Nearly two years ago, Troy Wilson was deemed incompetent to stand trial and Judge Stacy Trotter signed an order committing the suspected serial shooter to a state mental hospital so he could get well enough to return to Ector County to be tried.
He never made it.
Wilson, 39, is still sitting at the Ector County Law Enforcement Center. In fact, he’s one of 26 criminal defendants whose criminal proceedings have ground to a halt because they are waiting for a bed at either the North Texas State Hospital in Vernon or the Big Spring State Psychiatric Hospital.
Every one of the defendants, whose alleged crimes range from violating a protective order on the low end up to sexual assault of a child and capital murder on the high end, have been evaluated by mental health experts and found to be incompetent. In other words, because of their mental health issues they don’t understand the nature and point of the proceedings against them and they can’t assist their attorneys in mounting a defense.
In many cases, people can be “restored” to competency with the help of medications and education, but jail administrator Capt. Steven McNeill said there are currently 500-600 defendants who are waiting for that opportunity statewide. When the beds are available, those accused of violent crimes are sent to Vernon, the rest are sent to Big Spring.
There is some hope on the horizon, however.
Ector County and PermiaCare will soon be starting their own competency restoration program within the jail.
Todd Luzadder, the director of mental health services for PermiaCare, said they are in the process of hiring someone to head up the program and McNeill said they hope to have the program up and running sometime within the month.
PermiaCare began a pilot program in the Midland County jail that has been “very successful,” Luzadder said, adding that most patients have been restored to competency in under 70 days.
They adopted a model used in Florida, he said. Besides treating them for their mental health illnesses, PermiaCare staff members visits with defendants one to four times a week, depending upon their needs, to teach them about the different roles played by people in the criminal justice system and what is expected of them in terms of helping their attorneys, Luzadder said.
The pilot program is being funded with a state grant and a portion of it will pay for the Ector County program, Luzadder said. Ector County will contribute to the cost by providing nursing staff and detention officers.
“At the end of the day, we’re trying to make sure we’re serving patients in the least restrictive place possible,” Luzadder said. “We want to get them off the wait list and to wherever they need to be, whether it’s acquitted at trial or placed on probation or sent to prison.”
The Ector County jail currently has roughly 850 inmates with another 70 or more at other county facilities, McNeill said.
Roughly 10% of them have a serious mental illness, but only the 26 have been declared incompetent, McNeill said.
“Unofficially Ector County Detention Center is like the largest mental health facility right now in West Texas because a lot of these people commit crimes and end up incarcerated in many cases,” McNeill said. “The family doesn’t know that they’re mentally ill, they just can’t really put their finger on why their son or daughter or loved one is behaving that way. In some cases, they do know the diagnosis, but the person just refuses to take medication which is also very common and we experience that in here. We’re not unique in that regard.”
All of his officers receive special training to deal with mentally ill defendants and to prevent suicides, McNeill said. In addition, the jail has 24-hour medical staff on hand. Psychiatrists from Texas Tech University Health Sciences Center and PermiaCare come in regularly and are on-call. In addition, inmates have access to telehealth and telepsych services.
“Some of (the defendants) are more concerning than others because they don’t all have the same types of mental illness and some of them are being treated while they’re in custody because they’re willing to accept the psychiatrists’ prescription medication that’s needed to treat their different types of disorder and then others refuse to believe that there’s anything wrong with them, it’s everyone else and they’re completely delusional and in a state of psychosis. Those are the ones that tend to be more concerning and taxing on our existing resources,” McNeill said.
A lot of the mentally ill defendants they see at the jail have schizophrenia, bipolar disorder, schizoaffective disorder or a major depressive disorder with psychosis, McNeill said.
Despite what people may think, those with mental illnesses are not necessarily violent, McNeill said.
“Typically what we see as a police officer, as a jail administrator, is that they’re more of a danger to themselves than they are to others,” he said.
However, there are some patients who become delusional, have hallucinations and exhibit extreme paranoia, he said.
For example, a defendant could believe demons want to disembowel them.
“It would be extremely terrifying to them and in their mind this is extremely real, and nothing you or I can say to them, that’s going to change their beliefs, that’s their reality for them. So it’s very frightening to them and they may act out in a type of self-defense towards others believing that this person is trying to steal their thoughts or harm them in some way and so they can become violent in that regard,” McNeill said.
Detention officers sometimes have to deal with people who are mentally ill and have a borderline personality disorder or antisocial personality disorder, he said.
