Monday, August 18, 2008

LA County Jail - The Nation's Largest Mental Institution

NPR's recent series on the U.S. prison population featured a story entitled "Inside The Nation's Largest Mental Institution," which focuses on the 1,400 mentally ill inmates in the Los Angeles County Jail.

Read a summary of the story or listen to the segment in its entirety here.

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.

More on George Banks Competency Hearing

The Citizens Voice, out of Wilkes-Barre, Pennsylvania, has this update on the competency hearing of death row inmate George Banks ("Final expert says Banks incompetent for execution," August 16, 2008):

"The psychological disorders that have turned mass murderer George Banks into a rambling paranoid have not improved since before he was scheduled to be executed in December 2004, psychiatrist Richard G. Dudley Jr. said Friday during the second day of testimony in Banks’ competency hearing.

Dudley, the third and final psychological expert called by Banks’ attorneys, said the killer’s psychosis and vast delusions have made him incompetent to be executed, to petition for clemency or assist his attorneys.

Banks, 66, went on a shooting spree in September 1982 that left 13 people dead, including four girlfriends, who ranged in age from 23 to 29, five of his children, ages 1 to 5, and four others. He has been on death row since June 1983.

Banks believes, 'Jesus from Washington, D.C.' vacated his sentence, but a conspiracy has kept him incarcerated at the State Correctional Institution here, about 30 miles northwest of Philadelphia, until he renounces God, Dudley said.

'The central theme of the delusions is that Jesus, (or) God has pardoned him and therefore there is no case against him,' Dudley said, echoing the testimony of the two defense experts who appeared Thursday — psychiatrist John O’Brien and forensic psychologist Jethro Toomer.

Dudley said Banks believes the state Department of Corrections would go to elaborate measures to push him to renounce his religious beliefs, including subjecting him to a simulated execution.

'He said Jesus has jurisdiction over his life, not man, not the courts,' Dudley said.

Those beliefs, combined with a rambling, unfocused and illogical thought process, make it impossible for Banks to comprehend the meaning and totality of his death sentence, Dudley said.

'As a result of this delusional system, he does not appreciate his death sentence,' Dudley said. 'The content of his delusions are directly related to his understanding of the crime and his punishment.'

Dudley evaluated Banks prior to his 2004 execution, which was stayed by a last-minute ruling from the state Supreme Court, and in April, in preparation for the competency hearing.

Dudley said Banks’ behavior during the April meeting prevented him from asking questions designed to gauge Banks’ understanding of his circumstances and possible execution.

'He blurted out various things,' Dudley said. 'I just stood there and listened to him.'

Jennifer Buck, an attorney with the state Attorney General’s Office, questioned how Dudley could determine that Banks is incompetent to face death without asking about the death penalty.

'You didn’t need to ask him?' Buck asked.

'Not again, no,' Dudley said.

'You only needed to ask him that once?'

'It would have been nice to ask him,' Dudley said. 'If he had been cooperative.'

The prosecution’s psychological experts, psychiatrists Timothy J. Michals and Stephen Mechanick, are scheduled to testify Monday.

Senior Judge Michael T. Conahan, who has presided over recent proceedings in the case, prevented Michals from testifying at a competency hearing in February 2006 after Banks’ attorneys said the psychiatrist met with Banks without their knowledge.

Conahan deemed Banks incompetent to be executed, but that decision was overturned on appeal by the state Supreme Court because the prosecution case had been compromised by the exclusion of Michals and the use of another expert, psychiatrist Michael Welner, who had little time to prepare.

In a September 2005 report, Michals said Banks had the competency to be executed.

'It is my opinion that although Mr. Banks has a psychotic disorder,' Michals said. 'He had sufficient mental capacity to understand that he has been tried, convicted and sentenced to death as a result of the death of 13 people.'

***
Read more about the Banks case here.

Wednesday, August 13, 2008

TX Death Row Inmate Raymond Riles - Incompetent to be Executed, Still on Death Row

KPRC Local 2 news in Houston recently investigated the case of Texas death row inmate Raymond Riles, who has been declared incompetent to be executed on numerous occasions. Riles has spent more than 30 years on death row and will remain there indefinitely, despite the fact that the state is not seeking an execution date (and has not done so since 1986). All parties agree that Riles sufffers from severe mental illness and does not meet the standards for competency (awareness of his execution and the reason for it).

In its 1986 decision Ford v. Wainwright, the U.S. Supreme Court ruled that it was unconstitutional to execute someone who does not understand the reason for or the reality of his or her punishment. The Ford decision left the determination of insanity and competency for execution up to each state. It did not include any guidance to states as to how to handle the cases of those found incompetent to be executed.

The American Bar Association Recommendation on the Death Penalty and Persons with Mental Disabilities, which has been endorsed by the American Psychiatric Association, the American Psychological Association, and the National Alliance on Mental Illness, states that if, after exhausting his or her appeals, a death row inmate has been found incompetent to be executed, the sentence of death should be reduced to the sentence imposed in capital cases when execution is not an option.

