Houston’s biggest jail wants to shed its reputation as a mental health treatment center

 In Politics

A prison is pictured. | Getty

State lawmakers created a mental health jail diversion pilot program in Harris County in 2013, allotting $5 million a year to keep mentally ill inmates from becoming repeat offenders. | Getty

AUSTIN, Texas — The Harris County sheriff’s office doesn’t want its jail to be the largest mental health facility in Texas anymore — but first it needs to find somewhere else to accommodate patients before they get swept up in the criminal justice system.

The office created a separate bureau last year responsible for mental health and jail diversion. While other law enforcement departments around the country are also trying to keep mentally ill and drug-addicted patients out of jail and into treatment, Harris County believes it’s the first to formally create a separate bureau responsible entirely for mental health and jail diversion. It has equipped deputies with tablets that connect to a psychiatrist for on-the-spot treatment or triage and will set up a central booking desk this fall to better sort those arrested into treatment before they get charged with a crime.

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For the new programs to work, however, officials in Harris County, which includes Houston, need to seize on state lawmakers’ growing awareness of mental health. Without more treatment options in the community, the jail will keep doubling as a mental health hospital. Currently about one in four of its 10,000 inmates have a diagnosed mental illness and receive some form of psychiatric medication every day.

“We can only fill the slots we have,” said Republican county leader Ed Emmett, whose office is spearheading the efforts to keep mentally ill patients out of jail — and get them help in the community.

Harris County Psychiatric Center, which has nearly 300 beds, has long since reached its capacity and often closes its doors to officers who want to drop off patients instead of taking them to an emergency room or jail. In 2016, Disability Rights Texas filed a class action lawsuit against the state on behalf of nearly 350 inmates waiting for mental health treatment. That case is still winding its way through federal courts.

True pre-booking diversion “hasn’t totally occurred yet and won’t for quite a while,” said Emmett. Still, he said he’s hopeful “because everybody now is talking about the subject of mental health.”

The Harris County Jail already treats more mentally ill patients than the rest of Texas’ mental hospitals combined. In 2017, the sheriff’s office said it spent $22 million on providing mental health care in its jail.

The shuttering of state-run psychiatric hospitals over several decades has pushed jails like Harris County’s into the front lines of mental health treatment. With fewer treatment beds, jails are the only place for many mentally ill patients to go.

The number of people in state-run mental health institutions nationwide has plummeted to 45,000 in 2015 from 560,000 in 1955, according to a 2015 JAMA article. Meanwhile nearly 400,000 people behind bars around the country in 2016 had a mental health condition, according to the Treatment Advocacy Center. That’s about 20 percent of the jail population and 15 percent of the prison population.

“The reason Harris County Jail has become the largest mental health institution is because there is nothing else,” said state Rep. Gene Wu, a Democrat who represents the area, and who is also a former prosecutor in Harris County. “The jail has become a dumping ground for people who have minor violations.”

The sheriff’s office has worked on referring those arrested to mental health courts, treating and preparing inmates so they don’t get arrested again and training officers to respond to people with mental health issues to prevent situations from dangerously escalating. The effort has been going on for a few years, but now it can’t keep up with growing demands.

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