Mentally ill languish in Texas jails despite funding hike

Though a judge deemed her mentally unfit to stand trial fourteen months ago, Jennifer Lampkin is still sitting in an Austin jail cell because there are no free spots for her at the state’s psychiatric hospitals.

Lampkin, 35, has both intellectual disabilities and a mental illness, and without treatment, the court couldn’t reassess her competency to stand trial on an assault charge for allegedly slapping a child, which might at least allow her case to progress.

“I don’t think she understands why she remains in jail,” said her attorney, Elsie Craven. “She’s stressed because she doesn’t know what’s going to happen. I don’t believe she’s getting the treatment she needs. How could she? She’s in jail.”

Lampkin is one of hundreds of mentally ill Texas inmates who have been stuck in jail for months waiting for a spot at one of the state’s overcrowded and understaffed mental hospitals. Though such problems aren’t unique to Texas, its inmates face among the nation’s longest waits to receive psychiatric treatment and the problem is only getting worse despite recent efforts to improve the situation.

The average wait for a maximum security inmate to get in-patient psychiatric treatment has nearly doubled in the past two years, to 127 days, according to the Texas Health and Human Services Commission.

For inmates like Lampkin with intellectual disabilities and a mental illness, the average wait is more than three times as long, at 417 days. That’s partly because the state only has one unit dedicated to the treatment of such inmates, said Beth Mitchell, the supervising attorney for the advocacy group Disability Rights Texas.

“People who are charged but not convicted are supposed to be let out on bond,” said Mitchell, whose group has a class-action lawsuit pending against the state that argues the long waits are unconstitutional. “But in this case, these people can’t get put out on bond because they don’t have the capacity to agree to bond.”

Texas had the fourth-longest waits among states for inmates to receive psychiatric treatment, according to a 2016 survey by the Treatment Advocacy Center, a Virginia-based group dedicated to getting treatment for the mentally ill. Since then, Texas’ average treatment delay has increased by more than 50 days, according to the state’s own figures.

“Texas is unique in that there have been multiple lawsuits dealing with this issue and it is still coming up,” said John Snook, executive director of the Treatment Advocacy Center. “Texas has been struggling for years to effectively address this problem.”

The state has tried to improve the situation in the past couple of years and the Legislature plans to allocate more funds for mental health before its current session ends Monday. But thus far, the efforts have only helped to slow a worsening problem, not reverse its course.

Since ranking last in the nation in per resident mental health spending in 2009, Texas increased funding in recognition that it had a problem. In 2015, during the last legislative session, lawmakers allocated an additional $50 million to pay for the treatment of non-inmate mentally ill patients at private hospitals, which would open up spots in state-run facilities that can treat mentally ill inmates.

Although state mental hospitals went from housing 1,144 inmates in 2015 to 1,239 at the start of this year, the increase hasn’t kept pace with the pace of Texas’ population growth, said Four Price, a Republican state representative from Amarillo who has pushed for more funding for the treatment of mental illness.

Price said it’s important for the state to identify and treat the mentally ill before they get arrested, as once they end up in the criminal justice system, they typically have more serious mental illnesses that require longer hospital stays.

“In the past we were trying to build more hospital capacity, but we want to add to that more effort on the front end,” said Price, who is pushing for more preventive services, including outpatient treatment and community mental health services . Currently individuals often seek help in the community or in state mental hospitals, only to be turned away because of a lack of space, advocates said.