SB 1557 Clarification from Dee Wilson

A reader forwarded an email to me originally transmitted by Lee Johnson of the Texas Council of Community MHMR Centers:

As many of you are aware, April Zamora of TCOOMMI gave a presentation at the Behavioral Health Consortium Thursday, September 10, 2009 on the changes brought to Art.16.22, Code of Criminal Procedure.

She affirmed that Art. 16.22 has been in statute since 1994 as a tool for identifying and beginning treatment for an alleged offender with mental illness who has been jailed following arrest. The article requires a sheriff to provide notice to a magistrate within 72 hours of receiving evidence that an offender has a mental illness. If there is reasonable cause to believe that the defendant has a mental illness, the magistrate orders the local mental health authority to collect information to determine if a mental illness exist.

In an attempt to improve the screening in the jails, as required by Art. 16.22, the Texas Legislature passed SB 1009, Sunset legislation for the Texas Commission on Jail Standards (TCJS), which contained an amendment requiring TCJS to develop a set of risk factors to use in assessing the overall risk level of each jail. Among the 9 risk factors is whether the jail is in compliance with Art. 16.22.

Attached, please find a bulletin by Dee Wilson of TCOOMMI for the Texas Commission on Jail Standards. As Dee points out, the current process for conducting mental health and competency assessments have not been changed but does put in plain language a process for collecting that information and passing it along.

Here is the attachment.

Leveling the Playing Field: Practical Strategies for Increasing Veteran's Involvement in Diversion and Reentry Programs

Download the pdf.
Challenges facing the involvement of veterans in jail diversion and prison reentry programs and strategies to address these problems are explained. Sections of this report are: introduction; financial disparities; eligibility and access; experiential disparities and preparedness; practical steps -- five practical steps, three access and eligibility steps, five experiential and preparedness steps; and conclusion.

DSM-IV-TR ON TRIAL

Is the DSM-IV-TR on trial or are repressed memories?
Watch the video from Massachusetts Supreme Court here.
Criminal; Evidence-- Various issues arising out of a conviction for sexual abuse of a child, including the admissibility of "repressed memory" evidence.

2009 Crisis Redesign Survey by Texas A&M

This is a reminder to participate in the 2009 Crisis Mental Health Survey by Monday, October 5th. This survey is anonymous, so if you have already replied to the survey, please disregard this reminder!
______________________

Hello:

Law enforcement agencies, emergency room personnel, courts, mental health providers, and communities often find it challenging help people in mental health crisis. The 2006 “Crisis Service Redesign” report from the Texas Department of State Health Services (DSHS) observed:

The systems for responding to mental health crises in Texas are uniformly inadequate to meet community needs. Other systems called on to serve as alternative sources of help, such as law enforcement, jails, emergency rooms of general hospitals, and social services, are not appropriate, cost effective, or able to provide the level and type of services that people in mental health crises need in order to recover.

To address these problems, in 2007, DSHS was awarded $82.0 million from the Texas Legislature to redesign the community mental health crisis system. Researchers from Texas A&M University are evaluating the effects the Crisis Services Redesign (CSR) initiative has had on communities around the state. This evaluation will provide important feedback to DSHS and to the legislature about the success of CSR.

We are asking you to participate in a survey about crisis services in your community. You were selected for participation in this survey because of your important role in assisting individuals experiencing a mental health crisis in your community. This survey is your chance to say how you think CSR is working in your community.

Please feel free to forward this survey to others in your organization who are knowledgeable about mental health crisis services.

In the next week, we will be distributing this survey through other means, such as organizational list serves. If you receive another request to participate in this study, please disregard that e-mail and use the link found at the bottom of this e-mail.

If you are willing to participate, please click on the link at the bottom of this e-mail to be directed to additional information about the survey and the survey itself. If you have any questions about the study, please do not hesitate to contact the primary investigator for the evaluation, Dr. Dottie Carmichael (979-845-9378; dottie@ppri.tamu.edu).

