Caring for Mentally Ill in Jails, Emergency Rooms

The Austin-American Statesman (February 3, 2008) reports that since November, at least 125 depressed, suicidal, or violent people have been sent to emergency rooms in Austin, rather than the state hospital:

"Previously, most of those people would have gone to the state hospital, said Dr. Jim Van Norman, medical director for the Austin Travis County Mental Health Mental Retardation Center.

Now, some spend up to 14 days in emergency rooms waiting for a bed in a psychiatric facility. Others are treated and released from emergency rooms without any mental health care."

Late last year, for financial reasons, Austin mental health officials drastically cut the number of patients they send to the Austin State Hospital, a public facility for people with mental illness.

The Statesman chronicles the case of Daniel Whitehead, a man who has bipolar disorder and schizophrenia and who spent months in jail waiting to be sent to a psychiatric hospital. His case starkly illustrates the vicious cycle of incarceration and hospitalization in which many people with mental illness now find themselves:

"On Sept. 30, the 32-year-old Austin man — who said he was using crack, was not taking his psychiatric drugs and thought federal agents were out to get him — was arrested and jailed, accused of forging a $231 check at a sporting goods store to buy socks, sunglasses and a jacket.

He couldn't afford to pay the $10,000 bail, said Whitehead's wife, Lisa Valentine. And by the time Whitehead had a psychiatric evaluation a month later, his mental health had deteriorated so severely that he was unable to assist in his defense, said Amber Vazquez Bode, Whitehead's lawyer.

Whitehead was deemed incompetent to stand trial, and a judge ordered him sent to a psychiatric hospital. But because of a backlog of more than 40 inmates awaiting similar transfers, Whitehead spent more than three months in the Travis County Correctional Complex in Del Valle.

He is now at the Austin State Hospital."

Austin does not have a medical hospital with a psychiatric emergency room:

"Doctors, medical professionals and mental health advocates have had multiple meetings about the problem, but no solution has emerged. Some people want to see psychiatric hubs staffed with mental health professionals established in three local hospitals. Some want the state to give the MHMR center more psychiatrc beds. Others think a stand-alone emergency psychiatric hospital for the uninsured is the best solution.

For now, the MHMR center is applying for a $6 million state grant that would fund mobile mental health teams to work at several local emergency rooms. But whether the agency will get that money remains unclear."

Read the full article at:
http://www.statesman.com/news/content/news/stories/local/02/03/0203mental.html