Mental health advocates say proposed cuts to mental health care, mental retardation services, and reductions in Medicaid and CHIP coverage will effect every community in Texas.
The loss in support would leave many treatable patients facing relapses in their disorders, putting them into hospitals and possibly jails.
According to the Mental Health Association in Texas, more than 24,000 people would lose needed mental health care, or face reduced services. More than 50,000 people would no longer be eligible for drug benefits. Medicaid-enrolled adults would lose therapy services.
The burden of care would then fall to the criminal justice system.
“I would refer to Sheriff Margo Frasier’s frequent comment that the largest mental health facility in Travis County is the Travis County Jail,” Austin Police Department Chief Stan Knee said.
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The future
Law enforcements shares their ideas for dealing with the mental health crisis.
 
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Currently, APD has five officers and one sergeant who work with eight Travis County Sheriff’s deputies who are specifically trained and dedicated to handling cases involving the mental ill.
“Since December 1999, we instituted our own mental health crisis unit and the officers today would call on that unit to help them in handling that individual,” Knee said.
Often, those cases can take the majority of an officer’s time.
“An officer that comes in contact with a mental health person in crisis, he could be working on that call for two to three hours, maybe four hours trying to find out if that person has insurance. If he doesn’t have insurance that limits the options where he can receive treatment. If he does have insurance, the officer has to verify that. Then, there may be more additional options available,” Knee said.
One of those options may be hospitalization. The Austin State Hospital can hold 300 patients at one time. The hospital served about 4,000 people last year. They expect to treat the same number of people in 2003, according to CEO and Superintendent Carl Schock.
“All the patients that come here are at risks to themselves or others. That’s the criteria for getting hospitalization,” he said.
However, those treatments may become inaccessible because of restrictions the legislation may impose.
“Instead of using money to send people to jail, use it to prevent people from committing crime by giving them medication,” Dr. Rahn Bailey, an in-patient psychiatrist with the University of Texas Medical School in Houston, said.
Those restrictions may also affect a doctor’s ability to give the patient the best care possible, which could lead to lawsuits.
“When you take a one-size-fits-all approach, which is what pharmacy restrictions do, they say, ‘Well this is what we’re going to use because it’s the cheapest,’ – it’s this or it’s that. You put certain patients at clinical risk and that’s bad, I think, for the state, but it’s worse for the doctor. The doctor is the one who maintains all of the legal liability if a bad outcome occurs. When a bad outcome occurs, people don’t generally say, ‘Well the doctor was dealing with limited tools or a limited opportunity for the doctor to treat you best.’ We assume the doctor didn’t make a right decision,” Bailey said.
A doctor’s ability to treat mentally ill patients could be further reduced if a proposed cut to close one of the 10 state mental hospitals passes the Legislature.
ASH is the only facility that is able to accept patients in 36 counties who in an acute crisis. If it were to close, patients needing hospitalization would be taken to facilities far from Austin by an officer.
Both APD and Travis County average about 6,800 calls per year. One-third of those calls need transportation to a hospital. That raises the issue of taking an officer out of circulation to transport the patient.
"It is not uncommon for the hospitals in Austin or San Antonio to become full, which means we have to be diverted and drive someplace else with this person in their crisis. Whether it be San Antonio, Kerrville, Big Springs, Wichita Falls, [or] Waco at the VA clinic. So, that takes that officer away from the city of Austin or Travis County,” Deputy Mike Sorenson, a Travis County mental health investigator, said.
Knee proposes a drop-off center to ease officer workload.
“A drop-off center where police officers can take an individual that’s in crisis, drop them off. There at that location you would have professionals be able to do an evaluation,” he said.
Another solution offered by Knee is further cooperation, without political boundaries, between APD and the Travis County Sheriff’s Department. The interaction would allow APD officers to intervene in a situation when a sheriff’s deputy is unavailable and vice versa in the city, Knee said.
Most advocates agree the main goal is to get people suffering from a mental illness the care they need, so they don't harm themselves or someone else.
"For example an average person receiving community services through MHMR costs about $7,400 a year. Somebody who is not getting appropriate services and is cycling in and out of the criminal justice system or hospitals or detoxification centers costs the state about $55,000 a year," Lynn Lasky, CEO and president with MHA in Texas, said.
And Central Texas could possibly avoid seeing more incidents similar to those of Sophia King, who was fatally shot in June 2002, and Larry Elliott who drove his truck through a Georgetown H-E-B in January 2002.
