Tennessee Convict may be Re-evaluated for Competency

According to The Tennessean, Paul Dennis Reid may have his competency re-evaluated. Additionally, a petition has been filed with the Davidson County Criminal Court alleging that Reid had ineffective assistance of counsel during his trial for the murder of two restaurant workers. ("Lawyer says Reid is delusional", March 17, 2009). Here is the full article:

The attorney representing convicted killer Paul Dennis Reid is convinced the death row inmate is delusional.

During a post-conviction hearing in Davidson County Criminal Court, attorney Kelly Gleason asked that Reid's mental competency be re-evaluated.

"He thinks he's getting out of jail on June 1," Gleason said. "He thinks I'm an actress, not an attorney, and he's requested that I take him shopping at the Oak Ridge Mall for clothes, shoes and other hygiene products he might need once he gets out."

Reid was convicted of killing seven people at fast-food restaurants in Nashville and Clarksville in 1997.

Gleason, an assistant post-conviction defender, has represented Reid since August 2004 and maintains that he has never been competent.

"He was found in federal court to be incompetent," she said. "The state is choosing to ignore it."

But Davidson County Deputy District Attorney Tom Thurman argued that Reid had been evaluated numerous times and was found competent. The most recent competency hearing was held in May 2008. At the time, Davidson County Criminal Court Judge Cheryl Blackburn ruled that there wasn't enough evidence to show Reid was incompetent and that he should decide the course of his appeals.

In the courtroom Monday, both the defense and the prosecution declined to call witnesses for the post-conviction hearing, which centered on a petition filed by Reid in April 2003. In the case of the deaths of two workers at a Captain D's restaurant in Donelson, the petition argues that Reid had ineffective assistance of counsel.

Reid claimed to believe that he was under surveillance by secret government agencies and that his trial lawyers should have found the tapes that would prove his innocence.

He also claimed that his trial was not fair because the judge, the jury and all of the witnesses were scripted by the government to cause his death, the petition said.

Judge To Issue Ruling

Blackburn is expected to issue a written judgment in the Captain D's post-conviction petition within the next few months.

Gleason says if the petition is dismissed, she will appeal the decision.

Reid, dressed in a white Tennessee Department of Correction uniform and shackled at the wrists and ankles, sat quietly during the hearing. When it was over, Reid smiled and waved to several people before leaving the courtroom.

Since his conviction, Reid's execution has been stayed several times, most recently in 2006 when a federal judge intervened. The U.S. Supreme Court refused to lift the stay.

He is facing seven death sentences for killing seven people and injuring another in a 1997 crime spree in Middle Tennessee. He killed three people at a Nashville McDonald's, two at the Captain D's in Donelson and two store clerks at a Baskin-Robbins in Clarksville.

More on Paul Devoe

Here's an update on Paul Devoe, from the Austin American-Statesman ("Judge orders Devoe mental records sealed," January 14, 2009):

An Austin judge Tuesday sealed the psychiatric records of murder suspect Paul Devoe, a day after details from the records were aired on television.

On Tuesday, an American-Statesman reporter tried to get copies of psychiatric reports by two physicians who declared Devoe mentally incompetent to stand trial. Although copies of the reports were in Devoe's case file at the Travis County district clerk's office, the reports were sealed later that evening by presiding Judge Brenda Kennedy. The contents of such case files are public records.

Devoe is accused of shooting to death a man at a Marble Falls bar, four people in a Jonestown house and a woman in Pennsylvania in August 2007 before being arrested in New York. Two doctors, one hired by the prosecution and another by the defense, in December declared Devoe unable to assist in his defense.

The psychiatric reports detailed Devoe's history of mental illness and drug use. They were previously obtained and aired by Fox 7 News Austin on Monday night.

Phone messages to Kennedy's office were not returned Tuesday night.

Joel White, a lawyer on the board of the Freedom of Information Foundation of Texas, said there was "no point" in Kennedy's sealing records after they were disclosed.

"You can't disclose records and try to take them back," said White, who is not involved in the Devoe case. "It's not within the spirit of the law. Once the information is made public, the court can't pretend to take it back with a sealing order."

Normally, White said, a defendant's psychiatric records are sealed until they are used in a trial. Once used in a judicial hearing, they become public record, he said.

Devoe will be sent to a maximum security psychiatric facility in North Texas.

Private Defender Program for Defendants with Mental Illness

Texas Lawyer has this update on new model for legal representation in Lubbock ("First Private Criminal Defender Program in Texas to Commence," January 8, 2009):

"A first-of-its-kind program in Texas is scheduled to open Jan. 15 in Lubbock, providing specially trained private practitioners to represent indigent criminal defendants who are mentally ill or retarded.

Philip Wischkaemper , a Lubbock Criminal Defense Lawyers Association (LCDLA) member who helped develop the program, says, 'It's the first private defender service in the state.'

Private attorneys appointed by the director of the Lubbock Special Needs Defenders' Office, a nonprofit corporation formed by the LCDLA in October, will represent the indigent clients, says Lubbock solo Ted Hogan, a member of the corporation's board of directors.

On Dec. 22, the Lubbock County Commissioners Court approved a contract with the corporation to run the program. Precinct 4 Commissioner Patti Jones says the commissioners see the program as a way to ensure that jailed indigents with mental health issues receive legal assistance within 24 hours after they are arrested, so they can receive the services they need. 'That's been a void in the system,' Jones says.

On June 18, the Texas Task Force on Indigent Defense awarded a state-funded four-year grant totaling $419,360 to Lubbock County to set up the program.

David Slayton, Lubbock County's director of court administration, says the amount of state funding for the program will decrease in increments over the first four years of operations as the amount the county provides increases. In the fifth year, the county will assume full responsibility for funding the
program, Slayton says.

Hogan says the county will pay lawyers who represent mentally impaired clients, but the Special Needs Defenders' Office director will review the bills that the attorneys submit for payment.

Wischkaemper, the capital assistance attorney for the Texas Criminal Defense Lawyers Association , says a peer review committee will determine which attorney applicants qualify for appointments.

Attorneys seeking appointments through the new program must complete a minimum of 12 hours of continuing legal education on mental health issues in addition to CLE hours in criminal law, Wischkaemper says.
***

Earlier posts on this topic are available here, here and here.

Candidates for Harris County District Attorney Address Issue of Mental Illness

On November 4, voters in Harris County will elect a new district attorney. In an article that appeared in the Houston Chronicle ("Race for DA puts justice system on trial," October 12, 2008), candidates C.O. Bradford and Pat Lykos expressed interest in reform, with a particular emphasis on addressing the needs of inmates with mental illness. Here are excerpts:

"Harris County voters looking for a district attorney candidate with a 'tough on crime' theme are out of luck this fall.

The situation is a startling departure from the law-and-order tone set for the last 30 years by Republican former district attorneys John B. Holmes Jr. and Chuck Rosenthal.

But Rosenthal resigned in disgrace early this year, opening the door for Democratic candidate C.O. Bradford and Republican candidate Pat Lykos, former police officers who have never prosecuted a criminal case, to put the local justice system on trial instead.

Bradford, the former Houston police chief, and Lykos, a former felony court judge, make sure to mention, in a county known nationwide for its frequent use of the death penalty, that the worst criminal offenders should be prosecuted to the hilt. But, despite substantive differences between the contenders, they both put greater emphasis on reforming the system so that many minor offenders get drug or mental illness treatment rather than a cell in the already crowded jail.

'Simply locking everybody up for everything isn't going to get us out of the process we are in now,' Bradford said. 'Our taxes are high, the jails are full and crime continues to go up. So let's exercise good stewardship of fiscal resources, reduce crime and understand that most people who commit offenses are salvageable, they can be rehabilitated, but they must be given realistic opportunities to reintegrate back into our society.

'That's not occurring and there are a number of reasons for that ... There are a lot of people who make a lot of money, billions of dollars, designing, building, constructing (prisons) and there's not a concern about whether you are guilty or innocent. They get paid to keep a warm body there. That's not justice.'

Lykos called this 'a critical period in our county. We have a tarnished law enforcement system. It is bad for justice, it is bad for public safety and it's bad for business. I pledge to you to restore public trust and confidence in the district attorney's office.'" ...

The article reports that "As chief, Bradford upgraded the domestic violence unit and established a crisis intervention team for encounters with mentally ill suspects. Coincidentally Lykos, who would be the county's first female DA, aimed many of her creative sentencing approaches at healing family strife and getting treatment for mentally ill inmates."