Read a verbatim transcript of the story ("Is 30 Years Too Long on Texas Death Row?"), which aired on August 12, 2008. You can also watch the video at http://www.click2houston.com/video/17178415/index.html, which includes footage of KPRC's death row interview with Raymond Riles.

"Tonight, Local 2 Investigates digs into the case of an inmate from Houston who has been on death row for more than 30 years. So why hasn't Raymond Riles been executed?

When you read and hear his first TV interview in more than 20 years, you may understand why.

His case has sparked a debate of what to do with inmates spending decades waiting for an execution. Local 2 investigative reporter Amy Davis uncovers why Riles' case could change the future of Texas' death row.

'They told me they were going to kill me unless I stopped preaching my mystic gospel,' Riles told us during an interview from death row at the Polunsky Unit in Livingston. 'God is the greatest and I didn't come to die on death row.'

As Riles speaks, you're almost able to read his mind -- by not understanding it.

'They're trying to silence me because I know about the satanic secret societies of the TDC shadow government e-system,' said Riles.

His mind appears mixed-up, full of delusions and paranoia. This is the latest chapter of Riles' story -- 33 years of crime and punishment.

Riles committed his crime back in 1974. He was convicted of killing Houston used-car salesman John Henry during a 1974 robbery. A Harris County jury sentenced Riles to death.

But 33 years later, Riles still waits on death row with no execution date and no plans for one.

'It's because he's incompetent to be executed,' explained Roe Wilson, an assistant district attorney for Harris County.

Wilson handles death row appeals and says Riles case is that simple. Mental health experts have ruled Riles doesn't understand why his execution is imminent, or understand exactly why he's being executed. That makes him mentally incompetent, according to the U.S. Supreme Court.

'If you don't meet the standard, then you cannot be legally executed,' said Wilson.

During our interview, Riles told us he believes God committed his crime, thinks he was chosen to release men from death row, and believes a lethal injection would not kill him.

Riles also blamed God for his prison suicide attempt in 1985. Riles set himself on fire in his cell.
'God did that,' said Riles. 'God consumed me in fire.'

In 1986, Riles was inches from the death chamber in Huntsville and just minutes from execution.

That's when a federal court issued a last-minute stay. It was the fourth time the state scheduled Riles' execution. A new date hasn't been scheduled for the past 22 years.

'As long as he's living, I'm still living,' said Helen Riles, Raymond Riles' sister. 'We're still living.'

Helen Riles spoke to us from her Houston home. She's calls her brother's three decades on death row 'bittersweet.'

While Raymond Riles hasn't been executed, Helen Riles is fighting to get her brother off of death row and into a mental health facility instead.

'I don't think he could ever come all the way back,' said Helen Riles. 'I really don't. But he would able to feel more comfortable and get more rehabilitation.'

And that's the debate. If an inmate can't be executed, should he or she remain on death row?

A new call is coming from a nationwide association of attorneys, death penalty opponents, and a U.S. group of mental health experts to change the way mentally ill inmates are treated on death row.

They all say a life sentence is more appropriate.

'It makes no sense for the state to keep someone on death row under severe conditions, when he's been recognized as severely ill," said Kristin Houle', with the Texas Coalition to Abolish the Death Penalty in Austin.

On death row, all inmates spend 23 hours a day in their cell.

Houle' calls that cruel and unusual punishment for the mentally ill, claiming it gives inmates little access to psychiatric care.

The state disagrees.

'That really is not a factor in this case,' said Wilson. 'What the factor is, is that (Riles) was competent when he was tried and given a legal sentence. His confinement is still legal and he simply has a condition right now that makes him not eligible for execution. But that could change.'

That's right. Wilson says Riles is still periodically tested by doctors. His mental state and his future could always change.

Right now, Texas law doesn't allow a death sentence to be replaced by a life sentence.

Wilson argues Riles' punishment stands, no matter what his mental state is now. Many call that justice for the victims.

So, at age 58, Raymond Riles remains on death row -- 33 years and counting. His family and activists say they'll continue to work to change the law that keeps him there.

'I'm not just going to let him sit there and not fight for him,' Helen Riles said.

Courts and doctors have ruled five other death row inmates from Harris County are also mentally incompetent to be executed. Any change in Riles' case or state law could have a direct effect on many Texas inmates.

However, those inmates are all tested periodically. If they are ruled competent at any time, an execution date can be scheduled."

Tuesday, August 12, 2008

Improving Interactions Between Law Enforcement and the Mentally Ill

A recent issue of Newsweek magazine reports on programs aimed at improving police officers' response to persons with severe mental illness ("Cops and the Mentally Ill," July 31, 2008). The law enforcement community is on the front lines in addressing the needs of those with severe mental illness, given the shortage of services and treatment facilities.

