TEXAS VIEW: Texas must stop punting mental health care to the county jails

THE POINT: Roughly a third of the state’s psychiatric beds are offline.

Industries all over are mired in staffing shortages. But the problems in the state’s network of psychiatric hospitals are particularly distressing, with significant repercussions for patients, county jailers and taxpayers.

This is a puzzle with no simple solution. Still, state lawmakers must intervene to help counties with a growing load of mental health cases. The status quo is unacceptable.

Last Thursday, almost 400 people in the Dallas County jail were waiting for a bed in a psychiatric hospital. That’s because courts had deemed those inmates incompetent, meaning they weren’t well enough to participate in their defense because of mental illness. Although some have the means to seek treatment at a private facility, most of them have no choice but to go to a state hospital to recover.

Yet the state government cannot staff roughly a third of its psychiatric beds, according to a presentation given to lawmakers in late June. So Texas is shifting the burden to the county jails, which have no alternative but to house the inmates until they can be placed in a state hospital or, in some cases, until they’ve been behind bars for so long that they have essentially served the sentence for a crime for which they have not been convicted.

The latter has happened with misdemeanor cases. In those circumstances, cases get tossed, and inmates are released from jail. But then they don’t get the health care that could restore them and help them avoid another run-in with the law.

The wait times in Dallas County offer a picture of how bad the situation has become. Female inmates waiting for a bed in a hospital that is not maximum security used to wait about 20 days in 2017; now they wait 353 days. For men, the current wait is 401 days.

Men who need a bed in a maximum-security hospital wait 822 days.

Dallas County Commissioner John Wiley Price, who oversees the county’s jail population committee, estimates that these delays have cost county taxpayers about $13.5 million.

To be fair to state officials, it’s not that they’re idle on this issue. As our colleague Josephine Peterson recently reported, the Health and Human Services Commission has adopted pay raises, recruitment bonuses, flexible shifts and contracted staff to shore up its personnel shortage. And it has started a program with 15 counties to vet whether inmates waiting for a bed are actually legally incompetent.

In Dallas, a new state psychiatric hospital is about three years away. Officials said last week that the breakdown of beds for competency restoration and for the general population has not been determined yet.

State lawmakers should collect and review data about jail wait times and the outcomes of the mental health jail diversion services in which they have invested heavily in recent years. Are the programs successful, and are people enrolling? If not, what is happening?

And we urge them to take action to ease the burden on county jails.

“We understand the workforce challenges,” Dallas County Assistant Administrator Charles Reed told legislators in a recent hearing. “We get it; we’re experiencing the same thing … but it rings kind of hollow for us because we have no one else to pass the buck onto.”

Dallas Morning News