AUSTIN — Using Sandra Bland’s death as a suicide case in point, a Senate committee on Wednesday called for Texas county jails to provide improved mental health services for people held behind bars to curb continuing loopholes in the system.

Members of the Senate Criminal Justice Committee, after applauding the Texas Commission on Jail Standards for the success of revised intake forms designed to minimize suicide risks, said additional changes are necessary to achieve a “zero-tolerance” of locking up mentally ill inmates without proper observation and treatment.

The committee is studying changes in state law to minimize suicide risks in local jails, and whether additional state funding is needed to provide for additional beds in state hospitals to care for the mentally ill – a plan that could cost tens of millions of dollars. But committee members made clear they want a solution.

Committee Chairman John Whitmire, a Houston Democrat who has been highly critical of lax jail rules that he said can enable suicidal prisoners, said non-violent, mentally ill offenders who are sitting in jail cells should be released if they are not a danger to the community, citing the 10 suicides in jails since last September.

“If they’re hanging themselves with a sheet, can grown-ups not decide not to put people in jails who are upset, scared and with mental health issues?” Whitmire said. “Bland used a trash bag. Did somebody not consider that as a dangerous item?”

Bland, a Chicago-area resident pulled over for a traffic violation in Waller County, was found dead in her jail cell last July in what was later ruled a suicide. Her death has sparked several investigations, and has prompted calls and protests for revisions in how jails handle prisoners with mental health issues.

Brandon Wood, Executive Director of the Jail Standards Commission, said the key to achieve the committee’s hope of no suicides is identifying mentally ill individuals at intake and placing them in paper gowns until they are stabilized, while they are observed at 15-minute intervals.

Witnesses said that jail medication lists vary from county to county, and some jail doctors may modify an inmate’s drugs – a key issue of complaint by critics of current jail rules, who say that changing medications can often worsen symptoms. But Wood said some jails’ doctors oppose use of narcotics or methadone, and they substitute other drugs for those behind bars.

Inmates must take what they are given by jail doctors.

“A majority of the jails have very detailed policies and procedures at the local level,” Wood said. “They have a specific formulary they are following. If [inmates] try to bring medications that are not in the formulary, they’re now under the care of the jail doctor.”

The Harris County Jail, which holds more than 9,100 inmates as Texas’ largest jail, was singled out for criticism again on Wednesday for locking up too many mentally-ill prisoners who are  being held for non-violent crimes. Critics say that often exacerbates their mental instability and can trigger suicidal thoughts.

Harris County officials have defended their current policies.

Testimony showed that about 700 of the Harris County inmates last week were non-violent offenders, and 2,247 were diagnosed with mental health issues – and were on psychotropic prescriptions.

Greg Hansch, public policy director of NAMI Texas, a group representing the interests of the mentally ill, said people who are not getting the right medications and not allowed to get what they were previously prescribed can die while incarcerated.

“The contract with health care providers, hospitals and some counties seem to be unclear about what is meant about the idea of a formulary,” Hansch said. “There are cases in which they were prescribed Xanax by their doctors and they were not prescribed those meds in the jail and died by seizures due to withdrawal.”

Dr. Marcus Guice, interim executive director in the Houston jail, said physicians prescribe Ativan to patients previously prescribed with Xanax in order to deal with withdrawal.

“We have doctors 24/7 in the facility. We have licensed health care professionals for all of the mental health and medical health issues,” Guice said.

Smaller counties do not have these types of resources, and county officials cautioned that increased state regulations for addressing problems in urban jails could financially cripple some local jails. Jackson County Sherriff A.J. Louderback said 85 percent of county jails in Texas have 100 beds or less and they lack the funding for mental health professionals in the county or hospital district.

“I have a jail nurse who comes in one day a week on Tuesday. We have to rely 100 percent on local mental health authority,” he said. “As a finance issue this is a critical area for us to collaborate.”

Lauren Lewis, associate commissioner for mental-health service for the State Department of Health Services, said there is a backlog of 206 inmates with mental issues for maximum-security beds – meaning that they are held in local jails. Another 170 prisoners are waiting for lower-security beds to open.

Only 30 beds at one facility are flagged for maximum-security inmates with intellectual disabilities, she said.

According to Lewis, the costs for the beds needed to alleviate the backlog range from $25 to $30 million. Demand for those beds has increased by 20 percent the last three years.

Whitmire suggested restructuring a Montgomery County mental hospital to house maximum-security inmates to increase state capacity. He called for jail officials and state agencies to seek additional funding, or propose solutions to the continuing lack of appropriate bed space for the mentally ill.

“I can’t fix a problem that I don’t know is broken,” Whitmire said. “You do a disservice to victims, courts and communities. With that particular backlog, you need a plan. Inmates are in county jails due to unavailability of beds. You and your colleagues must be a bit more outspoken about giving you more money to evaluate mental health cases. It’s a major roadblock for criminal justice.”

Bland, a Chicago-area resident pulled over for a traffic violation in Waller County, was found dead in her jail cell last July in what was later ruled a suicide. Her death has sparked several investigations, and has prompted calls and protests for revisions in how jails handle prisoners with mental health issues.

The state trooper who arrested Bland was later fired for not following proper arrest procedures.

This article was published in the Houston Chronicle on March 31, 2016.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s