Thank you in advance for your assistance,

Dottie Carmichael

Texas A&M University



To participate click the link below:

http://csr.tamu.edu/dshs.htm

(if the link does not work, copy and paste this link into the address bar of your browser)

Updated Texas Mental Health Code

17th Edition
Texas Laws
Relating to Mental Health
Reflecting changes in law passed by the
81st Legislature, Regular Session – 2009*
Throughout this book will be various statutory references to the Texas Department of Mental Health and Mental Retardation, Texas Commission on Alcohol and Drug Abuse and the Texas Department of Health. On September 1, 2004 these three agencies were combined to form the Department of State Health Services. Any reference in statue to the legacy agencies should be read to mean the Department of State Health Services.
Disclaimer – The information contained in this book does not constitute the provision of legal advice. While every attempt has been made to ensure the accuracy of the information contained in this book, the Department of State Health Services, its officers and employees disclaim any responsibility for any errors in content or formatting that may be contained herein.
*Most changes in law reflected in this book become effective on 9/1/09.

Mentally Ill in US Prisons and Jails

Part one


Part two

From English Aljazeera's Fault Lines

As the healthcare debate rages in the US, the fate of the hundreds of thousands of mentally ill people in American jails and prisons has been absent from the agenda.

In a special report Fault Lines' Josh Rushing visited detention facilities in Texas and discovered the true reality of how inmates with mental illness are treated.

Creating Flexibility from the Bench: Meeting the Needs of Juveniles with Mental Impairments

Texas Appleseed released a new juvenile court resource in August 2009 that contains information on the impact of current laws and policies on Texas' young offender and an overview of alternative "front end" approaches proven to keep youth from repeatedly cycling through the juvenile justice system.

Creating Flexibility from the Bench: Meeting the Needs of Juveniles with Mental Impairments.

TCOOMMI and Henderson County

From Athens Review:
County gets reprieve on mental health program

By Rich Flowers News Editor

September 15, 2009 08:33 pm

— Just when it seemed Henderson County was going to have to pay about $80 each for inmate mental evaluations, a state-funded program found new life.
Tuesday, the Henderson County Commissioners Court adopted a memorandum of understanding between the county and the Andrews Center which will enable the county to take advantage of the Texas Correctional Office on Offenders with Medical and Mental Impairments program.
The program provides mental evaluations for non-crisis inmates who are not in imminent danger of attempting suicide or harming others.
Under the terms of the memorandum, equipment owned by TCOOMMI will be used by the jail to access mental health services from the Andrews Center for incarcerated offenders in custody there. The use of the telemedicine equipment is intended to allow better access to services, maintain public safety and decrease officer transport and wait time.
“This gives the TCOOMMI program the opportunity to screen them here,” Henderson County Mental Health Coordinator Kay Dingler said. “They will do it on a weekly basis, and probably see five to 10 people, depending on the time required on each one. It is state-funded, and we only have to provide the room.”
Henderson County pays Andrews Center $30,000 each year for help with the mentally-ill, mentally-challenged, chemically-dependent and mentally-disabled. The center offers screenings to determine if the individual is in need of emergency services, and provides the county with after-hour mental evaluation and commitment screenings.
TCOOMMI was created by the Texas Legislature in 1989 to “reduce the time of additional imprisonment, reduce recidivism and divert offenders with mental illness, mental retardation and severe medical impairments to appropriate treatments instead of incarceration.”
“TCOOMMI has had a renewed spirit of working with us over about the last 30 days,” Henderson County Judge David Holstein said.
Dingler said TCOOMMI had been set up as a pilot program, but due to its initial success, millions of dollars have been allocated to keep it running.

Excerpt from the Minutes of the 09/09 BHC Consortia

TCOOMMI Rider 21; Contracts & 2010 Focus – April Zamora

April discussed TDCJ updates and recent changes in administration. She clarified that TCOOMMI is no longer a standalone division of TDCJ, but has been incorporated into another division. Dee Wilson has been promoted to Re-entry and Re-integration division. There will be “Re-entry councils” developed and information will go out as these are implemented.

April discussed TCOOMMI’s capacity as there have been some budget cuts in the past year. This resulted from trending analysis on caseloads that were not staying full, but COC services that were booming. Cuts in some areas were reinvested in other areas where the service demands were higher. TCOOMMI is moving toward a hybrid model of care focusing on high risk offenders. Multi Systemic Therapy programs at two centers were discontinued because outcomes were not any better than other programs. New contracts have come out and MH and Probation requirements are separate and care is now individualized rather than limited to 6 months.

