Monday, December 31, 2007

Austin Police Department Assist Those with Mental Illness

From the Austin American-Statesman, December 29, 2007:

Protecting and serving the mentally ill: Austin police crisis officers strain to fill gaps in mental health care in the face of budget cuts, growing caseload

Joshunda Sanders

Willie, 71, was muttering to himself underneath a dying palm tree in his Clarksville front yard when Austin police officers Donnie Williamson and Kim Devitt showed up. He glanced at the familiar white car, then scurried into his house, screaming, "What'd I do now?"

Williamson approached Willie's door. "We're just here to check on you," he said calmly. "Go home now!" the older man yelled, slamming his door shut.

Like hundreds of other mentally ill people in Austin, Willie's not an immediate danger to anyone. (His last name has been withheld because he was not charged with any wrongdoing.) Still, he demands a lot of attention and resources, mainly those of the Austin Police Department's Crisis Intervention Team. Since 1998, police officers have visited him more than 20 times, trying to get him help or medication, to no avail. Williamson, a 21-year-veteran of the department who has been with the crisis team for five years, said, "You have to switch hats between police work and social work."

The team of six officers, created in 1999, follows up on attempted suicide calls, or visits people who either don't have or won't take medication. Patients with immediate needs are taken to psychiatric emergency services run by Austin Travis County Mental Health Mental Retardation Center. If officers take someone to be treated, they follow up with home visits and with center workers to make sure people are getting the help they need.

In the past, officers could take people like Willie to the state hospital. Now, they can only drop them at Brackenridge and Seton hospital emergency rooms. Willie is one of an estimated 900 people expected to need treatment in the next year who might not get it, according to the county. The Austin Travis County Mental Health Mental Retardation Center cut the number of Austin State Hospital beds available to mentally ill people in the city and county from 110 to about 63 this year because of inadequate state funding.

When Willie started tossing things around and screaming uncontrollably inside his house, Williamson said to Devitt, "We better go."

To no one in particular, he said, "I'd love to put him in the hospital to get him the medication he needs, but there's nothing illegal about being crazy in your own house."

Austin police officers work alongside nine Travis County sheriff's deputies on the Austin State Hospital campus.

About 200 officers on the force are trained to deal with the mentally ill as part of their normal duties, but the crisis team goes beyond that, said police Sgt. Michael Turner, who oversees the unit. Every year, Turner said, his unit faces caseload increases, possibly fueled by out-of-county clients. In 2006, officers wrote 5,685 reports; as of this November, the unit had 6,031 reports, about 20 per officer per week. "It's hard and can be frustrating work," Williamson said. "But I try to look at it as if this person was my kid — how would I want someone to deal with him?"

Devitt tried a similar approach with 51-year-old Marissa, communicating through a rickety apartment windowpane. The electricity had been shut off at her tiny downtown apartment, so when temperatures dropped, she had no heat. Her solution: burning charcoal in bowls inside her house.

"We don't want you burning this place up," Devitt warned. "You just call us if your lights go out again." Devitt and Williamson backed away from the apartment, cautiously eyeing the old wood before they got back into their police car and drove to their next visit.;445-3630

MORE ON THIS STORY: On the beat with the Crisis Intervention Unit

Tuesday, December 11, 2007

Mental Health Court in El Paso

From the El Paso Times, December 10, 2007:

"A new mental health court intervention and treatment program was created today by a unanimous vote by Commissioners Court.

The new court will address mental health issues among adult criminal offenders, including counseling services, treatment, supervision and mental health assessments. The new court will seek grant funds to help fund its operation."

Bexar, Dallas, and Tarrant Counties all have some sort of mental health diversion courts.

Read more about mental health courts at

Monday, December 10, 2007

An Innovative Approach to Prevention

Residents of Frederick County, Maryland soon will have access to first aid for mental health concerns, according to an interesting article that appeared December 8 in the Frederick News Post.

Maryland's Department of Health and Mental Hygiene is piloting the program, which offers a 12-hour training course to community volunteers. Members of the community will learn how to recognize the symptoms of mental illness, which should enable them to approach mentally ill people and refer them to the appropriate resources and services.