Read the full article.

Upholding Legal Rights of Mentally Ill Defendants

That's the title of a new posting on the blog Women in Crime Ink, by Lucy Puryear, M.D.:

"On June 19, 2008, the Supreme Court of the U.S. issued a decision in which it held that a higher standard must be used to determine defendants' competence to represent themselves in criminal cases than the test used to determine the accuseds' competence to stand trial. Plainly speaking, this means that while a mentally ill defendant can be found competent to stand trial it does not necessarily follow that they can competently represent themselves as their own counsel.

Fundamentally this could be viewed as a negative decision for the mentally ill. One of our constitutional rights is self-representation in court. We are allowed to tell our story the way we want it told and to plead our case in a manner that we believe is in our own best interest. Now most of us would do a pretty terrible job of maneuvering ourselves through a court case, but sometimes taking your lawyers advice doesn't turn out as you'd hoped. I have heard defendants ask, 'Why didn't my lawyer do this, or why didn't they say that?' Sometimes juries will express, 'Why didn't we hear from the defendant, I want to hear his version of the story.' Not speaking for yourself is not always the right decision.

It becomes very complicated in a case where the defendant is floridly psychotic (hearing voices, speaking in gibberish). Nothing useful will come from that defendant trying to conduct his own trial. The court process becomes derailed and nothing good is accomplished for either the defense or the prosecution. Often the defendant by his very mental state convicts himself with little effort by the prosecution.

But does it make sense to allow someone to be competent to stand trial and yet too ill to represent themselves? Most courtrooms are all too ready to allow a mentally ill defendant to be tried. Recently the Supreme Court of the United States said yes in the Indiana v. Edwards decision.

In July 1999, Ahmad Edwards was discovered trying to steal a pair of shoes from an Indiana department store. After being discovered, he fired a gun at a store security officer and wounded a bystander. He was charged with attempted murder, battery with a deadly weapon, criminal recklessness and theft. He was diagnosed with schizophrenia and subsequently found incompetent to stand trial and was committed to a state psychiatric hospital for further evaluation and treatment. His competency and mental status fluctuated over the course of five years and he was not found competent to proceed to trial until July 2004.

In June 2005, Edwards stood trial. He asked to represent himself but the trial court rejected this request and the jury found him guilty of criminal recklessness and theft but failed to reach a verdict on the charges of attempted murder and battery. The State decided to retry him on the attempted murder and battery charges and he was retried in December 2005. The trial court again found that he was competent to stand trial but not competent to represent himself.

Despite being represented by counsel at his retrial, the jury convicted him on both counts. Edwards appealed, arguing that he had been wrongfully deprived of his constitutional right to represent himself. The case eventually reached the Supreme Court, which addressed the legal question of whether the standard for allowing defendants to represent themselves at trial should be higher than the standard for finding defendants competent to stand trial.

The Court decided that there was a higher standard for representing yourself than the standard for competency. To be found competent to stand trial you must be able to consult with your attorney with a 'reasonable degree of rational understanding.' This means in general that you are able to know what you have been charged with, be able to consult in formulating your own defense, and be able to explain the nature of the pleas involved. (In an interesting aside, Andrea Yates was found competent to stand trial although she initially wanted to plead guilty so that she would be executed by the state which was the only entity who could kill Satan inside of her. She understood the plea but her psychosis was unable to initially allow her to follow her lawyer's advice.)

The Edwards decision states that to be competent to represent yourself you must have the ability for 'organization of defense, making motions, arguing points of law . . . questioning witnesses and addressing the court and jury.' The court is stating that those that are mentally ill may be well enough be found competent but still not be able to represent themselves. While this may appear to be taking away the rights from persons with a disability it may be ultimately in their best legal defense. The Court also comments on the humaneness of the decision, 'A right of self-representation at trial will not affirm the dignity of a defendant who lacks the mental capacity to conduct his defense without the assistance of counsel,' Justice Stephen G. Breyer wrote. 'To the contrary, given that defendant's uncertain mental state, the spectacle that could well result from his self-representation at trial is at least as likely to prove humiliating as ennobling.'

The United States has long struggled with the treatment of the mentally ill. From locking them up in sanitariums for years to locking them up in jails. No one knows quite what to do with the mentally ill defendant who, although it may be obvious that they've committed a crime, it's also obvious that they are seriously disturbed. In Houston alone it is estimated that some 50% of the inmates in the juvenile justice system are seriously and chronically mentally ill. Jail is not a great treatment for a psychiatric disorder.

Texas in particular has struggled with the death penalty and the mentally ill criminal. We have had a history of executing those with known, documented, and profound psychotic illness. This is an embarrassment for our state and a terrible example for respecting human rights. This ruling by the United States Supreme Court is a very small step forward in assuring that those who commit crimes and are suffering from mental illness have both their rights protected and receive fair trails [sic]. What to do with a mentally ill defendant after conviction is the topic of another blog. I look forward to sharing my thoughts on a very complicated issue."
***

Judge Orders Competency Evaluation for Jeff Wood

Just hours before the execution of Jeff Wood was scheduled to take place, U.S. District Judge Orlando Garcia in San Antonio granted a request by Wood's attorneys to delay the execution so they could hire a mental health expert to pursue their arguments that he is incompetent to be executed. Texas courts had previously refused similar appeals.

Here are excerpts from the story that ran in the Houston Chronicle ("Accomplice in 1996 slaying gets execution delay," August 22, 2008):

"Wood's 'motion presents non-frivolous arguments suggesting (he) currently lacks a rational understanding of the connection between his role in his offense and the punishment imposed upon him,' Garcia wrote in his order.

While Garcia wrote that the evidence was far from compelling, there were enough facts to conclude Wood had made a 'substantial threshold showing of insanity.'

Garcia wrote that his decision was based on the state trial court's refusal to afford Wood fundamental due process protections mandated by the U.S. Supreme Court's 2007 decision [in Panetti v. Quarterman], which blocked the execution of a mentally ill Texas death row inmate because lower courts failed to consider whether he had a rationa lunderstanding of why he was to be killed. (Ed. Note: Panetti has since been found competent to be executed though he does not have an execution date.)

Wood's attorneys say he suffers from paranoia and delusions, but the state does not recognize he suffers from mental illness. ..."

and

"Garcia appointed attorneys Scott Sullivan of San Antonio and Jared Tyler of Houston to represent Wood and a psychiatrist to work with them.

'We are relieved that we are going through the process whereby the court will determine if he is competent to be executed,' Sullivan said. 'It is a process that is dearly needed in this case.'

Sullivan said he will report the results of his client's psychiatric testing to the court early next year.

If the judge, after considering the psychiatric evaluation, finds Wood competent, he again will be scheduled for execution. If not, he will receive psychiatric care in a prison setting.

Sullivan acted as Wood's court-appointed attorney in an unsuccessful appeal to the U.S. Supreme Court. Since the high court's rebuff, Wood, though indigent, has been without court-appointed counsel. A Kerrville state district court denied Wood's petition to obtain another court-appointed lawyer.

Sullivan said he has provided Wood free legal assistance as the execution date drew near.

In a terse parsing of legal procedures, Garcia noted that Wood, in his latest appeals, was granted neither a court-appointed lawyer nor expert assistance in establishing that he was not competent.

Instead, Garcia wrote, the state insisted Wood make a 'substantial showing of incompetency' before he was entitled to a court-designated lawyer or mental health expert.

'With all due respect,' the judge wrote, 'a system which requires an insane person to first make a 'substantial showing' of his own lack of mental capacity without the assistance of counsel or a mental health expert, in order to obtain such assistance is, by definition, an insane system.'

Garcia conceded that Wood's claim of incompetence 'is far from compelling,' but noted that 'petitioner's delusional thought processes convinced at least one jury he was incompetent to stand trial in May 1997.'

The judge noted that mental health experts who interviewed Wood during the period between his two trials found the killer's 'narcissistic tendencies and almost delusional belief in the inevitability of his ultimate vindication have grown more prominent.'

'Moreover,' the judge wrote, 'the petitioner exhibited a bizarre, seemingly paranoid, clearly suicidal ideation during his capital trial.' During thepunishment phase, Wood banned his attorneys from calling witnesses on his behalf.