She reported that TCOOMMI was not allocated any new funds, but were given several new mandates. TCOOMMI is now responsible for the “wrongfully imprisoned” program which covers all the needs (MH, physical health, etc) for individuals who are wrongfully imprisoned. Another unfunded mandate is 44.51 which involves release of 17-19 y/o TYC offenders who have special needs and requires TCOOMMI to serve them. In adult services TCOOMMI is piloting transitional caseloads of 50-75 to facilitate the transition into regular RDM services.

April discussed Article 16.22 and SB1557 and clarified that the current processes in place for assessment of individuals jailed who have MH needs may continue. Any assessment which is less than a year old may be used. The intent was not to require MHAs to conduct competency assessments on all MH offenders in jails. TCOOMMI will be sending a letter to Texas Council which explains the intent of the law and which can be used to educate law enforcement. April noted that the intent is only to make sure the magistrate is aware of the individual’s possible MH involvement and may include self-report by the offender, prior MHA involvement, or jail CARE cross matching. It does not require an assessment. Once the magistrate is aware of the possible MH involvement he/she may order a full assessment at the expense of the county. Joe Lovelace reported that the Texas Council will be convening a workgroup to address concerns around this issue.

April reported that there are upcoming training opportunities including the Texas Correctional Association conference. She encouraged MHAs to send people to this conference.

April discussed Rider 21 which provides new funding and requires TJPC to contract with MHAs if they want to provide MH services in order to divert kids from TYC. She explained that many areas are not applying for the funds due to fear of having to return part of the funds if outcomes are not met. She reported that so far only 4 areas have submitted applications, but she is continuing to work on encouraging TJPC programs to include MH services in their grants.

Medicaid Substance Abuse Expansion – Matt Ferrara

Matt discussed comprehensive Medicaid substance abuse services legislated by the SB796. The expansion will be studied after a period of time and must save money rather than increase Medicaid spending. Matt reported implementation timeline is targeted for June 1, 2010. Providers will probably have to have a Medicaid provider number and if in a Medicaid managed care area, must be in the network. Policies are currently being developed and must have CMS approval. Rates must also be developed by HHSC and rate hearings are anticipated sometime in October or November. Private LCDC providers will probably not be an approved provider type.

Results from the 2008 National Survey on Drug Use and Health: National Findings

Access the report here.

This report presents the first information from the 2008 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Unless otherwise noted, all comparisons in this report described using terms such as "increased," "decreased," or "more than" are statistically significant at the .05 level.

Missouri Sets New Standard for Juvenile Detention

From ABC's Primetime

Watch video

Innovative Facilities for Kid Criminals Are Short on Guards and Long on Hugs:

For most of the nearly 100,000 kids in America's juvenile justice system, life in prison means orange jumpsuits, barred cells and constant guard.
But the Waverly Regional Youth Center in Missouri is a different kind of detention center. It's the home and hope for 44 boys already embarked on a life on crime. The walls are adorned with colorful posters and bulletin boards with positive affirmations. Counselors and dormitories have replaced guards and cellblocks.

For over a year, "Primetime" lived alongside the kids to examine firsthand this radical take on juvenile justice. By taking some of the hard edges out of juvenile corrections, the state of Missouri has chalked up results that have corrections experts across the country taking notice.

Wrongly convicted Texans become instant millionaires New law makes Texas most generous state for payments to cleared prisoners.

Read the rest here.

DALLAS (AP) — … Exonerees will get $80,000 for each year they spent behind bars. The compensation also includes lifetime annuity payments that for most of the wrongly convicted are worth between $40,000 and $50,000 a year — making it by far the nation's most generous package. … Exonerees also receive an array of social services, including job training, tuition credits and access to medical and dental treatment. Though 27 other states have some form of compensation law for the wrongly convicted, none comes close to offering the social services and money Texas provides.

Educational Aftercare & Reintegration Toolkit for Juvenile Justice Professionals, 2nd ed.

Download toolkit here.

Youth who are adjudicated delinquent frequently encounter problems in obtaining appropriate education services in placement, as well as when they are released and reintegrated into their communities. This Toolkit provides the basic information and resources needed to help juvenile probation officers and other juvenile justice professionals in Pennsylvania overcome (or at least minimize) these problems. While this Toolkit is specifically directed to juvenile probation officers in Pennsylvania, it may also be useful for the youth's attorney or for other juvenile justice professionals to help them plan for and participate in the educational aftercare of their clients.

