Pursue unit near the jail to treat the mentally ill
Despite the best efforts at diversion, many people with mental health issues end up in the criminal justice system. It’s led to no small amount of tragedy.
Think of Janice Dotson-stephens, who lived with schizophrenia and died in the Bexar County Adult Detention Center in 2018. She spent months in jail on a criminal trespass charge, losing 136 pounds because she refused meals. Think of Jack Ule, a homeless and schizophrenic man who died in the jail in 2019, also placed there on a criminal trespass charge and nominal cash bail he could never afford.
Bexar County officials estimate about 25 percent of inmates in the county lockup have mental health issues. There is no doubt those with mental health issues, especially the ones accused of nonviolent offenses, would be better served in a setting that treats mental health.
On this front, we like Sheriff Javier Salazar’s plans to convert space in the county’s jail for a dedicated mental health facility. The sheriff has proposed a facility separate from the jail and staffed by health care professionals. As Salazar told the Express-news, the facility would not only allow inmates to receive the services they need, but it would also reduce the population in the main jail and ease staffing woes.
The county jail’s daily population is usually about 4,000 inmates, placing it near 80 percent capacity. Meeting the state’s jail standards, which require one detention officer for every 48 inmates, always has strained the county budget and led to chronic overtime challenges. Meeting the demands for spacing and isolation of inmates during a pandemic has only compounded the problem. County officials want to work with University Health on the proposed mental health unit. Discussions are underway on the hiring of a consultant to conduct a feasibility study and determine the construction and operational cost for such a facility.
It has the makings of a good partnership. University Health officials recently approved spending an extra $300,000 a year to provide better access to health care for people who are homeless or mentally ill. It’s an effort to keep down emergency room costs.
The county’s hospital system and several San Antonio area hospitals help fund programs through the South Texas Regional Advisory Council, or STRAC, to divert medically stable patients from jails to appropriate mental health facilities. This is not just a Bexar County problem. An estimated 2 million people with mental illness are booked into jails each year, according to the National Alliance on Mental Illness. The numbers indicate that nearly 15 percent of men and 30 percent of women booked into jails have a serious mental health condition. Incarceration of people for minor infractions does more harm than good, does nothing to address public safety and allows mental health issues to persist.
We think Salazar’s idea is in the right direction. Questions to consider going forward: Is the jail the best place to provide such mental health treatment? Should inmates be treated in a less-restrictive environment outside the jail? Whatever the outcome, Salazar’s proposal is another example of why the jail needs to remain under the authority of the sheriff.
Newly elected Precinct 3 Commissioner Trish Deberry has expressed an interest in returning jail management to county commissioners. Bad idea. This has the potential to open the door to privatization.
A better approach is to improve the existing system. A designated mental health unit for those who find themselves in the criminal justice system simply because of the lack of capacity to treat mental illness would be a step in the right direction.
How that unit is structured, and where it is placed, should be the conversation.