Garcia wrote that Wood's petition for a stay 'at least arguably suggest(s) petitioner lacks a rational understanding of the causal link between his rolein his criminal offense and the reason he has been sentenced to death.'"

And here is the article that appeared in the New York Times ("Federal Judge, Chastising the Texas Courts, Orders a Stay of Execution," August 22, 2008):

"With only hours until his scheduled execution, a man won a stay Thursday when a federal judge granted him a hearing to determine whether he was mentally competent.

The condemned man, Jeffery Lee Wood, 35, was to be put to death Thursday evening for a killing committed by his partner in a 1996 robbery. But the execution was put off for at least six months by the decision of the judge, Orlando Luis Garcia of the Federal District Court in San Antonio, who suggested that he would hold the hearing next February or March.

The Texas attorney general, Greg Abbott, had yet to decide Thursday night whether he would appeal the decision, said a spokeswoman for his office, Lauri Saathoff.

Mr. Wood’s lawyers argue that he is too delusional to understand why he is to die and thinks that among other things he is the victim of a Freemason conspiracy.

Judge Garcia wrote that Mr. Wood’s bizarre statements at his trial and in prison 'at least arguably suggest the petitioner lacks a rational understanding of the causal link between his role in his criminal offense and the reason he has been sentenced to death.'

The judge said the Texas courts erred badly in the last week when they refused to hire mental health experts to determine whether Mr. Wood was mad or to appoint a lawyer to represent him at a competency hearing.

The United States Supreme Court has held that it is unconstitutional to execute insane people who cannot understand why they are being put to death or that their execution is imminent.

Judge Garcia said lawyers for Mr. Wood had submitted enough evidence of a delusional state of mind to warrant a hearing on the matter, and he strongly chastised the state courts for denying Mr. Wood a lawyer and a psychologist to help make that claim.

Mr. Wood was caught in a Catch-22, the judge said. The state courts ruled that he had to show he was insane for them to appoint a lawyer and a psychologist to help him prove he was insane. That, the judge said, is 'an insane system.'

Mr. Wood has a very limited intellect and a history of emotional problems, learning disabilities and, in prison, suicide attempts.

'He will become delusional and deny the apparent reality right in front of him,' said one of his lawyers, J. Scott Sullivan. 'He has a delusion a bribewould solve this whole problem.'

Mr. Wood was arrested shortly after his partner in crime, Daniel Reneau, fatally shot a cashier during the robbery of a gas station 12 years ago. Mr. Wood was outside in a getaway car when the shot was fired by Mr. Reneau, who was executed in 2002.

Mr. Wood’s mental problems were severe enough that one jury found him incompetent to stand trial. After spending time in a mental hospital, he was found competent by a second jury. In 1998, he was convicted of murder under a Texas law that makes all who are involved in a felony, like robbery, subject to the death penalty if one of them commits murder in the course of it.

Evidence of Mr. Wood’s mental troubles was never brought before the jury that imposed the death penalty, largely because he became angry and told his lawyers to do nothing during the penalty phase, instructions with which they complied. In his ruling on Thursday, Judge Garcia said that this behavior by Mr. Wood was 'bizarre, seemingly paranoid and clearly suicidal.'"
***

Additional coverage:
http://www.abajournal.com/news/judge_delays_execution_blasts_insane_system_to_determine_sanity/
http://ap.google.com/article/ALeqM5gpkdpV0pGSS_ozv30DC1F1QkVd5wD92MUUEG4
http://afp.google.com/article/ALeqM5jTfYEAqM59CPb8mVNODlJeBudbiw
http://www.chron.com/disp/story.mpl/metropolitan/5956797.html

Jeff Wood Receives Stay of Execution

A federal judge has granted a request to delay the execution of Jeff Wood, in order to allow his attorneys to hire a mental health expert to pursue their arguments that he is incompetent to be executed.

Here's a press release from Texas Defender Service:

STAY OF EXECUTION GRANTED IN TEXAS DEATH PENALTY CASE OF MENTALLY-ILL INMATE WHO WAS NOT TRIGGERMAN

WOOD EXECUTION HALTED BASED ON TEXAS STATE COURTS FAILURE TO PROVIDE DUE PROCESS ON ISSUES RELATING TO WOOD'S MENTAL ILLNESS

Austin -- Today, the Federal District Court granted a stay of execution in the case of Jeff Wood to allow the court to consider compelling evidence that Jeff Wood is too mentally ill to be executed. The Court held that the Texas state courts have not carefully reviewed the question of Wood's competence and that a stay of execution is necessary to ensure that Wood's mental health issues are fully presented and considered by the courts. The Court's Order Granting Stay of Execution is attached.

"We applaud the Federal District Court for upholding Jeff Wood's rudimentary due process right to have his competency evaluated," said Andrea Keilen, executive director of Texas Defender Service, who, along with attorney Scott Sullivan, are representing Mr. Wood.

The Federal District Court authorized an attorney and the assistance of mental health experts, pointing out that the Texas state courts had not complied with the basic due process that the United States Supreme Court required in another Texas case - that of Scott Panetti, a mentally ill death row inmate with a 20-year history of schizophrenia, who was permitted to represent himself at trial dressed in a purple cowboy costume.

In its 20-page order, the Court stated, "With all due respect, a system that requires an insane person to first make "a substantial showing" of his own lack of mental capacity without the assistance of counsel or a mental health expert, in order to obtain such assistance is, by definition, an insane system."

Prosecutors have indicated they will not appeal today's decision. Yesterday, the Texas Board of Pardons and Paroles denied the application for clemency ona vote of 7-0 despite the mental health evidence and fact that it isundisputed that Jeff Wood did not kill the victim in this case, but rather wasoutside the building in a car at the time of the murder. The actual killer, Daniel Reneau, was already executed by the State of Texas in 2002.

Wood was convicted and sentenced to death as a party for the death of Kriss Keeran in Kerr County, Texas. Mr. Wood was convicted under Texas' "law of parties" statute that allows for the conviction of participants in a crime even if they have do not know a murder will be committed or commit murder themselves.

Wood has never taken a human life by his own hands. Keeran's unfortunate death was the result of a reckless scheme devised to steal the money that had accumulated in a Kerrville convenience store over a holiday weekend. Reneau armed himself, entered the store, and shot the victim. Wood was involved in the robbery this case because of his longstanding mental illness that allowed him to be easily manipulated by the principal actor, Daniel Reneau. Wood's emotional and psychological impairments, including his intellectuall imitations, diminished Wood's capacity to anticipate what Daniel Reneau would do inside the convenience store.

At the punishment phase of the trial, influenced by his mental health issues, Woods directed his lawyers not to present any evidence in his defense. Mr. Wood's attorneys made no cross examination of any of the State's witnesses. They presented no evidence or witnesses on Mr. Wood's behalf. And they offered no reasons or arguments why the twelve people sitting on Mr. Wood's jury should extend mercy to him and spare his life.

Wood's mental illness was a critical element at trial and in 1997, Wood was initially found incompetent to stand trial. Mr. Wood suffers today from the same psychological and emotional impairments for which a jury found him incompetent to stand trial in 1997. He has never received psychiatric or mental health care for these impairments. The same deficiencies that prevented Mr. Wood from communicating with his trial lawyer with a reasonable degree of rational understanding prevent Mr. Wood from having a rational understanding of his death sentence and impending execution.

A neuropsychologist who evaluated Wood's competence to stand trial said that Mr. Wood "ha[d] a delusional system, an inability to grasp the reality surrounding the issues specific to this case, his role in it, in the crime, as well as other things that present a direct threat to his own well-being, his own sense of self."
###

More on TX Inmate Jeff Wood

The following AP story contains more information about Jeff Wood's mental impairments ("Lawyers try to block execution set for Thursday," August 20, 2008). His attorneys have argued that Wood's delusions render him incompetent to be executed.

"Lawyers for condemned prisoner Jeffery Wood say his mental problems led him to get involved in a robbery scheme that left a Texas Hill Country store clerk murdered in a fatal shooting carried out by a partner while Wood sat outside in a car.

Attorneys for Wood were in the federal courts seeking permission to hire mental health experts to pursue their arguments that he was incompetent to be executed Thursday for the January 1996 slaying of Kriss Keeran, 31, at a Kerrville Texaco gas station convenience store.

Texas courts have refused the appeals.

Wood would be the 9th condemned prisoner put to death this year and the 5th this month in the nation's busiest capital punishment state. At least a dozen other Texas inmates have execution dates in the coming months.

