New state policy limiting criminal psychiatric beds has local officials upset

By CINDY V. CULP, Tribune-Herald staff writer

Area officials are once again decrying the state's approach to mental health care as they grapple with a new policy that will place more of the burden of caring for mentally ill criminal defendants on local jurisdictions.

Earlier this week, the state initiated a policy that limits the number of criminal commitments to state hospitals. Designed to relieve overcrowding at the psychiatric facilities, the new rule says that only a certain number of beds can be occupied by people charged with a crime. The rest must be reserved for non-criminal admissions.

But the problem, local officials say, is that the inmates still have to be cared for. The only difference now is that local jurisdictions will have to pick up a bigger portion of the tab, since jails will have to keep inmates during periods when forensic beds aren't available.

“It's basically just a lack of funding for state hospitals,” said Barbara Tate, executive director of the Heart of Texas Region Mental Health Mental Retardation Center. “It shifts the costs back to the counties.”Texas has 11 state hospitals with a total of 2,278 beds. Of those, the state has now designated 642 beds for the so-called forensic patients.

However, there are already more criminally committed patients in the system than that. During the first fiscal quarter of the year – September, October and November – the state averaged 739 forensic patients each day, said Doug McBride, spokesman for the Texas Department of State Health Services.

That means there likely won't be a large number of open beds any time soon. Although the state probably won't wait until criminal commitments plunge below 642 to allow more, it does intend to stall forensic admissions until some of the current patients leave, McBride said. As that happens and beds become available, they will be filled on a first-come, first-served basis, he said.

How long that will take is difficult to determine, officials say. The majority of criminal commitments are for people who have been found incompetent to stand trial. That means they don't understand the charges against them and cannot aid in their defense.

On average, such competency patients are hospitalized for 85 days, officials say. But some stay longer.

The rest of the forensic population is even slower to treat. They are people who have been found not guilty by reason of insanity, and their treatment often lasts for years, if not their lifetime.

Tate, the head of the local MHMR, estimated that it will now take several months to move someone from a local jail to a state hospital. In the past, the process usually only took a few days, she said.

Each year, about 20 inmates in the six-county area served by the local MHMR office are found incompetent, Tate said. If that many people languish in local jails for weeks or months, it won't be good for anyone, she said.

Even though the local jails are good about getting mentally ill prisoners the medications they need, they can only provide minimal treatment, Tate said. Plus, caring for the inmates isn't cheap, she said, and the longer they have to stay in local jails means the more counties have to spend.

“Justice is not served,” Tate said. “...They are just in limbo at the county's expense.”

McLennan County Sheriff Larry Lynch expressed similar thoughts, saying his jail is housing all three of the local inmates who have been declared incompetent recently. One is set to be moved to a state hospital sometime in March, he said, but it will be April or after until the other two are transferred.

That lag is a source of both potential liability and stress, Lynch said.

“We should not be holding these people because this is not a place (designed) to do that,” Lynch said. “It's kind of scary. We are not trained to do this ... but they keep forcing it on us.”

McBride said the current policy is only a temporary fix. The state will either have to allocate more money for forensic beds or come up with other solutions to stem the tide of criminal commitments. Since 1999, they have more than doubled, he said.

Whatever the long-term solution may be, local officials are hoping the state will resolve the current crisis soon. In particular, they want the Texas Legislative Budget Board to approve a request made recently by the director of the state hospital system.

The director asked for emergency funding in the form of $34 million in state money and $7 million from other sources. If that money is approved it would pay for 100 more civil beds and 98 more forensic beds.

The Associated Press contributed to this story.

Email at: cculp@wacotrib.com 

Online at: http://www.wacotrib.com/news/content/news/stories/2006/02/03/20060203wacmentallyill.html