The article points out two interesting studies:
  • A 2005 study by researchers at the Feinberg School of Medicine at Northwestern University suggested that persons with serious mental illnesses are 11 times more likely than the general population to be victims of violent crime, with perhaps as many as 1 million crimes committed against those with serious mental-health issues each year.
  • According to a 2000 report by the federal government's National Institute of Justice, once a mentally ill person is arrested for disorderliness, that person is labeled a "criminal" and will likely continue to be arrested when acting out in the future, rather than receive treatment.

Read the full article here.

Is Mentally Ill Inmate Competent to be Executed?

Here's an article from The Scranton Times-Tribune regarding Pennsylvania death row inmate George Banks ("Banks' mental capacity will be at issue at hearing," August 11, 2008), who suffers from severe mental illness. A hearing will take place later this week to determine whether Banks should be declared incompetent to be executed. He was found incompetent in 2006, but the state Supreme Court overruled the judge's decision.

Last month, the Pennsylvania Supreme Court ruled that two death row inmates with mental illness can be forcibly medicated in order to render them competent to continue their appeals and face execution.

A full timeline of the case accompanies the article, excerpted below:

"George Banks sits in his cell at the State Correctional Institution at Graterford for days at a time, alone with the fantasies and delusions that have played in his psyche since before the 1982 killing spree that left 13 people dead in Wilkes-Barre and Jenkins Township, including five of his own children.

He often remains behind, locked away in his own world, during the hourlong period each day when he and the other inmates in the prison’s death row unit are permitted to leave the solitary confinement of their cells for exercise and recreation.

Banks, 66, has lived at SCI-Graterford, a maximum-security facility in Montgomery County, about 30 miles west of Philadelphia, since 1985.

A competency hearing scheduled to begin Thursday at the prison could determine whether he dies there.

'You’ve got a man who is severely mentally ill, there’s no dispute on that,' Banks’ attorney, Luzerne County public defender Al Flora Jr., said. 'The only issue is whether he dies in prison as a result of lethal injection or whether he dies in prison as the result of a natural life.'

Banks has lived in the shadow of death since June 1983, when a jury convicted him of the murders of at least four girlfriends, his five children, ages 1 to 5, and four others, and then imposed a capital sentence.

He has survived on the strength of the appeals filed on his behalf in state and federal courts, and on the weakness of his own mental state.

Two years ago, Banks claimed God had granted him clemency and the U.S. government and the Islamic faith were conspiring against him.

In 2004, he claimed he was fighting a 'private war' with former President Bill Clinton and Monica Lewinsky, the former White House intern with whom Mr. Clinton had a sexual relationship.

Since his arrest in September 1982, Mr. Banks has attempted suicide at least four times and has gone on prolonged hunger strikes, including one in 2003 that caused his weight to drop more than 100 pounds.

Luzerne County Senior Judge Michael T. Conahan, who will preside over the competency hearing, must look beyond the delusions to determine Mr. Banks’ competency, Mr. Flora said.

The judge must weigh two questions: whether Mr. Banks understands he is under a sentence of death and that he will be executed, and whether he is competent to assist his attorneys in petitioning the state Board of Probation and Parole and the state Board of Pardons for clemency.

Judge Conahan ruled Mr. Banks incompetent on both criteria in February 2006, but that determination was overturned on appeal by the state Supreme Court because the judge had prevented a prosecution psychiatrist, Timothy J. Michals, from testifying.

'It is in my opinion that although Mr. Banks has a psychotic disorder, he has sufficient mental capacity to understand that he has been tried, convicted and sentenced to death as a result of the death of 13 people,' Mr. Michals said in a September 2005 report.

Mr. Michals said Mr. Banks had told him the conviction and death sentence, 'had been vacated by God and his continued incarceration and execution was the result of a wide-range conspiracy between the correctional officers, prosecutors and other government officials.'

Psychiatrists deemed Mr. Banks competent to stand trial in 1983.

Mr. Flora, using an insanity defense, described Mr. Banks at the time as 'delusional' and 'psychotic,' and suggested the 'torment and agony' of a childhood in an interracial home, coupled with living in a racist environment, had led 'to the destruction of George Banks.'

'Competency to be tried is different than competency to be executed,' Mr. Flora said last week. 'You can go through a whole round of appeals on his competency to be executed and you could come back four years later and his condition could have deteriorated.'

If Judge Conahan rules Mr. Banks competent to be executed, Mr. Flora said he could challenge the decision in the state Supreme Court and, if unsuccessful, take the case to the federal court system.
'You would be looking at years of appeals,' Mr. Flora said.

If Judge Conahan rules Mr. Banks incompetent, the decision must be affirmed by the state Supreme Court before Mr. Banks is removed from death row. ... "

Monday, July 28, 2008

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.'"