“They’re aware of what they’re doing, and they do it because they get some type of enjoyment out of it. They like to be malicious or sadistic and hurting somebody. They are usually the more dangerous ones, because they have some control over what they’re doing,” McNeill said.
If they happen to be bipolar, too, and aren’t taking their medications, they could become extremely depressed and suicidal, he said.
Those patients need to be monitored 24 hours a day, McNeill said.
“We have had people with borderline personality disorder who are also having manic episodes with bipolar disorder. They are at high risk of suicide and impulsive behavior, and I’m talking things like swallowing razor blades and you know, very violent self acts of harm,” he said. “For those unique and rare cases, we have to do a constant watch where we actually assigned a detention officer to sit there and monitor them 24 hours a day.”
McNeill said he’s not only excited about the jail restoration to competency program, but he’s also looking forward to a new $80 million regional behavioral health facility that is expected to be built by 2024.
Many times, law enforcement agencies throughout the Permian Basin receive calls about mentally ill people who are behaving oddly and committing petty offenses. Once built, officers will have the option of taking them to the new facility for evaluation and treatment instead of taking hours out of their shift to drive them to facilities hundreds of miles away.
The facility will also benefit thousands of other struggling Permian Basin residents who also have to drive to Lubbock or San Angelo to receive care.
Last year, legislation was passed that includes $40 million for the behavioral health center, which will be constructed and built by the hospital districts in Midland and Ector counties.
The center will include 100 inpatient beds and outpatient psychiatric care facilities, along with a crisis stabilization unit, professional offices, and counseling and therapeutic spaces appropriate for all ages.
“We’re excited about this facility. It’s going to be a huge benefit to the people in our community and it’s going to be even a bigger benefit in a lot of ways to the silent minority of people that are taking care of loved ones that have these disorders,” McNeill said. “It’s going to give them some peace of mind and maybe for the first time in a long time a nights sleep where they can rest comfortably knowing that they’re in good hands. We have a lot of concerned family members who call up here almost every day, sometimes multiple times a day because their loved one is in jail and they don’t think that we’re aware of what their disorder is or how to treat that.”
Medical Center Hospital CEO Russell Tippin said that right now law enforcement officers are taking mentally ill people to San Angelo facilities, dropping them off and having to arrest the same person on their next shift.
Tippin said he and Russell Meyers, president of Midland Memorial Hospital, have been reaching out to companies and potential donors to secure the rest of the funding for the facility.
“We have enough requests out to cover the difference and a little more for operation for the first couple of years. But cash in the bank, that’s yet to happen, because there’s still a lot of paperwork to be done at the state level. But we’ve gotten a lot of good calls. We want more,” Tippin said. “You know, even though some people say ‘Yeah, we’d like that project. That sounds good.’ There’s a difference in saying that and depositing the check to different things. So we never stop looking for new sources of funding, never.”
They’ve also been looking at locations for the facility, including land out by the airport and east of the MCH Center for Health and Wellness. Where they decide to purchase the land will depend not only on the price, but also on the availability of utilities, he said.
The smallest piece of land would be 40-50 acres, but 75-100 would be great, he said. They’d like to have walking trails and reflection areas.
The parties are also working with the state on the “pages and pages and pages” of paperwork that needs to be taken care of, Tippin said.
“I think the legal work between this group and the state is moving along. You know, I won’t say it’s moving at warp speed, but it is not standing still. So I’m happy. I’m happy about that,” Tippin said.
Once built, Tippin said the facility will be able to provide the type of one-on-one help that just isn’t readily available here now, especially for children. He anticipates having a staff of 500, including those who would work in billing, administration and facilities.
“Something that’s come up from some of our conversations we’ve had with local groups, law enforcement and school districts is the need for pediatric service. That is a huge need. I’m telling you, I think we could build a 100-bed pediatric center by itself,” Tippin said.
Studies have shown that during the pandemic, there’s been an increase in pediatric stress and mental health issues have risen, he said.
“I think we’d be foolish if we didn’t address that in a pretty significant way, in the Permian Basin. And I know and you know, too, if it was my child or your grandchild, we’d want those people to be as close to that care as possible and we got an opportunity to do that,” Tippin said.
“I know a lot of people know there’s no place like home. People heal and recover better locally, whether that’s in a local facility and local hospital or at home, they recover better, and they get more support when they’re in their hometown and not three hours down the road, four and a half hours down the road.”
