Local jails around the country are becoming virtual psychiatric wards, and Kerr County is no exception.
To address this problem, the county and a state agency wants to form a new rapid response team that would aim people toward the mental health system rather than the criminal justice system.
During a county meeting last week morning, Kerr County Sheriff W.R. “Rusty” Hierholzer expressed discomfort at having a deputy, or another law enforcement officer, go into someone’s home to make sure they are on their meds.
“I don’t feel that’s a law enforcement function,” Hierholzer said.
But finding a place to put people undergoing mental health emergencies is another problem.
The proposed team would be composed of a peace officer, an emergency medical services provider and a social worker. This team would be deployed to assess people in crisis and take steps to resolve the situation with a medical — rather than law enforcement — solution, when warranted. The county and MHDD haven’t set aside funding for this team, but are looking for grants.
One advantage of having a licensed peace officer on the team is that the officer is legally authorized to sign civil commitment orders, although that authority is not being utilized at the moment, Hierholzer said. Judges serve that function for now.
As a preventive measure, the team also would check on people at risk of not taking their psychiatric medications. People who can’t seem to take their psychiatric meds without prompting are a source of a lot of public safety and law enforcement problems, officials have said. The peace officer on the team would remain outside a person’s residence and serve as security.
Due to the dearth of mental health facilities, a person at risk of harming himself or someone else may almost be as likely to be jailed as sent to the tiny, 16-bed crisis stabilization unit in Kerrville that’s supposed to serve a 19-county area that includes Kerr.
“Jails don’t need to be state hospitals,” Hierholzer said in an email.
The crisis stabilization unit — or CSU — is an in-patient crisis unit for people at risk of harming themselves or others. It is operated by Hill Country MHDD, a nonprofit funded through a contract with the Texas Department of State Health Services. The CSU has two beds per room. Men and women cannot occupy the same room — a limiting factor when it comes to occupancy if a patient is there for an extended time waiting for space at a state hospital.
Additionally, some patients are in such a state that they shouldn’t have a roommate, which also limits occupancy. The CSU, which is in a building leased by MHDD from the state hospital, averages 80 percent occupancy. Kerr County Judge Rob Kelly holds court periodically in the CSU to determine whether patients should remain committed there.
The state hospital in Kerrville is not for people in crisis, but is a forensic facility for two types of patients: those who have been deemed not guilty of a crime by reason of insanity, and those who are being treated in the hopes they can become competent to stand trial.
Land has been set aside in Uvalde for a new, 45-bed psychiatric hospital that could accept patients, but no funding has been secured to build it, said Kelly, who also sits on the board of the MHDD.
Hill Country MHDD Executive Director Ross Robinson said the goal is to secure funding assistance from private donors for the building of the hospital, as well as funds from the legislature for its ongoing operations. If all goes as planned, the hospital could be operational in late 2022 or early 2023, Robinson said.
As it stands now, many rural areas such as Uvalde and Kerrville often must send patients far and wide to available facilities, which include private psychiatric hospitals. Hierholzer said his deputies and Kerrville police pair up to drive people in crisis as far away as Austin, with the agencies taking turns providing vehicles.
“Now we’re transporting 100 a year because what’s happening now is that the other counties like Bandera, Rocksprings … are putting them on ambulances and sending them to the hospital here,” Hierholzer said.
The waiting line to get into a state hospital is two to three months, and eight months to a year if the person already is in the county jail, officials said during Monday’s meeting.
Hierholzer told commissioners 75 percent of the inmates at the county’s jail have mental health problems.
“And we’ve having to deal with that, and not MHDD or the state,” Hierholzer said.
Officials seem hopeful that forming the mental health team will be a big step in the right direction. Hierholzer said agencies as close as Bexar County have used such teams to very good effect.
“I think it can be a big help,” Hierholzer said.