Daniel Reneau, the gunman in Keeran's slaying and Wood's roommate, was executed in 2002. Wood, whose 35th birthday was Tuesday, was convicted under the Texas law of parties, which makes accomplices as liable as the actual killer in capital murder cases.

Wood's mental illness 'was a critical element throughout his trial and sentencing,' Wood's lawyers said.

Attorney Scott Sullivan said in a motion rejected Tuesday by the Texas Court of Criminal Appeals that he met with Wood a month ago at death row and Wood told him he believed the trial judge in his case was corrupt but would accept a $100,000 bribe and then deport him to Norway where he couldlive with his wife.

Sullivan said Wood also believed, among other things, that the government will pay him $50,000 a year once he's released and that he's willing to give that money to the judge.

'Wood's delusional beliefs are true to him and always presented in grandiose fashion,' Sullivan said.

While the U.S. Supreme Court has barred the execution of prisoners determined to be mentally retarded, the same blanket prohibition has not been extended to those with mental illness.

Wood, who declined to speak with reporters as his execution date neared, initially was found by a jury to be mentally incompetent to stand trial. After a brief stint at a state hospital, a 2nd jury found him competent.

At his capital murder trial, he tried to fire his lawyers before the penalty phase. The trial judge denied the request but Wood's lawyers followed their client's wishes, called no witnesses and declined to cross-examine prosecution witnesses.

Wood's appeals lawyers urged Gov. Rick Perry to use his authority to grant a 1-time 30-day reprieve for Wood so a mental health expert could be appointed to examine him.

"Given his long-standing history of mental illness, Gov. Perry must not allow Mr. Wood's execution to go forward without allowing the court to rule on this rudimentary due process right," said Andrea Keilin, executive director of the Texas Defender Service, a legal group that represents death row inmates.

The Texas Board of Pardons and Paroles already has refused, on a 7-0 vote, to recommend the governor grant clemency to Wood, whose lawyers compared his case to another convicted Texas killer, Kenneth Foster. A year ago, Foster won a commutation from the parole board, Perry agreed and Foster now is serving a life sentence.

Foster also was condemned under the law of parties, although Perry's explanation for commuting Foster was that Foster and his co-defendant were tried together on capital murder charges for a slaying in San Antonio.

In Wood's case, he and Reneau were tried separately.

At least a half dozen other Texas inmates have been executed under the law of parties.

Reneau and Wood knew Keeran, 31. Wood's lawyers said his mental illness allowed him to be easily manipulated by Reneau, who they called "the principal actor" in the shooting.

Lucy Wilke, the Kerr County assistant district attorney who prosecuted Wood, described him after his 1998 trial as "not a dummy" and called the slaying "cold-blooded, premeditated."

Evidence showed Reneau entered the store before dawn on Jan. 2, 1996, and fatally shot Keeran once in the face with a .22-caliber pistol. Then joined by Wood, they robbed the store of more than $11,000 in cash and checks. Both were arrested within 24 hours.

According to court records, Wood was waiting outside the store and came in after Keeran was shot, then both fled with the store safe, a cash box and a video recorder containing a security tape showing the robbery and slaying. Evidence showed the pair had planned the robbery for a couple of weeks and unsuccessfully tried recruiting Keeran and another employee to stage a phony robbery."

Controversial Execution in Texas Set For This Evening

AFP has the following story about Jeff Wood, who is scheduled to be executed in Texas this evening, barring any last-minute intervention by Governor Rick Perry ("US to Execute Mentally Ill Man," August 21, 2008). Wood was convicted under the "law of parties," even though he was not involved in the shooting death of Kriss Keeran and in fact was standing outside the convenience store when the murder took place.

Wood's attorneys have questioned his mental competence and have argued that he suffers from longstanding emotional and psychiatric impairments for which he has never received treatment.

More information is available from Texas Defender Service.

Here is the AFP article in full:

"Texas is scheduled today to execute a mentally ill man for conspiracy to murder in a case that death penalty opponents say illustrates why the practice is deeply flawed.

Jeffery Lee Wood, 35, 'has never taken a human life by his own hands,' and 'was outside the building in a car at the time of the murder,' his lawyers said in a statement.

Wood's partner in crime, Daniel Reneau, was executed in 2002 for killing a store manager during a robbery.

'At Reneau's trial, the prosecution had argued that Reneau was the person chiefly responsible for the crime and that Wood's role was secondary,' the Death Penalty Information Centre said.

'Wood was involved in the robbery in this case because of his longstanding mental illness that allowed him to be easily manipulated by the principal actor, Daniel Reneau,' his lawyers argued.

Texas is the top executioner in the United States, with 413 executions over the last 30 years, out of a national total of 1,119 for that period.

It is also one of the few US states that permit capital punishment in a case involving conspiracy to murder, not murder itself.

Seven people were executed for conspiracy after 1976, when the death penalty was reauthorised in the United States, but Wood will be the first to die since 1996.

'Executing someone who didn't kill violates the most basic principles of justice,' David Fathi, US program director at Human Rights Watch, said in a statement.

In right-leaning Texas, support for the death penalty and the state's tough 'law-and-order' approach remains high.

Advocates argue the punishment is just, deters crime and provides comfort to victims' families.

Ambiguity surrounding mental illness also makes Wood's case controversial.

Wood's lawyers asked the governor of Texas to delay Wood's execution by one month, after he had been in solitary confinement on Death Row for 10 years, 23 hours a day, to evaluate his mental health.

In 1986, the Supreme Court effectively banned executing anyone too mentally ill to understand what was to happen to them and why. But it did not establish criteria for evaluating mental competency.

'If a person is only mentally ill and not incompetent, the decisions are less clear and are up to individual judgments by the governor or the jury,' Richard Dieter, director of the Death Penalty Information centre, told AFP.

In March 2008, Richard Taylor, condemned to death for murdering a prison guard 27 years earlier when he was gravely afflicted with schizophrenia, had his death penalty commuted to life in prison in the southern state of Tennessee.

But Kelsey Patterson was executed in Texas in May 2004 despite having been diagnosed with paranoia and schizophrenia prior to his criminal act.

The Pennsylvania Supreme Court recently authorised the state penal system to administer, by force if necessary, psychotropic medicine to two convicts on Death Row, to render them mentally competent and subject to execution.

The case of Raymond Riles, on death row since April 2, 1976 - more than 32 years - is emblematic of the ambiguity surrounding mentally ill inmates.

His execution was delayed three times, and after 1986 the Texas Department of Criminal Justice never set a new date for it. But he is still on Death Row."

More on the Private Mental Health Defender's Office in Lubbock

Texas Lawyer reports that the Lubbock Criminal Defense Lawyers Association (LCDLA) aims this fall to create a private defender's office that will represent indigent defendants with mental health issues ("First and Goal: LCDLA Close to Creating Nonprofit to Run Private Defender's Office," August 11, 2008). The Texas Task Force on Indigent Defense awarded the county a four-year, $407,000 matching grant to start the office.

Here's an excerpt from the article:

"Concerned that mentally impaired indigents too often languish in their jail, Lubbock County officials are trying a new approach - a private defender's office. It's a hybrid; a cross between a public defender's office and the assigned counsel system used in most Texas counties.

Lubbock solo Ted Hogan says the Lubbock Criminal Defense Lawyers Association (LCDLA) is creating a nonprofit entity that will seek to contract with the county to run the private defender's office, which will assign attorneys in private practice to represent indigent defendants who are mentally ill or retarded. The courts would no longer appoint attorneys in those cases.

David Slayton, Lubbock County's director of court administration, says the County Commissioners Court will decide Aug. 25 whether the county can negotiate a contract with the LCDLA's nonprofit entity without going through a formal bidding process. The aim is to get the private defender's office up and running this fall.

'This literally is the first of its type in Texas,' says James D. 'Jim' Bethke, director of the Texas Task Force on Indigent Defense, of the office being developed in Lubbock.

Bethke says he originally talked to Lubbock County officials and the criminal-defense bar about starting a public defender's office for mental health, but the idea did not generate much enthusiasm.

Slayton says a public defender's office would provide possibly two or three attorneys to represent indigents with mental health issues. The private defender's office will have access to attorneys in the private defense bar, and between 10 and 15 attorneys are expected to take the cases, he says.

