Tarrant County officials wanted the state Legislature to fund a study into building a new, local state psychiatric hospital to reduce the long list of people in the county jail waiting for a psychiatric bed.
That push for the hospital study failed this session, but the state opened up new funding to get people off the waitlist.
The Legislature put up money to establish 150 more psychiatric beds for inmates at local hospitals statewide and created a $100 million bucket for criminal justice-related mental health services, said Russell Schaffner, the assistant Tarrant County administrator in charge of legislative issues.
“While we did not get the study this session, we did get a number of tools that can help us deal with our problem more immediately,” Schaffner told county commissioners last week.
Statewide, thousands of people are waiting in jail for a state psychiatric bed, with their criminal cases on pause. They’ve been declared mentally incompetent to stand trial, and their cases can’t proceed until they go through a process called competency restoration.
Competency restoration is not like other forms of mental health treatment, according to the Texas Judicial Commission on Mental Health. The goal is to stabilize someone so they can understand the charges against them and participate in their own defense.
"This is not the same as providing access to a fully developed treatment plan and treatment services with the goal of long-term recovery and rejoining the community,” the commission’s website states.
But there aren’t enough psychiatric beds to meet demand, and the state has had a hard time keeping up staffing.
As of June 9, there were 174 people in the Tarrant County jail waiting for a bed at state psychiatric hospitals in Wichita Falls and Vernon, according to the Tarrant County Sheriff’s Office. Both Tarrant and Dallas counties have reported that some people wait for years, and Dallas County is suing the state over the problem. So is the advocacy organization Disability Rights Texas.
People sometimes spend more time on the waitlist than the maximum sentence for the crime they’re charged with, said Susan Garnett, the CEO of My Health My Resources (MHMR), Tarrant County’s mental health authority.
That means their cases time out and they’re released.
One way MHMR plans to speed up the competency restoration process is to expand its jail-based competency restoration program, with help from the state’s new $100 million funding pool, Garnett said.
Jail-based competency restoration is an alternative to sending people to a state psychiatric hospital. As the name suggests, willing participants can undergo the competency restoration program from jail instead.
Jail-based competency restoration doesn’t work for everyone, but it provides another option, Garnett said.
“This is why we look forward to a combination of both jail-based competency restoration and hospital-based competency beds from the state," Garnett said. “We think with those two resources together, we'll be able to do a better job of meeting people's needs and be able to get them in the program that's right for them.”
Not all see jail-based competency restoration as a good solution.
Beth Mitchell, an attorney with Disability Rights Texas, said jail-based competency restoration programs don’t solve a fundamental problem: Jail is a dangerous place for people with mental illnesses, and the environment can make their illness worse.
"In part, it's making it easier for the state, because now the state doesn't have to provide the beds and the other resources that it should be providing for this population," Mitchell said.
North Texas will get more psychiatric beds this decade. UT Southwestern is partnering with the state to build a new psychiatric hospital in Dallas. The project broke ground in December, and the adult facility is expected to open in late 2025. The Legislature this session put more than $2 billion toward increasing state psychiatric hospital capacity.
As for the 150 extra psychiatric beds for people in jail, housed at local hospitals around the state, Garnett said she’s not sure how many could come to Tarrant County, or which hospital would take them on.
Democratic Tarrant County Commissioner Roy Charles Brooks said the state will realize someday that Tarrant County needs its own psychiatric hospital.
“If I was the benevolent dictator of the state of Texas, the first thing I would do is to put mental health treatment on parity with physical health treatment,” Brooks said. “Equal resources on both sides of the equation.”
Texas ranks low among states for mental health care access. Jails are the largest providers of mental health care in Texas, according to the Texas Association of Counties.
That needs to change, Brooks said.
“We don’t count on people to get arrested in order for their physical health needs to be met,” he said.
Got a tip? Email Miranda Suarez at msuarez@kera.org. You can follow Miranda on Twitter @MirandaRSuarez.
KERA News is made possible through the generosity of our members. If you find this reporting valuable, consider making a tax-deductible gift today. Thank you.
