SOUTHEAST TEXAS RECORD

By Janna Fulbright

Beaumont�When people are accused of a crime, the courts occasionally must declare some of those people incompetent to stand trial due to mental illness. Often, due to psychiatric issues, a person who is accused of an offense may not understand what is happening to him, and therefore, be unable to participate adequately in his own defense. This means that the accused may linger in a county jail, an inpatient hospital behavioral health ward or a state hospital at great expense to taxpayers and to the detriment of his ability to receive a speedy trial.

To help remedy this problem, the Texas Department of State Health Services (DSHS) has awarded Spindletop Center (formerly Spindletop Mental Health, Mental Retardation) in Beaumont nearly $300,000 to establish a residential competency restoration program to help accused persons in Jefferson, Hardin, Orange and Chambers counties achieve a level of mental health stability that will allow them to stand trial. The grant for the program covers FY 2012 and 2013 and the staff has already begun work with its first client.

The program will use Spindletop's current respite facility, which is a short-term place for people to reside while they begin to access the center's mental health services. In addition to medication and individualized treatment plans, residents in the competency program will also receive basic legal education, using a mock courtroom facility that will help acquaint the accused with the layout and procedures of a court of law.

Garrett Craver, director of crisis and intake services at Spindletop, said, "If a person is so ill that he doesn't understand that he doesn't have to say things in court that might incriminate him, if he doesn't know the difference between a prosecutor and a defense attorney, then he isn't getting a fair trial. If we can restore him to mental health and provide him with basic info about what will happen to him in the system, and if we can do it faster and more cost-effectively than the current system, everyone benefits."

Craver continued, "The current system might require that an accused person be transported from jail to Rusk [State Hospital]. That requires two deputies to accompany him at a large expense to the county and then more expenses to the state to treat him at the hospital. If we take that same person from jail to our facility, the cost is much, much less. Further, our treatment goal is to restore competency in 60 days, not the months it sometimes takes in other facilities."

The program is one of similar plans at 11 behavioral health centers in Texas. The 80th Legislature launched the program in 2008, and in the 82nd session, the Legislature added five new sites, including Spindletop, to the system. Since its inception, this treatment option has served 600 clients, the majority of whom have schizophrenia (50%) or bipolar disorder (17%). Over a third of clients have co-occurring chemical dependency issues. Seventy percent of clients in these pilot programs were restored to full or adequate competency, and many had their charges either dropped or were placed on probation to continue their treatment at local mental health outpatient centers like Spindletop.

According to DSHS, it costs approximately $15,000 for an offender to receive treatment at a local outpatient facility as opposed to over $30,000 to treat that same person at a state psychiatric hospital. This is, in part, due to the fact that Spindletop and other facilities take care to work within the pharmaceutical industry to acquire medications that are reduced in cost or, in some cases, free.

"This is just common sense," said Craver. "When you can find a way for a person to have a good outcome at half the cost to the people of Texas, then we are using the taxpayers' dollars in a way that makes our mental health system run more smoothly. It unburdens hospitals to treat those who need their services but end up on waiting lists because offenders are taking up the beds they need.

"More people served�lower cost. It's a win-win situation."

To be eligible for Spindletop's program, the accused must not be a danger to himself or others (i.e. No charges such as Aggravated Assault).

Spindletop Center is one of 39 similar centers in Texas. It serves 8000 people a year with intellectual and developmental disabilities (formerly known as retardation), mental health issues, chemical dependency and early childhood developmental delays. For more information on Spindletop services, call (409) 839-1000. For 24-hour mental health crisis services, call 800-937-8097 (all calls are free and confidential).