In April 2007, Travis County opened the first stand-alone public defender's office for mental health cases. Jeanette Kinard, director of the Travis County Mental Health Public Defender, says her office is part of county government.

Kinard says her office, which has two attorneys, two social workers, two caseworkers and support staff, handles only misdemeanor cases for clients with certain types of mental illnesses, such as schizophrenia, major depression and bipolar disorder.

The office is funded to handle 500 misdemeanor cases a year, Kinard says. 'I think we'll end up with 400, which will be a more reasonable caseload,' she says.

Lubbock County is familiar with the concept of a public defender's office. Opened in late 2007, the West Texas Regional Public Defender's Office for Capital Murder Cases is based in Lubbock but serves 85 counties, extending from the Panhandle to Central Texas. Slayton says that since there are substantially fewer capital murder cases than other types of cases, the private defender's office for mental health is expected to have a bigger impact than the regional public defender's office.

The jail incarcerates about 13,000 inmates a year, Slayton says. Even with a conservative estimate that 10 percent of the inmates are mentally impaired, that would be about 1,300 cases, he says.

Bethke says a public defender's office is a governmental entity that employs lawyers whom a court can appoint to represent indigent defendants.

In contrast, a nonprofit entity will run the private defender's office in Lubbock County, and that entity will assign private practice attorneys to handle the cases, Bethke says.

Philip Wischkaemper, an LCDLA member and the capital assistance attorney for the Texas Criminal Defense Lawyers Association, says attorneys who want mental health case assignments will go through an application process in which a five-member peer review committee will scrutinize their experience and qualifications. Wischkaemper says he selected the committee members - with the agreement of LCDLA president Laurie Key - based on the fact that all of them are well-respected in Lubbock and do not take court appointments, especially in mental health cases. The peer review committee - made up of former U.S.Magistrate Judge J.Q. Warnick and criminal-defense attorneys Bill Wischkaemper (Philip Wischkaemper's brother), Charles "Chuck" Lanehart, Danny Hurley and Floyd Holder Jr. - also will monitor the performance of the attorneys assigned to represent indigent defendants with mental health problems, Philip Wischkaemper says. All the peer review committee members, except Warnick, are LCDLA members, he says. Key could not be reached for comment.

Wischkaemper says the LCDLA held a meeting of its membership after Bethke suggested the creation of a private defender's office in Lubbock. The association formed a committee of members to work on the project, Wischkaemper says.

Hogan, the LCDLA's point man for the project, says, 'The hope is in the long run we can set this up so it will run more efficiently than a public defender system or that the county can do with an assigned-counsel system.'

Lubbock County Judge Tom Head says county officials are 'very much in support' of the private defender's office, because they believe it will help keep the mentally impaired out of the jail. Head says inmates with mental health or mental retardation issues could make up as much as one-third of the jail population, although Hogan estimates their numbers at closer to 20 percent to 25 percent.

Drue Farmer, judge of Lubbock County Court-at-Law No. 2, is another supporter of the private defender concept, because the private-practice attorneys who will be assigned to represent mentally impaired indigents must receive training on how to recognize different types of mental illnesses as well as on competency and insanity issues. 'We felt like it was very important to have counsel specially trained to handle these cases,' she says.

Farmer says Lubbock County currently has a mental health wheel from which judges appoint attorneys. But while training on mental health issues is available to the attorneys on the wheel, their participation in the training is voluntary, she says.

Hogan says attorneys who currently represent mentally impaired indigents 'aren't sitting on their hands' while their clients sit in jail. But Hogan notes the attorneys don't have the resources to adequately serve these clients, who he says can take up an inordinate amount of attorneys' time.

The private defender's office should be able to represent mentally ill or retarded clients more efficiently, Hogan says. As planned, he says, the office will hire one lawyer who will serve as a full-time administrator. Two investigators/social workers also will be in the office to work with the mentally impaired clients, assisting them in meeting basic needs, such as finding housing and obtaining food stamps or checking on their whereabouts when they are scheduled for court appearances.

Hogan says many of the indigents with mental health issues are homeless and it has been difficult for attorneys to keep up with them. 'It's like herding cats,' he says.

Also as part of the office, the county will employ professional mental health workers who will screen jail inmates for mental illness or retardation and identify those who possibly could be diverted from the criminal justice system to treatment facilities. ..."
***
The article goes on to describe the model for this private defender program and provides information about other innovative approaches to mental health issues in Lubbock County. This includes a partnership between Lubbock Regional Mental Health and Mental Retardation and jail staff that aims to provide services to inmates with mental health issues and, ultimately, divert them from the corrections system altogether.

Read the full article.

Earlier posts on this program are available here and here.

Agencies Struggle to Provide Mental Health Services in Central Texas

In "Mentally Ill Don't Belong in Jailhouse" (July 27, 2008), the Temple Daily Telegram presents a compelling and comprehensive picture of the issues facing people with severe mental illness in Central Texas. It also explores the limitations imposed on government agencies, given funding cuts, a decrease in facilities, and other constraints.

The following article is a lengthy but worthwhile read.

"Before Carolyn Law was sent to prison in March 2006 for killing her mother, she was a college educated woman who had worked in real estate and tried to control her schizophrenia through medication.

At one point, she was so successful at controlling her illness, the state used her in a video that promoted the services that helped her cope.

'She was a poster child for services offered through the (Central Counties Center for Mental Health Mental Retardation),' said Eldon Tietje, executive director for MHMR.

Tietje said Ms. Law could still be considered a symbol for the mentally ill, only now she would be a symbol for what is wrong with the state’s treatment of the issue.

'She is someone who did pretty good for a long time,' Tietje said. 'She could and did take advantage of services when they were available, but she deteriorated over time and didn’t comply with treatment.'

Much like Ms. Law’s condition, the state’s funding for mental health programs has eroded over time, Tietje said.

And Tietje is not the only local official voicing concern over the treatment options for mentally ill in the state.

Judge Martha Trudo, 264th State District Court, sentenced Ms. Law to 45 years in prison for murder. Judge Trudo thinks it’s time for the state to do a better job addressing mental health issues.

'It isn’t a problem to be hidden,' she said. 'We really need to be doing something about (the mentally ill). They end up being warehoused in the pen.

'We do not do a good job of taking care of the mentally ill in Texas. There are tremendous waiting lists, doctors won’t see them unless they get picked up and put in jail. Then we are obligated to do it.

'A lot of people can function and work if they have support.'

In March 2006, Ms. Law addressed the court before her sentencing and said that mentally ill people such as her are misunderstood. She also said she hoped to see advancement in the treatment of mental patients.

'You have heard from many people here who have been hurt. I’ve been hurt for the last 20 years,' she said. 'I’m the biggest victim of all, as I see it.'

The local mental health picture

In his 16 years at the top post at Central Counties MHMR, Tietje said referrals have doubled as the population in the area has increased.

'The prevalence of mental illness may not be greater but we have more people and the resources are less, also during that time most of the private hospitals have closed, so there are fewer in-patient services,' he said.

A 2003 state budget crunch took more than $100 million out of the community MHMR system. But rather than this being an anomaly, it looks more like a pattern. In 1994, Tietje said his budget was $16.5 million. It was slashed to $12 million in 1995, a 25-percent cut.

'A result of that budget cut, we lost a Fort Hood work program that served 200 people,' Tietje said.
Closely supervised program participants cleaned buildings and restocked the commissary on base.
Budget constraints have also contributed to the closing of a three-quarter-way house in Gatesville that helped get people back on their feet. It had 30 beds and was a place where people could stay and look for work while they stabilized on their medications.

'It was a structured environment that made sure they got meds and food,' Tietje said.

And the Gatesville center has not been the only facility that has been shuttered.

Clinics in Bell, Coryell, Hamilton, Lampasas, and Milam counties have all been closed.

Patricia Roy-Jolly, MHMR supervisor who works with community support services, said she has witnessed a general pattern with many of the mentally ill she attempts to help.

She said mentally ill people often commit a crime and are incarcerated in Bell County Jail, which, in turn, ships them to Austin State Hospital. In Austin, the person gets stabilized on medication and usually within about a month is sent back to the area with three weeks of medication and the charge to regularly visit a doctor.

Ms. Roy-Jolly said usually the patient makes one or two appointments before he or she stops taking their medication and disappears for a while until he or she is rearrested and the process starts all over again.

'We’re just in a terrible predicament. A lot of these people do not have family members or they have family members who can’t help them anymore,' Judge Trudo said.

