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New program unveiled to help mentally ill in Bexar County jail get to trial

Bexar County Adult Detention
Paul Flahive
Bexar County Adult Detention

As many as 300 people at the county jail are so mentally ill, addicted, or disabled they are not competent to stand trial. They don't understand the charges against them, the reason they are there, or what is happening around them.

Those on the “clearinghouse list,” as it is called at Bexar County Adult Detention, are there waiting for a state hospital bed to get treatment. The treatment is solely to assist them to the point where they understand enough about their situation to go to trial.

In recent years, the wait times for state hospital beds have swollen to more than 18 months, causing a backlog of people waiting in jails.

According to the Bexar County Sheriff’s Office, the wait for competency is longer than many of them would have been sentenced to begin with.

Bexar County Jail has been regularly above 80% capacity for more than two years. The Texas Commission on Jail Standards has said these levels can strain staff to maintain order and keep everyone safe. It has also seen overtime costs run more than $10 million last year.

Paul Flahive
Sheriff Javier Salazar stands behind Center for Healthcare Services CEO Jeylnne LeBlanc Jamison

The population deemed incompetent are at heightened risk because of their vulnerabilities. Sheriff Javier Salazar said Monday they also exacerbate the problem because this population requires more attention from staff.

“Under normal circumstances, normal inmates would be a one to 48 ratio — one deputy for 48 inmates. Some of these inmates that we're talking about of these 300, some of these are almost on a one to one ratio,” he said at a press conference.

The Justice Department has given the Center for Health Care Services (CHCS) $1.6 million to assist the Bexar County Sheriff’s Office get people back to minimum competency levels so they can continue to trial. Commissioners court voted on Tuesday to allow the work to begin.

The grant funds a pilot program of treatment within the jail to restore competency. Between now and the end of 2024, when funding ends, they hope to help 120 people. CHCS hopes to continue the program with another DOJ grant after 2024.

“I think that there's a good, good program here — a portfolio of different solutions for those individuals that need those services,” said Grant Moody, a Bexar County commissioner.

According to the Bureau of Justice Assistance, about a little more than half of the people that have been restored to competency through one of these grant-funded programs have their charges dropped.

Rises in assaults, deaths, and suicides plague the state's 242 jails as the state saw a 9% rise in population numbers. Mentally ill inmates seen by regulators as in 'dire' situation.

The chief criticism of programs like this is that people with disabilities or who are severely mentally ill or in acute crisis should not be in jail.

“I think [jail-based competency programs] are a really bad idea. A jail is not the proper setting for any sort of mental health care,” said Krishnaveni Gundu, who is with the Texas Jail Project, in a February interview with TPR. “The solutions to these issues lie outside the jail."

CHCS CEO Jelynne LeBlanc Jamison said ideally this would not be done in the high-stress environment of a jail.

“We're trying to work within the system," she explained. "And we're trying to address those individuals so that they are competent to stand trial and continue their court proceeding. But no, jail is no place for someone who is faced with mental health or substance use challenges."

The county has struggled to find state mental health access. The San Antonio State Hospital — which is the closest provider for treatment— serves 24 counties as well. In short, Bexar County is underserved.

“It is time for Bexar County to have a psychiatric center," said LeBlanc Jamison. “Houston has one Dallas has one, It’s Bexar County’s time. Our population is growing.”

A recent report out by the Meadows Mental Health Policy Institute said Bexar County needs its own psychiatric campus. County officials have yet to be successful in obtaining the tens of millions of dollars needed to build one. There is no clear path forward on the project yet.

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Paul Flahive can be reached at Paul@tpr.org