to get consenting persons evaluated by camera from the county jail. Facilities with capacities of 96 beds or fewer can seek TCJS grant funding to provide required electronic monitoring systems in conjunction with the passage of SB 1849 by Whitmire (85R). House County Affairs Chairman Garnet Coleman was instrumental in ensuring telehealth evaluations and grant funding, which originated from the County Affairs 84th legislative interim report, were included in the enrolled version of SB 1849. Holt described telehealth as the wave of the future, noting that small rural counties can band together to find viable options. 

County Successes

In a panel moderated by Susan Redford, TAC Judicial Program Manager and incoming Executive Director, county officials discussed ways they’re addressing mental health issues in their home counties. Some counties have begun working cooperatively with their local hospitals and LMHA crisis teams to take advantage of LMHA grants available to provide mental health deputies. Other counties have begun a centralized magistrate office, and another county official shared his inter-local agreement with police: If a mental health call is within the city limits, the city police officer transports the person to the hospital but if not within city limits, the sheriff handles the transport.

Idea Exchange

The conference ended with round table discussion and brainstorming solutions to proposed mental health scenarios. Participants at each table provided an example of what works in their county based on their population and needs. Several good take-away suggestions included obtaining a mental health officer through the LMHA, having quarterly meetings with stakeholders to address recurring problems, leveraging 1115 waiver funds for a full time mental health deputy, utilizing the LMHA for telehealth grant funds and inquiring about an inter-local agreement with city law enforcement for patient transport within city limits. 

Across the state, the rate at which law enforcement officers respond to calls involving people with mental issues has been increasing. A working knowledge of how to handle mental health calls and how to best find treatment outside the county jail is becoming more important for law enforcement officials and counties. Diverting people to mental health facilities rather than taking them to jail will save taxpayers money. 

The conference in Georgetown was at full capacity, and the hope from county officials is that a future conference can take place with continued funding from the Judicial and Court Personnel Training Fund Grant.