'It’s probably time for Texas to look at having group homes or do something.'

One funding cut came at the hands of the Texas Commission on Alcohol and Drug Abuse when the agency overextended funds by not regulating properly.

'Our funding from substance abuse services went from $80,000 to $15,000. We gave up our patient substance abuse services,' Tietje said. 'We got rid of it because we couldn’t afford it.'

Right now the best option for temporary inpatient care for mentally ill patients is the Austin State Hospital, but up until about eight years ago Temple was able to provide inpatient crisis stabilization.
'We had to give it up because it became too expensive for us to run,' Tietje said.

And the Austin State Hospital is often near capacity. For at least two weeks this month the hospital was so full it was on diversion and recommending people go to San Antonio for services. The other option for jails was to warehouse the prisoners until a slot opened at the hospital.

Other programs or services impacted by budget constraints include: two-day treatment services in Temple and Killeen that served 30 to 40 people, access to counseling services, transportation and noon meals.

'There’s a whole lot less mental health services in these five counties than there was 13 years ago,' Tietje said. 'When there are no support services, people are less likely to seek or stay up on treatment.'

This year’s budget for Central Counties MHMR is $14.5 million.

'We have fewer resources today and inflation has eroded our spending ability. We have had no inflationary increases from any funding groups, county or state,' Tietje said. 'As a result, our services have eroded and more and more people with mental illness show up in jails or emergency rooms.'

The impact on the community

The struggles of the state in answering the question on how to deal with people who struggle with mental illness is often shared by the families and church communities of these individuals.

In Ms. Law’s case her former minister Joe Baisden, Belton Church of Christ, said he spent a tremendous amount of time ministering to her in the years preceding the killing of her mother.

'Carolyn used to be a member of my Bible class. I was called in many times when her mother and her had problems,' he said. 'She freely talked about mental illness and gave us a great deal of insight. When she was on her meds she came to support group and was smooth as silk - other times she was erratic.'

Baisden said he will never forget when his church community was having a fellowship day in Yettie Polk Park in Belton and he was called to help Law’s family.

She had dropped her boys off at a mall in the Austin area and was later arrested at the State Capitol building when she pulled a fire extinguisher off a wall and sprayed paintings on display in the building.

'It grieved me that she had this kind of destiny in this life,' Baisden said about Ms. Law. 'It’s sad.'"

Costs of Mental Health Care Overwhelm Harris County Jail

Today's Houston Chronicle features the following article about the revolving door of severely mentally ill homeless offenders in the Harris County Jail ("Finding escape behind bars," July 21, 2008). Many of these inmates have been arrested on dozens of occasions; many have substance abuse disorders in addition to mental disorders.

As the number of these chronic inmates continues to increase, the cost of both incarceration and treatment has soared to $87 million annually. While some organizations have launched new programs aimed at providing support for severely mentally ill homeless people immediately upon their release from jail, the demand for services still far outpaces the limited resources available.

Here's the article in full:

"At the Harris County Jail, deputies and health care workers have a name for them — frequent fliers.
They are mentally ill homeless people who return to jail so often, sometimes on minor charges, that they become familiar to the psychiatric staff.

During a recent survey, county officials found that more than 400 of the jail's 11,000 inmates were homeless and suffered from a major mental illness: schizophrenia, bipolar disorder or a chronic depressive-psychotic disorder. They were among 1,900 inmates on psychotropic medications.

When the mentally ill homeless leave jail — and leave behind its mental health care staff — many stop taking medication and end up on the street again. Treatment resumes only when they commit a crime and return to jail or their dementia overwhelms them and they are brought to an emergency psychiatric center.

Treating the mentally ill as they cycle through jail and emergency psychiatric wards is expensive. A county budget analyst estimates that it costs $80,000 a year, per person.

At the jail, spending on mental health care has risen to $24 million annually, and the combined cost of incarcerating and treating the mentally ill is $87 million annually.

'The jails have become the psychiatric hospitals of the United States,' said Clarissa Stephens, an assistant director of the county's budget and management services office who has been studying the jail's mental health costs.

The Commissioners Court is so concerned about the rising costs that it has retained a consultant — psychiatrist Avrim Fishkind — to study whether providing outpatient services and supervised housing would reduce the numbers of mentally ill revolving through the jail.

'The costs of reincarcerating and court costs far outweigh what the costs would be if you housed, clothed and supervised the mentally ill,' Fishkind said.

A June survey of more than 11,000 inmates revealed:

•About one-quarter suffer from mental illness or once suffered from it.
•Of those on medication, 978 suffered from schizophrenia, bipolar disorder or a severe depressive-psychotic disorder.
•Of the 978 with a major mental health disorder, 423 likely were homeless.
•Of the 423 homeless with a major mental health disorder, 97 percent had been arrested at least once before during their lifetimes; 43 percent had a prior arrest during the last 10 years.

On the day of the survey, the jail's mentally ill homeless inmates included:

•A 39-year-old woman booked 45 times since 2001.
•A man, 26, booked 30 times since 1999.
•A man, 52, booked 33 times since 1992.
•A man, 25, booked 20 times since 2001.

Some of the mentally ill — many of whom also are substance abusers — keep committing crimes and getting rearrested, in part, because few are properly supervised when they are released, said David Buck, a Baylor College of Medicine associate professor and president of Healthcare for the Homeless-Houston.

Houston isn't alone in facing this issue. After many mental hospitals were closed in the 1970s and 1980s, countless patients were released in cities that were ill-equipped to house those who needed such care.

'What happens here happens in many communities. We are criminalizing mental illness,' said Betsy Schwartz, president of Mental Health of America of Greater Houston, a nonprofit that promotes effective treatment for the mentally ill.

Left to find her own way

Patricia George, 34, said her thinking always becomes clearer when she returns to jail and gets back on medication.

In the past 20 years, George, who says she is bipolar and schizophrenic, has been charged with 12 felonies and 31 misdemeanors, with most of the bookings in Harris County. In all, she has spent nine years in jail.

Like other mentally ill inmates, George has been expected to find her way — with no car and little money — to mental health providers, to line up counseling and to fill prescriptions for her medication in the weeks after her release.

In the meantime, medications she was taking in jail wear off, she said during an interview three days after her July 5 release from jail.

'Just walking down here (for the interview), I'm starting to hear voices,' said George, who finished a six-month sentence for prostitution.

Not filling prescriptions

Many of the mentally ill never fill their prescriptions or return to counseling, said Steven Schnee, director of Mental Health and Mental Retardation Authority of Harris County, a government agency that provides mental health care locally. They just return to their former lives, usually on the streets.
George, who often is homeless between jail stints, hopes she can avoid a return to jail this time. She has been working with Healthcare for the Homeless-Houston, which started a program that helps released mentally ill inmates find housing and reach appointments with mental health providers and counselors.

Michael Seale, director of the county jail's health services, said the mental health staff becomes frustrated because inmates stabilized in jail drift into psychosis when they get out.

'Whatever good work we've done may not have any value two or three weeks after they get out,' Seale said.

The jail — which has come under scrutiny recently for inmate deaths and was inspected by federal investigators earlier this month — spent about $10 million on mental health care in 2004. Two years ago, only 600 inmates were on psychotropic medications.

But staffing and funding then wasn't nearly adequate for the increasing numbers of mentally ill inmates.

Since mental health wards have been expanded, the jail now has beds for 244 mentally ill inmates, including 70 who are acutely ill.

The jail contracts with Harris County Psychiatric Center for 24 more beds.

The jail's mental health team delivers medications to an additional 1,650 inmates through outpatient treatment.

The team is big, employing 82 health care workers. That includes eight psychiatrists, 18 psychiatric registered nurses, 34 psychiatric technicians, seven licensed vocational nurses and 12 employees who screen incoming inmates.

Chief Deputy Mike Smith of the Sheriff's Office said the jail's mental health operation is comparable to the biggest non-jail mental health hospitals in the state.

Smith, as head of the jail, is among those credited with upgrading its mental health services. 'I've had people say I better watch what I say or I'll come across as a liberal,' he said. 'We shouldn't be treating our mentally ill in the jails. We should be treating them in the free world.'

Advocates say the number of mentally ill cycling through jails and psychiatric wards can be greatly reduced.

Many need to be placed in permanent supervised housing, Schwartz said.

Those who are less ill could be placed in apartments and monitored at least weekly by case managers.

