Tuesday, August 10, 2010

Texas county violates state law by not giving psychiatric care to mentally ill inmates

The intro to a much longer story in The San Antonio Express-News:


Bexar County is breaking a state law requiring the swift examination of every mentally ill prisoner in jail, leaving an untold number of inmates languishing without proper psychiatric care.

Local courts are supposed to order psychiatric exams and use the results to route many of the mentally ill offenders toward treatment and away from the jail, where only one part-time and two full-time psychiatrists are employed to treat about 900 inmates a day suffering from some form of mental illness.

The jail is screening inmates when they are booked and providing a daily list of the mentally ill to magistrates.

But the courts at that point drop the ball, saying they are overwhelmed and lack the resources to order the examinations or distribute reports to attorneys. And mental health providers inside the jail say they lack the staff to adequately examine every prisoner who might be mentally ill.

As a result, the jail continues to warehouse mentally ill offenders accused of minor crimes who would be better served in psychiatric hospitals. The courts’ failure to follow the law contributes to crowding at the jail, where an estimated 21 percent of the 4,500 prisoners have a mental illness.

Rep. Pete Gallego, D-Alpine, who sponsored a bill last year to clarify how officials must share information about inmates’ mental health, said the law’s aim is to ensure resources are directed more efficiently.

“The goal is to do it up front,” Gallego said. “The way the system was working was, you weren’t catching (the mentally ill) until the tail end, and by then the person had been sitting in jail and needing health care for a period of time.”

Amended in the last legislative session, the law now requires jail officials to notify “a magistrate” within 72 hours of learning that a prisoner is mentally ill.

The magistrate then must order an examination of the inmate, and a report of this examination — including a recommended course of treatment — must be submitted to the magistrate within 30 days of the order.

The magistrate then must send a copy of the report to the prosecutor and the defendant’s lawyer. The court can’t resume criminal proceedings against the inmate until after it receives the examination report, according to the law.

But local magistrates aren’t following through after they receive the jail lists.

Ana YaƱez-Correa, executive director of the nonprofit Texas Criminal Justice Coalition, objected to this failure.

“Without this information, how are you going to serve justice?” she asked.

Bexar County Criminal Magistrate Judge Andrew Carruthers said facilitating the process is not his job.

“I have a full-time responsibility working for 10 criminal district courts,” Carruthers said. “My schedule will not accommodate that.”

He added that the law “says ‘a magistrate.’ It does not say the criminal magistrate of Bexar County.”

Carruthers made that much clear when he wrote jail officials a bemused memo in March.

“Over the past several weeks, someone in jail administration has been e-mailing me a list of persons suspected of having a mental illness,” he wrote, adding that his “duties and resources do not encompass compliance” with the law, Article 16.22 of the Texas Criminal Code.

Criminal District Court Administrator Melissa Barlow Fischer said the law’s designation of “a magistrate” is too vague.

“That’s part of the problem,” she said. “We don’t know who they mean. And the poor jail doesn’t know who they mean.”

Fischer said judges at the county’s central magistrates’ office, where three work full time and nine work part time, are “not doing mental health evaluations. That’s not their job.”

She added, “Most (Texas) counties are like us. They don’t have the resources and they have not implemented this to the letter of the law, like it should be.”

In a May letter, District Judge Mary Roman told county commissioners that Bexar lacks “additional medical personnel, mental health magistrates and administrative staff” to follow the law but is in “substantial compliance with the intent of Article 16.22.”

“We’re doing everything we can at this point,” Roman said in a recent interview. “We would be glad to do even more, but the resources have to be there, and we’re not in charge of the resources.”

Roman said she believes the statute is more suited for smaller, rural counties, an assertion echoed by other local officials, including Bexar County Sheriff Amadeo Ortiz and District Attorney Susan Reed.

Gallego refuted that.

“I would argue that Austin, San Antonio, Houston, Dallas, Fort Worth, El Paso, just statistically, they’re going to have more people with mental health issues in their jails than the rural counties are,” the lawmaker said.

He called so-called “substantial compliance” with the law insufficient.

“The analogy that I’ve used is basketball,” Gallego said. “The ball either goes through the hoop or it doesn’t.”