A Civil Court order committed 1,529 individuals to one of ten Texas psychiatric hospitals in 1988 for mental health treatment. By 2015, that number had fallen to 6. Where did they go? Were they “cured”? Unfortunately more likely they are roaming the streets or in the state or federal jails.
Almost 1 in 3 Individuals in Jail Have Mental Health Issue
Of the 9,000 inmates in Harris County Jail, close to 3,000 have a mental health illness that requires psychotropic medications. Harris County Jail is often a holding facility for repeat offenders and minor offenses, which is useful to highlight because while almost 33% of these inmates have serious mental health issues, they are not even the one necessarily committing the most egregious crimes. In other words, if 1 in 3 of those awaiting trial or sentencing for lower tier crimes have mental health issues, imagine what the ratio must be for those in state and federal prisons.
Exorbitant Cost to Treat Absorbed by Criminal Justice System
The Average Cost per day to incarcerate the entire Harris County Jail pre-trial population is $333,645. That is nearly 1/3 of a million dollars spent each day in one Texas county to manage the pretrial population.
The state of Texas had grand plans of mental health treatment for those 1,529 individuals back in 1988, with the intention of helping patients receive the needed care to manage their mental health issues through medical and therapeutic interventions. The commitment to care never continued because funding expired or step down care was unavailable which meant patients making progress were released from a psych hospital directly back into society, not typically a recipe for long-term success.
Rather than spending the money to hopefully help patients become productive members of society by providing the necessary mental health care, these former patients are likely contributing to hundreds of thousands of dollars in costs every day to bring these individuals through the courts and jail system.
Continuum of Care
The challenge in our mental health system is often that we lack preventive and continued care, instead either seeking the quick fix or the least costly outpatient alternative such as periodic therapy visits. Outpatient therapy clearly has incredible usefulness, but the challenge is that for those struggling with significant trauma or psychiatric issues a one-hour session once or twice a month is not enough to create lasting change.
What we need is a continuum of care. Without psychiatric hospitals with stepdown to residential treatment that steps down to varying degrees of intensity and frequency of outpatient care, the most challenging patients have little chance of finding long-term positive mental health. Instead, these individuals commit crimes and fall through the cracks clogging up our jails and court system or wandering the streets. We as a society still pay for this lack of care every single day.