But in Harris County, there are fewer than 1,500 rooms or apartments where the mentally ill can receive supervision or services, Schwartz said.

About 10,000 such units are needed.

'If these kind of housing opportunities existed, there would be far fewer mentally ill in jail,' she said."
***
An earlier post on the mental health care system (and its impact on criminal justice issues) in Harris County is available here.

More on Healthcare for the Homeless-Houston is available here.

New Private Mental Health Defenders Office in Lubbock

KCBD, NewsChannel 11 in Lubbock reports that officials in Lubbock County have received funding for a new program aimed at diverting offenders with mental illness from jail and providing them with quality legal representation ("New Program Addresses Lubbock County Inmate Mental Health," July 10, 2008). While both Travis and Bexar Counties provide public mental health defenders to those who have committed misdemeanor offenses, Lubbock's Private Mental Health Defenders office will be the first of its kind in Texas. The program will use county funds to pay a nonprofit organization to oversee cases defended by private attorneys

Here's the full story:

"Efforts are underway in Lubbock County to save taxpayers money and increase public safety. A $400,000 state grant will help Lubbock County open a Private Mental Health Defenders office. The goal is to address the mental health of Lubbock County inmates could save the county thousands of dollars at the same time.

If you commit a crime in the Hub City, you will most likely end up in the Lubbock County Jail. But Lubbock County Director of Court Administration David Slayton says, for some, crime is a by-product of mental health illness. 'These individuals need help, we understand that but we don't want there to be a public safety risk by releasing them back out on the street. To figure out how to best deal within the justice system has been really tricky,' Slayton said.

Slayton says, come this fall, the county will try something new - a Private Mental Health Defenders office. The office initially will be funded mostly by the state, but by the fifth year Lubbock County will pick up the entire bill. '[What] We anticipate is the savings in the jail cost will be enough to pay for this over, probably multiple times over,' Slayton added.

The state grant will put experts in the jail to help identify inmates with mental health issues. Something Sheriff David Gutierrez says will help the problem. 'We as sheriffs have had problems throughout the decades with mental health issues in the jail. The reality is that now we are trying to bring this across through the judicial system to identify them prior to intake,' Sheriff Gutierrez said.
Slayton says as part of the program the court will have the option to appoint specially trained attorneys to defend those identified with mental health problems.

Defense Attorney Ted Hogan says it will help move people more efficiently through the court system. 'It's a way of dealing with folks that aren't your traditional criminals. Helping folks get back on their feet who hopefully don't come back and enable us to do it much more efficiently than what the old system has allowed us to do,' Hogan added.

The idea, and its potential savings, has some Lubbock County commissioner's support. 'Take the grant money and do what needs to be done. Take care of these folks and give them [sic] learned council and keep those folks from possibly going to jail which will save us tax dollars,' Commissioner Bill McCay said.

But not all are in support. District Attorney Matt Powell tells NewsChannel 11 his office is already taking steps to make sure those with mental issues have good representation.

Still Slayton says many could benefit from the new office. 'It's good from the perspective of the tax payer, it's good for the defendant and they can get the mental help they need with their mental illness,' Slayton added.

This will be the first program of its kind in the state and one of the few in the country. It's expected to be up and running by the beginning of October."
***
An earlier post about this program is available here.

Government Agencies and Foundations Invest in Mental Healthcare

Here's an update from the Austin American-Statesman on efforts aimed at increasing funding for mental health services in Austin/Travis County ("Spending on mental illness sees a sudden boost," July 5, 2008):

"... Across Austin and in other parts of Texas, foundations and government organizations are giving more money to programs that help people with mental illnesses — an area that advocates say has long been underfunded in Texas.

The Travis County Healthcare District recently budgeted $3.2 million to pay for more in-patient care at local psychiatric hospitals, up from $1.9 million in 2007. St. David's Community Health Foundation last month awarded $2.3 million in grants to local nonprofit groups working on mental health issues, up from $1.3 million the year before.

In May, the Department of State Health Services handed out $25 million in new money to 17 local mental health centers, including more than $4.6 million for crisis care in Austin. The funding is part of $82 million the Legislature approved in 2007 to stem the tide of people with mental illness flooding emergency rooms, psychiatric hospitals and jails.

That state-sanctioned financial support was widely seen as a victory in Texas, which is ranked 47th in the country for its per capita spending on people with mental illnesses. It's unclear whether the extra spending will continue, though.

'It's hard to tell whether or not it's a turning point, but a lot of eyes are on this,' said Mike Maples, director of mental health and substance abuse programs for the Department of State Health Services.

Mental health advocates have long tried to push psychiatric issues into the spotlight. Those efforts have received a boost from media coverage of mental health problems facing Iraq war veterans. State and national lawmakers are debating ways to improve mental health care for veterans. And this week, the U.S. House passed a bill requiring group health plans to provide the same level of coverage for mental illnesses that is given to other health problems.

On the state and local level, crisis appears to be a driving force in the new spending.

Last fall, in an effort to stay within its state-allocated budget, the Austin-Travis County Mental Health Mental Retardation Center cut the number of patients it sent to Austin State Hospital. At that time, the center usually housed 100 to 110 patients at the hospital at any given time. Since then, the number has fluctuated: at one point in January, 56 Travis County patients were in the state hospital; this week there were 75.

With private mental health hospitals often full and unable to fill the void, dozens of suicidal, manic or violent people — insured and uninsured — have been diverted to area emergency rooms, where they might wait hours or even days to be sent to a local psychiatric hospital.

Local hospitals have responded by devoting more resources on the crisis patients.

The Seton Family of Hospitals, for example, added 16 beds at Seton Shoal Creek psychiatric hospital. It also set aside six beds at the University Medical Center at Brackenridge emergency room for people with mental and physical health problems — a move that cost about $460,000 during the fiscal year that ended July 1. Seton also said it would double its $3 million a year psychiatric residency program, adding four more residents to the program.

'You can't deal with community health problems if you're not also taking care of mental health issues,' said Greg Hartman, senior vice president of University Medical Center at Brackenridge. 'There's too much of a connection.'

The hospital bed shortage also spurred officials with the Travis County Healthcare District to increase mental health funding.

'I think (the bed shortage) was the catalyst for saying to ourselves, We've got to do something,' said Patricia Young Brown, president of the healthcare district. 'There has to be a better way.'

The district increased its contribution to the local mental health effort by agreeing to finance inpatient care over the next year that could help 368 to 728 additional indigent patients, depending on their length of stay in the hospital. Officials said they plan to continue that level of financing indefinitely.

Although the St. David's foundation also provided funding for in-patient psychiatric beds, most of its recent grants support local nonprofits. Waterloo Counseling, for example, will receive $112,000 for mental health employees, including counselors. Any Baby Can was given $149,00 to provide in-home counseling to 85 additional clients each year.

'It was really clear there was a lot of need, a big gap in mental health services," he foundation's president Dick Moeller said. ...'"

Read the full article.
**
More information about the $25 million in grants awarded by the TX Department of State Health Services is available here.

The History of Crisis Intervention Teams

The June 2008 issue of Law Enforcement Technology features an interesting article on the history of Crisis Intervention Teams (CIT), pioneered by the Memphis Police Department.

Here are a few excerpts:

"The program builds a team of officers available to respond to calls that partner with families, mental health providers and individuals who are diagnosed with mental diseases. The Crisis Intervention Team, or CIT, preserves the individual's dignity, insures greater safety for both responding officers and the mentally ill person — called consumers — and reassures families."

"NAMI (Memphis) credits CIT with saving lives and preventing injuries, both for consumers and officers," [Major Sam] Cochran [of the Memphis Police Department] wrote in an opinion piece on the department's Web site. "Officer injury data has decreased by seven-fold since the program's inception. University of Tennessee studies have shown that the CIT program has resulted in a decrease in arrests rates for the mentally ill.

"Most importantly, CIT officers give consumers a sense of dignity. This dignity generates a new respect and outlook on the police and the mental health systems."

Read "Diffusing Crisis" in its entirety.

More on Healthcare for the Homeless-Houston

Here's more information on the pilot program designed by Healthcare for the Homeless-Houston, which aims to provide services to those inmates with severe mental illness immediately upon their release from the Harris County Jail.


