State Cuts Force Police To Care For Mentally Ill

AUSTIN (AP) – In a state that offers meager funding for mental health, law enforcement officers across Texas have performed the duties of psychologists and social workers — roles they have neither the training nor the manpower to bear.

The Texas Legislature, which has never been generous to mental health clinics, has further withered services under the strain of a strapped state budget, and as a result, police and sheriff’s departments say the number of mental health calls they respond to is snowballing.

And thanks to a new $27 billion budget crisis, it may only get worse.

Initial proposals would cut services provided by the Texas Department of State Health Services by 20 percent, making it more likely for mentally ill Texans to end up in emergency rooms, having mental breakdowns or being thrown behind bars.

“We’re about to see huge setbacks. I think we’re going to get slaughtered,” said Leon Evans, chief executive of Bexar County Mental Health Care services. “We’ve been developing some tools so people don’t have to go to the hospital and prison. But I think all these programs that are very effective, that help to reclaim lives, are at risk.”

Experts say slashing mental health funding will have a painful and resounding effect across Texas when the mentally ill can’t access the treatment and medication they need to function.

“What’s happening is the criminalization of mental illness,” said Polly Hughes, public policy chair of National Alliance on Mental Illness. “It shifts the responsibility of taking care of mental illness to the counties and officers who are already stretched thin.”

Community services such as clinics, crisis hotlines and outpatient treatment are critical to keeping the mentally ill out of state institutions and jail.

The shortage of mental hospital beds means officers often have to drive a mentally ill person hundreds of miles to the next open bed.

“What we’re facing in 2011 are law enforcement officers as de facto social workers and jails becoming asylums,” Houston Senior Police Officer Frank Webb said. “Police officers are responding to more mental illness than social workers.”

Jails are packed with mentally ill Texans who most often haven’t committed a violent crime, but cycle endlessly through the system for minor violations, costing taxpayers thousands of dollars.

Texans with a serious mental illness are eight times more likely to be incarcerated in jails than treated in hospitals, according to the National Alliance on Mental Illness. A community health care program costs $12 per day to care for a patient, compared to $137 per day to incarcerate them, the group said.

Dallas County Sheriff Lupe Valdez said mentally ill inmates cost the county the most money, with more than a third of the county jail’s 6,000 inmates requiring mental health services. The cost of housing and providing care for these inmates was nearly $19 million in 2010.

As the seventh largest in the country, the jail is already dealing with limited resources and overflowing cells.

“If community mental health services don’t get the money they need, we’re going to end up being mental health institutions. In fact, we’re already there,” Valdez said. “If we start overloading the system, we’re not going to have what we need to take care of them.”

The stream of people into jail is continuous because it’s easier to get arrested than get treatment, Webb said.

Mental health cases are becoming so prevalent that departments across the state and nation have made Crisis Intervention Training a major part of department curriculum. Departments team up with local mental health authorities and receive specialized training to better understand mental illness and learn how to respond more responsibly.

Webb took the lead on engineering a unique program at his department that pairs a Crisis Intervention Training officer with a licensed therapist from Harris County. The pairs are designated as Crisis Intervention Response Teams and ride as partners to respond to the most serious crisis calls.

Webb said having a mental health professional to help with the diagnosis on the scene works effectively.

“If the person is in the (mental health) system, the clinician has direct access to the records and history, doctors and hospitalizations of the person,” Webb said. “It’s a stronger, smarter response.”

Officers learn about major mental illnesses like schizophrenia and bipolar disorder from professionals as well as people who suffer from mental illness. Role-playing is a crucial element in preparing officers.

But fundamentally, Webb said police officers are trained to deal with criminal law, not the mentally ill.

“The average officer around the state and country sees this as a burden,” he said.

The Washington-based National Alliance on Mental Illness found that between 2008 and today, 32 states and Washington, D.C., cut mental health services right on the heels of layoffs and home foreclosures that increased demand for services.

States are removing hospital beds, shuttering outpatient services or simply treating fewer people.