Developing Mental Health Screening in Juvenile Justice

Download here.

The development of routine mental health screening for juveniles involved with the criminal justice system is explained. Sections of this brief include: the drive toward mental health screening; considerations in the implementation of a screening and assessment process -- fulfilling regulatory requirements, improving staff decision, and managing resources; and policy recommendations.

Jaycee Dugard, transfixed by a monster - Includes past psych eval

Public revulsion will focus on Phillip Garrido, the delusional sex offender likely to spend the rest of his life in jail
by Karen Franklin, from the Guardian.co.uk

In these harsh economic times, the saga of Jaycee Lee Dugard is especially riveting to the public imagination. Our horror and revulsion unite us. Who can we blame? How could this monster hide amongst us while committing unspeakable acts against innocent children?

Our collective furor and thirst for vengeance run counter to the principles of our justice system, under which a criminal defendant is presumed innocent until proven guilty. Psychiatric issues will make justice especially slow for Phillip Garrido, the registered sex offender who is accused of holding Dugard hostage for 18 years, after kidnapping her in June 1991 when she was just 11. (Garrido and his wife Nancy have both denied the charges.)

Initial evidence points toward a psychosis. In an interview from jail, Garrido called Dugard's story "heartwarming" and referenced secret documents and "hundreds and hundreds of thousands" of lawsuits. And that is just the tip of the iceberg. The wonders of the internet allow us to travel back in time and enter his mind, via rambling blog posts about voices in his head, mind control, and religious delusions of himself as the savior.

Ironically, more than a year ago Garrido referenced the potential for psychotic symptoms to cause violence against children. A woman who drowned her three children in the San Francisco Bay was, he wrote, "led by a powerful internal and external (hearing) process that places the human mind under a hypnotic siege that in time leads a person to build a delusional belief system that drives them to whatever course of action they take."

Defense attorneys in such cases would undoubtedly consider an insanity defense, inciting more public anger. High-profile cases skew public perceptions of this defence, which is rarely used and even more rarely successful. As one lawyer put it, "You can be extremely crazy without being legally insane. You can hear voices, you can operate under intermittent delusions, you can see rabbits in the road that aren't there and still be legally sane." Here, the prosecution could counter any insanity claim by pointing to Garrido's seemingly rational conduct, for example in running a printing business.

Another public misconception is that freedom follows a successful insanity defense. In reality, most insanity acquittees are sent to locked state hospitals that look very much like prisons. And, in the unlikely event that the 58-year-old Garrido was ever considered for discharge, he would be eligible for further detention under California's sexually violent predator law.

Competency to stand trial is another psycho-legal issue that may engender confusion in this case. While insanity pertains to an accused person's past state of mind, and whether he knew the difference between right and wrong at the time of his crime, competency pertains to his present ability to understand the legal proceedings and assist his attorney. As such, incompetency is not a permanent barrier to prosecution. A person who is found incompetent is treated until he becomes competent, at which time he stands trial.

After the dust settles and the legal manoeuvring ends, Garrido will likely spend the rest of his life behind bars if found guilty. Meanwhile, as with abduction survivors Elizabeth Smart of Utah, Natascha Kampusch in Austria, and fellow Californians Colleen Stan and Steven Stayner, the details of Jaycee Dugard's tragedy will gradually fade from our collective memory.

Until the next monster comes along and creates panic anew.

Fortunately, cases like this are so extraordinarily rare that they do not merit the public panic they engender. Although riveting, in the end the Dugard saga serves to distract us from the real dangers facing children in California today, including family child abuse and bankrupt schools preparing children for hopeless futures.

see also: A deluded man, certainly, but probably not America's Fritzl

Here's his 1976 Psych Eval.

County scrambling to fill the void

Officials try to find funds for inmate services after a state program was cut
By Rich Flowers News Editor

Henderson County is scrambling to overcome a loss of funds cut from a state program that provided inmate mental evaluations and other services.

The Texas Correctional Office on Offenders with Medical and Mental Impairments had funded the program which was administered in Henderson County through the Andrews Center. Last week, Henderson County Judge David Holstein’s office received notice the inmate evaluations had been terminated.

Tuesday, the Andrews Center board met to try to fill the gap left by TCOOMMI. Chief of Operations Cindy Grace said the meeting left the board still looking for answers.