From KUHF-Houston Public Radio News:


Health Care For Former Inmates Saves Harris County Money
2 June 2008
By: Capella Tucker

The Harris County Jail system is said to have one of the best mental health programs. But those services stop once inmates are released. Too often those inmates repeat the same patterns that get them right back jail. Capella Tucker reports on a program that looks to literally walk inmates from the jail doors to clinic doors to stop the cycle of re-incarceration.

Click here to listen or read the transcript below.

"Hi, this is George Bement with Healthcare for the Homeless Houston. I've arranged a special release this morning for Rhanda Gillespy. Okay, I'll be there in about five minutes, thank you."

It's 8 o'clock Saturday morning. Bement walks four blocks to the Harris County Jail.

Rhanda Gillespie has been in and out of the Harris County jails since the mid-1990's.

She's served time for theft, delivery of controlled substances and prostitution. And Gillespy suffers from mental illness. She knows most people expect her to wind up back in jail.

"In fact one of the jailers told me, the lady I worked for, she told me, she says we'll have a job waiting for you when you get back, I said hopefully I find one with better pay."

First Gillespy has to get her feet on the ground, that includes walking back to the clinic with Bement for a doctor's appointment.

"The severely mentally ill people generally are treated in the jail and in fact the jail has a very good mental health unit, but then once they get out there's no linkage of services. Once they are out the door the Harris county sheriff's department no longer has responsibility for their care so they are basically on their own."

Every other time Gillespy has been released it's been at 12:01 a.m., which is the traditional time when inmates are freed.

"The people most unable to be productive in our society are left to fend where I certainly couldn't figure out how to get from jail and before my blood levels of my anti-psychotic are gone get that new medicine. There isn't a place to do it except for clogging the Er's."

Or winding up back in jail. Doctor David Buck founded the Healthcare for the Homeless Houston. The group hopes to make a difference for Gillespy and others like her so they won't wind up behind bars again.

In a pilot project, Buck has found that the level of recidivism drops when inmates are directly connected with services upon being released. He's been following two hundred forty-five patients for the past year.

"When we looked at a comparable group from 2004 and looked at our group, the re-arrest rates from 2004 were sixty percent. The re-arrest of this group from last year was 30 percent."

Buck says that saves Harris County money. Commissioners are expected to vote tomorrow on whether they'll fund the continuation of the program which costs about one hundred thousand dollars a year.

***
Thanks to Cherie Wyatt, with HHH for sharing this with me.

Mental Health & Criminal Justice in Harris County

In Houston, Local 2 Investigative reporter Robert Arnold spent the past six months researching the mental health care system in Harris County. He filed an informative series of reports that explain some of the system's shortcomings (links to the entire series can be found below).

Here are some of his findings:

HCPC has 250 beds, but only enough money to operate 188 of those beds. Countywide, it's even worse. A study by the Mental Health Mental Retardation Authority of Harris County reports there are only 825 psychiatric beds for a county of more than four million.

A report from Mental Health America of Greater Houston shows more than 92,000 adults in Harris County have a serious mental illness and no insurance. MHA reports only about 18 percent received services.

MHA estimates it costs taxpayers between $25,000 and $35,000 per person for crisis care every year. A lack of bed space and no long-term follow-up care when they leave the hospital forces those with mental illness to cycle through the system over and over again. In fact, 20 percent of the patients seen at the County's Neuro-Psychiatric Center last year had been there between two and 11 times in one year.

Jail is an expensive way to treat the mentally ill. It costs $65 a day to house an inmate. It costs $132 a day to house an inmate in the mental health unit. And that doesn't include medication, transport and court costs.

HPD's Mental Health Unit transported more than 2,000 people for psychiatric treatment last year. Sixty of those calls involved people who had been picked up by police three or more times in one year. HPD also estimates 46 percent of its SWAT callouts last year dealt with someone who is mentally ill.

On a more positive note, a jail in-reach program designed by Healthcare for the Homeless-Houston appears to be having some success. This program addresses the critical flaws in the way that homeless, mentally ill inmates are released from jail. Instead of being released at midnight and left to wander the streets alone, those in the program are met outside the jail by an advocate at 8 a.m. The advocate immediately helps the person get prescriptions filled, signs them up for mental health services and tries to find them a home. This program has only been running for a year, but led to a 35 percent decrease in the re-arrest rate of the mentally ill, homeless inmates who participated. Expanding the program could save taxpayers $7 million a year in jail fees. But despite this success, the program is struggling to find the funds to keep going.

Harris County is also running a similar program with mentally ill probationers, called New Starts.
***
Links to the entire series:

http://www.click2houston.com/investigates/16352802/detail.html
http://www.click2houston.com/investigates/16353061/detail.html
http://www.click2houston.com/investigates/16364907/detail.html
http://www.click2houston.com/investigates/16365021/detail.html
http://www.click2houston.com/news/16377187/detail.html
http://www.click2houston.com/investigates/16395993/detail.html

TX Legislative Committees to Hold Hearing

A joint committee hearing involving the House Corrections Committee's subcommittee on Substance Abuse and Mental Illness and the House Committee on Appropriations subcommittee on Criminal Justice will take place on Thursday, May 29, 2008 at 10:00 AM in E1.030 at the State Capitol.

The committees will hear public testimony on the following interim charges:

Review and research the availability, coordination, efficiency, and allocation of substance abuse treatment resources for probationers, pretrial defendants, people in the custody of the Texas Department of Criminal Justice (TDCJ), and parolees. This review should include methods to reduce and improve current assessments, training, and referring protocols and the identification of any barriers that may be impeding all of the above.

Assess the relationship between mental illness and criminal behavior and offer reforms needed to address the proliferation of mental illness in the adult and juvenile criminal justice systems. This review should include an examination of data sharing between criminal justice and health and
human services agencies, proper screening, assessments, treatment, discharge planning, post-release supervision, and community services.

http://www.legis.state.tx.us/tlodocs/80R/schedules/html/C2002008052910001.HTM

TX Dept. of State Health Services Awards $25 Million in Grants

The Texas Department of State Health Services (DSHS) has awarded $25 million in new funding to 17 local mental health centers for community-based crisis mental health services.

A total of $21.4 million has been granted to 14 local mental health centers to establish or enhance psychiatric emergency service centers or other facilities that will divert mentally ill patients from hospitals or jails by treating them efficiently in more appropriate settings. Another $3.5 million will enable 5 mental health entities to provide outpatient treatment to people who have been found incompetent to stand trial.


According to DSHS, "The funding is part of an overall effort to increase access to crisis response services, reduce the need for hospitalizations and provide alternatives to incarceration for those in mental health crises. Crises may include situations in which people are, or believe they are, suicidal, a danger to others or having significant deterioration due to a mental condition." The $25 million is part of a $82 million two-year appropriation provided by the Texas Legislature in 2007.

Read the news release from DSHS.

Here are details on some of the projects that have received funding:

Tarrant County has received more than $4 million to pay for four new mental health crisis service programs, including one that could keep patients found incompetent to stand trial out of state hospitals. The funding will pay for programs such as restorative mental healthcare for prisoners in the Tarrant County Jail, a crisis stabilization unit, and more adult residential and respite services. (Fort Worth Star-Telegram)

Austin Travis County Mental Health Mental Retardation Center has been awarded $4.6 million to establish a crisis stabilization unit for adults, where people experiencing suicidal, delusional or violent behaviors can be evaluated and stabilized. The grant will also pay for crisis transitional housing, where patients can receive care. (Austin American-Statesman)

El Paso Mental Health and Mental Retardation has been awarded $1.8 million grant to provide community-based crisis mental health services to El Paso County. (El Paso Times)

The Burke Center, in East Texas (Lufkin), received $1.66 million to establish a psychiatric emergency program. "The money, combined with funding from local hospitals, county governments and help from the T.L.L. Temple Foundation in finding a facility in Lufkin to use for the program, means Lufkin will soon have the only psychiatric emergency facility in the Deep East Texas region." (Lufkin Daily News)

The Heart of Texas Region Mental Health Mental Retardation Center, based in Waco, will receive more than $1.7 million in state money to launch a new center for people in psychiatric crisis. The center will include a short-term observation unit, a 16-bed residential unit for people who need a place to stay for 1-2 weeks while receiving treatment, and another 16-bed unit known as the "safe haven" program for those who are no longer in crisis but who need assistance with transitioning back into the community. (Waco Tribune)

All of these projects aim to relieve the stress on law enforcement and local emergency rooms and to provide critical assistance to those with mental illness and their families.