This article is of particular interest because, while bemoaning Dallas County's lack of mental health care and the length of time mentally ill prisoners have to wait to be sent to state hospitals, Sharif, who is a perfectly normal human being, was rushed in hospital care. The cost of keeping him in jail is just over $100 per day while the cost of treating him at the state hospital is closer to $500 per day. It is our suspicion that, when the lawyer, the doctor, and the prosecutor realized that they had falsely arrested Sharif, they quickly had the court declare him incompetent and shipped him out before he could speak to the judge.
MENTALLY ILL CARE WORSENS
Jail situation under scrutiny; state hospitals overburdened
By JAMES M. O'NEILL /
The Dallas Morning News
E-mail
joneill@dallasnews.com
09:24 PM CDT on Sunday, July 17, 2005
http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/071805dnmetstatebeds.6db3912.html
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Dallas County's mentally ill are getting squeezed at every turn.
As anemically funded community programs struggle to help them remain stable, many mentally ill wind up in the county jail, only to be denied vital medication for weeks at a time.
And now, because of a waiting list for beds in the overburdened state hospital system, inmates found incompetent to stand trial must languish in the jail for weeks longer before getting treatment -- a further risk to
their health.
"Jail is no place for people declared incompetent," said Vivian Lawrence, a criminal justice specialist with the Mental Health Association of Dallas. "They will continue to deteriorate."
Julie Noble, president of NAMI Dallas, a mental health advocacy group, agreed. "It's a bad situation getting worse," she said. "To have them sitting in the jail won't do anyone any good."
Ed Moughon, superintendent of Big Spring State Hospital, said that jail confinement probably has the most dire consequences for those with mental illness than those with any other illness.
County court records indicated that at the end of June, at least 10 inmates who had been found incompetent to stand trial during the month were still waiting for beds. Some had their competency hearings two or three weeks
earlier. One had his hearing in mid-May.
Health care at the jail has come under intense scrutiny, especially since a mentally ill inmate, James Mims, nearly died last year because he did not receive his medications for weeks and water was shut off in his cell.
To this day, inmates, family members and advocates say mentally ill inmates wait weeks for their antipsychotic medication. Experts say that going without medications creates serious withdrawal symptoms and leaves inmates open to depression or manic episodes.
Dallas County commissioners are working with national experts to improve jail care and have made a verbal commitment to increase spending.
The backlog of incompetent inmates awaiting state hospital beds has been sparked by the growing number of mentally ill people winding up in jail and then being found unable to stand trial.More patients
Kenny Dudley, director for the state hospital section of the Texas Department of State Health Services, said that of the 2,200 mentally ill patients in the state hospital system, about 650 are sent from jails to be stabilized for trials. Five years ago, inmates took up only about 300 beds, Mr. Dudley said.
"The demand keeps growing, but the capacity of the system has remained the same," he said. "It was infringing on our ability to take in civilian patients."
The length of stay for inmates is usually longer than that of other patients because they need to be stabilized enough to converse with their attorney and understand the charges filed against them.
In the past, most of the system's facilities took inmates. Terrell State Hospital was the primary recipient for Dallas inmates, but last year the hospital was running 100 people beyond its normal capacity, Mr. Dudley said.
The huge spike in demand forced the state this year to consolidate staff that work with inmates at five facilities. The idea was to provide better, more intense care and hope the inmates would improve and not return.
But the demand is such that the new primary facility for Dallas jail inmates -- the state hospital in Wichita Falls -- has been full, and so has the secondary facility at Big Spring.
"Right now we're jammed up," Mr. Moughon said. "The whole system is overloaded."
Big Spring is about five hours west of Dallas, so transporting prisoners there can tie Dallas sheriff's staffers up overnight. And the distance makes it more difficult for families to visit.
Mr. Moughon said the Big Spring campus includes a facility for visiting family members.
Dallas' poor jail health also exacerbates the state hospital overload. Dr. Mitchell Dunne, a Terrell staff psychiatrist, has said that even after Terrell staff stabilized mentally ill inmates and sent them back to the jail, inmates often returned to Terrell in bad shape, saying they hadn't received their medication in the jail.
Advocates say the root of this domino of problems is the dearth of funding for community-based programs for the mentally ill that would help keep them medicated and out of the jails and state hospitals in the first place.
"When folks don't have community services, they keep showing up in the courts," Mr. Moughon said. "The charges are minor, and initially they are usually dropped. But then it keeps happening, and they end up in jail. The people we treat are not doing violent crimes. There just aren't enough resources in the community for them to get the medical help they need."
Advocates say the county also needs to step up its diversion programs, aimed at keeping the mentally ill who commit minor crimes out of the jail. The county recently started a divert court for mentally ill arrestees, which has had some success.
But advocates point to other cities with far more developed diversion efforts.Houston
The Houston Police Department started a crisis intervention team in 1999. Specially trained police officers know how to identify the symptoms of mental illness and cope with the mentally ill people in crisis.
The program, begun as a one-year pilot with 60 officers, proved so successful that after six months it was expanded. Currently 600 Houston officers are trained through the program.
Betsy Schwartz, executive director of the Mental Health Association of Greater Houston, said the Houston program started after a 1998 task force of area advocates visited similar programs across the country.
When they identify a mentally ill suspect, the Houston police also have a designated facility to take them. Harris County taxpayers pay for a Neuropsychiatric Center with a 24-hour stabilization facility and a 16-bed unit for stays of up to five days. Then patients can be transferred to the Harris County Psychiatric Center.
"The intent of all this was to reduce the number of mentally ill in the county jail," Ms. Schwartz said. "But the lack of funding for community-based services causes more mentally ill people into crisis, and more end up in jail. It's catastrophic."
Dallas has nothing like Houston's diversion programs. Police sometimes take mentally ill people to Parkland Memorial Hospital. Ms. Lawrence said police also take about 200 people to Green Oaks Behavioral Healthcare Services each month but not all meet the private hospital's criteria.
In addition, Dallas County has only two crisis intervention officers to cover the entire county.
Dallas Police Department has no similar program, but it does call on the city's crisis intervention unit. The unit director, Dave Hogan, said staff arrive when police call them to a scene and help link mentally ill people
with community programs.
