Tarrant County leaders want the state’s help to shorten the long waitlist for state mental health beds – a waitlist that forces many people to sit in jail instead of a hospital.
Last week, the Tarrant County Commissioners Court approved its list of policy priorities for the ongoing state legislative session in Austin, including a request for the state to look into building a new state mental health hospital in Tarrant County.
The people in the jail waiting for state hospital beds have been court-ordered into a process called “competency restoration.” This action provides mental health treatment for people who have been charged with a crime, evaluated by a psychologist, and deemed unfit to stand trial.
“Then the judge orders the person to the state hospital for competency restoration, and then everything stops because they can’t get to the state hospital bed,” said Susan Garnett, the CEO of My Health My Resources (MHMR) of Tarrant County.
That leaves many people waiting for a state hospital bed behind bars. As of Feb. 7, there were about 180 people in the Tarrant County Jail waiting for a state hospital bed, Assistant County Administrator Russell Schaffner told commissioners. Some of them have been waiting since 2020.
MHMR oversees mental health care at the Tarrant County jail. People waiting for a state hospital bed still get mental health treatment, Garnett said, but it’s not the hospital-based combination of medication, talk therapy and explanations of the justice system that people need to be able to participate in their own defense.
“Jail is a place to be when you’re awaiting trial. It is not an ideal treatment location,” Garnett said.
Garnett noted that some people undergo treatment but are never fit to stand trial.
Tarrant County jail inmates who do land a bed in a state hospital are sent to North Texas State Hospital, which has campuses in Wichita Falls and Vernon. That hospital serves 53 counties, including Tarrant, according to its website.
More beds in Tarrant County could also mean better treatment outcomes, because people can stay closer to loved ones, Garnett said.
“We know that part of what getting healthy and staying healthy means is connections to family and friends and the things that are familiar to you,” she said.
The state hospital waitlist is a statewide problem. As of December, more than 2,500 people in Texas were waiting for a bed, most of them in need of competency restoration, according to Houston Public Media. On top of that, a staffing shortage has left hundreds of beds unavailable.
To reduce wait times, counties can also do jail-based competency restoration. That’s treatment that happens in the jail instead of a state hospital.
But that’s not ideal, Garnett said.
Jail-based competency restoration is for people who might be able to “regain competency” quicker, like someone who’s had some mental health treatment before. In the Tarrant County Jail, there are about 45 people undergoing jail-based competency restoration on any given day, according to Garnett.
When asked about the perfect number of beds for a potential state hospital in Tarrant County, Garnett said she wasn’t sure. That’s why the county is asking the state for a study: to determine the best move forward.
This study is the top priority for Tarrant County Commissioner Roy Charles Brooks during the state’s legislative session. And he’d like also to see more beds for people not involved in the criminal justice system.
“We need to strike a balance between allocating those beds, when we get them, between competency restoration and long-term mental health for persons in our general community who currently have no beds available to them,” Brooks said.
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