Dallas County expects a minimum increase of 60 percent in prisoners with mental illness next year. That can be tied directly to the state’s decision to deeply cut mental services, Valdez said.

“We’re the only ones who will pick up the mentally ill,” she said.

And counties across the state will be saddled with similar costs and challenges. Law enforcement officials have no doubt that for the foreseeable future they are the state’s front line social workers.

“Whether we should be doing it or not, whether we like it or not, the bottom line is that we are and we have to do the best job we can,” Webb said. “The budget cuts are just going to make it worse.”

(© Copyright 2011 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

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  • jim smith

    Another example of why our system is broken. Who are the imbeciles that make these absurd decisions? It is not the mentally ill population that mismanaged State or Federal funds. Based on the information in this article it is obvious that yet another misguided policy will result in making a bad situation worse. The cost comparison data $12 per day in mental health treatment vs. $137 in jail(more than that in prison) is crystal clear. Why did they even discuss this issue? It is a no brainer to any lucid person with a 5th grade education. This will result in more unnecessary deaths. Don’t the police kill enough people in the Metroplex?

  • Ellen

    This is not a good idea at all. i agree with everything jim smith posted. services for the mentally ill benefit everyone. Texans will figure that out once these services are further cut. Having a mental illness is not a criminal act and should not be treated as such.. If mental illness were like a broken leg, you could see the problem and understand why the person is suffering, I think more citizens would be concerned with their fellow man who is suffering a more private illness that can’t be easily “fixed” or understood.

  • 2sister

    I agree it’s not a good thing. I think many people, including some officials, don’t realize that many mental illnesses are physical illnesses caused by something going wrong in the brain. Insurance agencies are also bad about this kind of thinking.

  • Claudia

    Are prisons a growth industry in Texas?

  • Christopher

    According to the Bureau of Justice Statistics, by the end of 1990 there were 771, 243 people in state and federal prisons. Today it is estimated that there are 2 million people incarcerated in state prisons throughout the United States.

    In the 2006 report from the Human Rights Watch the number of people in jails and prison with mental illness nearly quadrupled to 1.25 million from 1999.

    Interestingly enough, in 1999, the U.S. Supreme Court issued its ruling in Olmstead v. L.C. 527 U.S. 581, which held that people with disabilities have a protected right under the Americans with Disabilities Act, not to be forcibly confined in state institutions.

    So, from 1999 to 2006, the states responded by simply locking these people up in herds, in state prisons, instead and in contast to what exists today, it is not all that different.

    The 2009 report from the Human Rights Index estimates that in 2009, there were 350.000 people with mental and other like disabilities in jails and prisons for, which was higher if you include anxiety disorders.

    In terms of managed health care services, Valitás Health Services which owns Correctional Medical Services, holds the contract to provide medical and dental servies in Missouri prisons. And according to the March 4, 2011 report by St. Louis Today website, Valitas will have an estimated $1.4 billion in revenue received this year.

    Mental Health Management Services, Inc., which owns Mental Health Management Correctional Services holds the contract to provide mental health & psychiatric, services in Missouri prisons. And from 2007 to 2011 it has received $86,963,449.17.

    Suffice to say, crime is a major money maker for private corporations, and because it is premised on a flat-fee payment, the objective for them is to produce financial profits. This begs the question of what incentive is there for these corporations to help offenders, when doing so will likely mean lower corporate profits?

    According to the March 2011 report from the National Alliance on Mental Illness, states, across the board, are making serious budget cuts to mental health care and treatment services. The natural cause and effect when we decrease services is to increase crime rates and with this, increase the prison population of offenders with mental and other like disabilities.

    As pointed out in the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act of 2008, “In addition, mentally ill offenders can be affected psychologically by incarceration differently than general population offenders.”

    People with disabilities are NOT second class citizens but are routinely treated as such, and when we cut funding for mental health / developmental services and programs, and for community housing providers, we disenfranchise this class of citizens and inflict irreparable harms.

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