“All we know is TCOOMMI is no longer funding that,” she said. “We’re awaiting direction from the Texas Department of State Health Services on how that is going to be funded. Right now we don’t have any direction on that.”

TCOOMMI was created by the Texas Legislature in 1989 to “reduce the time of additional imprisonment, reduce recidivism and divert offenders with mental illness, mental retardation and severe medical impairments to appropriate treatments instead of incarceration.”

Henderson County pays Andrews Center $30,000 each year for help with the mentally ill, mentally retarded, chemically dependent and mentally disabled. The center offers screenings to determine if the individual is in need of emergency services and provides the county with after-hour mental evaluation and commitment screenings.

Holstein said the county has only been involved with TCOOMMI for a few months. He was optimistic the program would be beneficial for the county.

Kay Dingler, with Holstein’s office, serves on the Andrews Center board.

“As it stands right now there are two options. The Texas Department of State Health Services would supplement it and provide services. They could either fund what they’ve taken away, or provide a different program,” Dingler said. “Another possibility is for the Andrews Center to offer the services. Right now, it’s a hurry up and wait sort of thing — but there are not many options right now.”

Grace said her office has been in contact with Dingler concerning the issue.

“I don’t think we’ve come to any agreement yet,” Grace said. “It’s still in the process of planning. I can‘t really tell you what the result is going to be.”

TCOOMMI provided several services in addition to mental evaluations for local county jail inmates. The program also offered assistance for parolees and probationers residing within Henderson County, Dingler said.

If the county has to pick up the bill for inmate evaluations, the funds will have to be found in an already tight 2010 budget.

Not Guilty by Reason of Insanity (NGRI) Treatment and Monitoring - New Hampshire

This policy covers the provision of "confinement, security and treatment for persons committed" to the Secure Psychiatric Unit (SPU) due to their being deemed by the court not guilty by reason of insanity (NGRI). Procedures explained are: admission procedures in addition to general rules; discharge from SPU; discharge from New Hampshire Hospital (NHH) to another unit; and transitional services after SPU discharge. Also attached are "Guidelines for NGRI Transfer Process from SPU," the sample from "Request to Initiate NGRI Transfer," and "Facilitating Conditional Discharge for Not Guilty by Reason of Insanity (NGRI)."

Download document.

Inmate Behavior Management: The Key to a Safe and Secure Jail

This guide “presents six key elements that, in combination, will help jails reduce a wide array of negative, destructive, and dangerous inmate behavior” (p. v). These elements are: assessing risk and needs; assigning inmates to housing; meeting inmates’ basic needs; defining and conveying expectations for inmate behavior; supervising inmates; and keeping inmates productively occupied.

Download the guide.

Mental Health Symptoms of Incarcerated Juvenile Offenders: Change and Continuity During the First Three Months in a Secure Facility

Click here for the study.
The changes in juvenile offenders' mental health symptoms over the first 11 weeks of their incarceration and the relationship of these adjustments to violent behavior are examined. Sections of this Bulletin include: highlights; introduction; methodology using MAYSI-2 (Massachusetts Youth Screening Instrument, Version 2); mental health at baseline; mental health symptoms over time -- alcohol/drug use, angry-irritable, depressed-anxious, somatic complaints, suicide ideation, and mental health symptoms and violent behavior; and summary/implications. Variable patterns of mental health change exist.

Jail Suicide / Mental Health Update Newsletter

From the Newsletter:
The Tragic and Preventable Death of David Thomas:

David Thomas1 was born into a life of turmoil and discord in
Atlanta, Georgia on November 3, 1987. His mother, Anne,
gave birth to her son at age 18 after many years of institutionalization
for incorrigibility and mental illness. She was reportedly raped at
age 13 in one of many institutional placements. David’s father left
the family early on in his life, but not before sexually and physically
abusing both he and his younger sister. Anne Thomas was in and
out of her son’s life for much of the early years, debilitated by both
substance abuse and mental illness. As a troubled young adult,
she was self-described as an irresponsible parent. During this
time, David was cared for by his grandmother, Barbara Mitchell,
herself a victim of childhood sexual abuse. Ms. Mitchell tried to
become a stabilizing factor in his life. However, as a result of his
unsettled and dysfunctional early years, David experienced
learning difficulties at school that were associated with delinquent
behavior. (Click on the newsletter to read the rest)