County Magazine | February 13, 2023
Decriminalizing Mental Health
Four years ago, a police incident in Hockley County made Sheriff Ray Scifres think about his job differently. It was a typical call — a restaurant had a patron who was causing a scene and refused to leave.
“This person is possibly disorderly conduct, possibly criminally trespassing in a location they've been asked to leave. So, it could be an arrestable offense,” Scifres said.
When officers arrived at the restaurant, the person was pacing back and forth and still being disruptive.
“(Officers) started to see some indicators that something's not quite right with this individual,” Scifres said. “They identified this person was off their medications.”
The responding officers knew this wasn’t a criminal situation but rather a mental health one. They made some calls to get the person proper medical support, but nothing like that existed. With no other options, the person went to jail and stayed there for 27 days until the case was resolved.
“At the time, it really got us thinking: How is it this person has to come to jail to get active for services?” Scifres said. “Why are we just now having to deal with this? Where was the breakdown? So, we started asking those questions and that's kind of what pushed us towards having a CIT program out here locally.”
CITs, or crisis intervention teams, are a new addition to the Hockley County Sheriff’s Office.
“We have a trained deputy that rides along with a qualified mental health professional, and they respond to calls for crisis. It may be a disturbance … it could be somebody who is expressing suicidal ideations, has threatened suicide or has made an attempt,” Scifres said. “We then connect them with that qualified mental health professional to do an on-site assessment to see what we can do for them.”
This crisis intervention team is one tool Hockley County is using to help divert people with mental health issues away from jails and toward medical professionals. This effort is necessary because Scifres said county law enforcement officers are dealing with mental health, rather than criminal, issues daily.
“About 70% of our inmates are flagged as having a possible mental illness. That plus a co-occurring substance use disorder,” he said.
Texas jails are the largest mental health providers in the state.
Hockley County, just west of Lubbock, is far from unique in this situation. County jails across Texas are filled with people who would be better served by mental health professionals instead of law enforcement.
“I would say the jails still are serving as the largest mental health provider, because unintentionally we have criminalized mental health disorders,” said Kristi Taylor, the executive director of the Texas Judicial Commission on Mental Health (JCMH).
JCMH works with judges and attorneys to better serve Texans with mental illness, intellectual disabilities or substance abuse disorders who get caught up in the legal system. The focus of JCMH’s work is to get these people services rather than a criminal record.
When Taylor talks to county jails on any given day, they report having 70%-90% of their beds filled by people experiencing some sort of mental health crisis.
“From my understanding, it's taken 40 years to create this crisis, with the deinstitutionalization that happened in the ’70s,” Taylor said.
This deinstitutionalization she’s talking about is the widespread closing of state-run institutions for people with mental illness. When these facilities were closed, nothing replaced them.
“What we still had left were jails, and if we have a hammer, everything looks like a nail,” Taylor said. “So, people who might not have been incarcerated 40 years ago are being funneled through the system, and the jails are serving as that filter to find those with mental illness. And this is obviously not optimal.”
Diverting dollars to health care
While his goal is diversion, Scifres still finds people with mental health needs in his jail. Scifres' crisis intervention team members, which includes Deputy Brandon Lewis and Abigale Blasingame, a crisis worker employed by the local mental health authority, work with inmates to connect them with services, including after their release.
"(The CIT is) following up with individuals that may have been contacted prior to arrest, but more often, they are contacting individuals that have a known history of mental illness and are hoping to keep them connected to resources after release," Scifres said. "It is rare (individuals) enter for a crisis incident, but it does happen on occasion that an inmate makes statements about self-harm and they will visit with the inmate."
Taylor and her organization want to see more investment happening in preventive and community services related to mental health treatment.
“I'm going to encourage that we look at the small steps that we can take for some savings and then track that progress to show that if we keep investing on the front end, that we will be able to build more diversion centers and rely less on state hospitals, less on jails,” Taylor said.
There are still some state-run mental health hospitals, but they can’t meet demand. As of Nov. 18, the capacity at state-run facilities was 1,764, and the waitlist was 2,550, with about 50 people being added to the waitlist every day. So, it’s crucial to put solutions in place at the local level.
Taylor said it’s important to start small because many communities in the state don’t have the resources necessary to divert people in a mental health crisis away from jails.
Having alternative facilities such as diversion centers would be helpful. But not every person experiencing mental health issues needs an in-patient facility. She said having outpatient services in every community would provide support to many people. Also, she said changing laws and attitudes around convictions would help people in these situations because they won’t be strapped with criminal records, which take away job and housing opportunities in the future.
Chad Stroud, a lieutenant at the Hunt County Sheriff’s Office, said his community is trying to implement this kind of change. He said about 50% of the people brought to his jail suffer from mental health issues, and his community has started to collaborate across the entire judicial system to reduce this number.
“With the county attorney's office, the sheriff (and) our county judge, we're implementing this team that's going to consist of four mental health officers available to be out in the community, helping to prevent these individuals from coming in the jail,” Stroud said. “The other thing that we're putting into place is having a licensed professional counselor that's going to be on staff here at the jail to provide counseling for our individuals with mental health issues.”
Stroud said these are helpful first steps but not the comprehensive solution to this problem.
Of course, these solutions cost money, but Taylor said that cash can come directly from current county jail savings. She said an average cost of housing someone in county jail is $225 a day. So, diverting even one person from county jail and a stay of 180 days (the minimum sentence for a felony in Texas under the state’s Penal Code) would save that community about $40,000.
That money could be directed to mental health organizations and health care workers, who could help these people in the long term.
“I think that it is going to require a change of the head and the heart to this in Texas,” Taylor said. “I think that we are going to have to see mental health as health and have more empathy and understanding. Just as if our aunt had cancer, we wouldn't expect the police to answer that call. We wouldn't expect the jails to be the service providers.”