The "first aid program" has been offered in Australia and Scotland; leaders in Maryland decided to follow suit while developing strategies in the wake of the Virginia Tech shooting in April. The state is using a Mental Health Transformation State Incentive Grant to pilot changes, including the first aid initiative.

The program aims to reduce stigma and will serve an educational purpose. A workgroup recommended the program so people who notice someone with problems will be able to help them before it is too late.

More information is available at

A Dangerous Wait for Treatment

Here are some excerpts from an article that appeared on December 9, 2007 in the Austin-American Statesman, "After policy change, ERs seeing more mentally ill patients":

"It's been one month since Austin's mental health authority slashed the number of patients it sends to the Austin State Hospital.

Since then, nearly 30 people with mental health crises have been routed to local emergency rooms, which don't have adequate expertise or facilities to deal with psychiatric patients. The number of Travis County prisoners with mental illness waiting to be transferred to a state hospital has jumped from 30 to 43. And local health officials don't know when relief will come."

"The mental health center runs the county's public mental health system. The quasi-nonprofit, which operates on government and private dollars, provides psychiatric care for low-income, uninsured and indigent people. It also sends people to state-run psychiatric hospitals.

How many people can go to those hospitals, and how long they can stay, is largely ruled by money.

The Texas Department of State Health Services gives the center $8.4 million a year to spend on psychiatric hospitalizations. That generally translates to 63 people per day.

But for years, because Austin has a shortage of psychiatric hospital beds, the center routinely housed up to 110 patients in Austin State Hospital at any given time. Now, the state is telling the center to stop exceeding its quota or pay the state millions of dollars for the care of those extra patients.

That makes emergency rooms the new safety net for many mentally ill people."

"Meanwhile, a number of people in the Travis County Correction Complex deemed incompetent to stand trial are now waiting months to be transferred to a psychiatric hospital. Some have been waiting to be moved since September, said Sgt. Kitty Hicks of the Travis County sheriff's office."

Read the full article.

Court to Rule on Acting As Own Lawyer

From the Austin-American Statesman, December 7, 2007:

"The Supreme Court said Friday it will review whether a defendant who is judged competent to stand trial has the right to be his own lawyer, even if he has a history of serious mental illness.
Ahmad Edwards was convicted of attempted murder and other charges in 2005 following a shooting at an Indianapolis department store in 1999.

He was initially found to be schizophrenic and suffering from delusions and spent most of the five years following the shooting in state psychiatric facilities. But by 2005, he was judged competent to stand trial.

Edwards asked to represent himself, but a judge denied the request because he was concerned that Edwards' trial would not be fair. Edwards, represented by a lawyer, was convicted anyway and sentenced to 30 years in prison.

He appealed and Indiana courts agreed that his right to represent himself had been violated, citing a U.S. high court decision from 1993. The courts overturned his conviction and ordered a new trial.
State Supreme Court Justice Theodore Boehm said the judge's determination that Edwards' schizophrenia made him incapable of defending himself seemed "at a minimum, reasonable." But, Boehm said, the U.S. Supreme Court has held that "competency to represent oneself at trial is measured by competency to stand trial."

Criminal defendants may be ruled competent to stand trial if they understand the proceedings and are capable of assisting their lawyer. The justices said they will consider in the Edwards case whether states may impose a higher standard for measuring a defendant's competency to be his own lawyer than when determining he is competent to stand trial. Arguments probably will take place in March.

The court recently saw an aspect of this dilemma in the case of Scott Panetti, a mentally ill killer from Texas who was nonetheless judged competent to stand trial and allowed to represent himself.
Panetti was convicted and sentenced to death after personally arguing that only an insane person could prove the insanity defense. He dressed in cowboy clothing and submitted an initial witness list that included Jesus Christ and John F. Kennedy. The court blocked his execution in June, in a ruling that did not address his role in his own defense.

The new case is Indiana v. Edwards, 07-208."