By MELISSA McEVER: The Brownsville Herald

October 12, 2005
When her son's behavior became erratic and violent, Ruth Kowalsky worried for his safety -- and her own. Days later, she ended up in the hospital with cracked ribs, and son Craig was in jail on an assault charge.

Craig, who is schizophrenic, was experiencing hallucinations and delusions during the attack, Ruth said. Both Ruth and Craig believe the incident could have been avoided if doctors had monitored Craig's condition more carefully, and both believe that Craig should have been treated in a hospital, not locked up in jail.

"It was very wrong to punish me for having a nervous breakdown," said Craig, whose symptoms are now under control. "When I was in jail, I had only one visit from the doctor, and it wasn't a beneficial environment for me."Texas jails and detention centers are crammed with people who, like Craig, suffer from mental illnesses. According to data from the former Texas Department of Mental Health and Mental Retardation, now part of the Texas Department of State Health Services, about 22 percent of inmates in the state's prisons in 2004 were once MHMR clients.

Based on that figure, about one in five inmates could have some type of mental illness, the Texas Correctional Office on Offenders with Medical and Mental Impairments has reported. Other studies have suggested that about 16 percent of inmates have a serious mental illness, and Valley rates are likely to be similar.

"We've been dumping huge numbers of people into the criminal justice system," said Joe Lovelace, executive director of the National Alliance of the Mentally Ill of Texas. "The numbers are staggering."

Those numbers are why the Texas Legislature included a new jail diversion program as part of a 2003 bill to revamp the state's mental-health system. The program attempts to steer some individuals away from the penal system by using strategies like screening inmates for mental illness and working with the courts to route some nonviolent, misdemeanor offenders into mental-health care instead of jail.

Many mentally ill Valley residents have ended up in trouble with the law -- usually with minor offenses -- while in the throes of their illness, said Stephanie Contreras, president of NAMI's South Texas chapter. If those patients receive proper attention and treatment, they can avoid jail and future brushes with the criminal justice system, she said.

However, funding for such a program isn't coming easy.

Tropical Texas Center for Mental Health and Mental Retardation, which serves Cameron, Hidalgo and Willacy counties, is working on developing a jail diversion program in cooperation with Hidalgo and Cameron counties. However, they're not getting any extra dollars from the state to do so.

"Although we have the state mandate to provide jail diversion (services), there's no funding stream identified to assist with any of those activities," Tropical Texas CEO Terry Crocker said. "Currently, we're identifying funds however we can."

Which means Tropical Texas must shift funds originally intended to serve the mentally ill in the general population to the jail diversion program. Tropical Texas already has had to cut about 300 patients from its rolls as part of the statewide system changes, and diverting more funds away from its regular services means that more patients might be shortchanged, Crocker said.

"We end up with lots of irons in the fire, and it makes it difficult when there's no funding attached," Crocker said.

Tropical Texas has set aside $250,000 of its yearly $23 million budget for the jail diversion program, which is still in its infancy. So far, officials have focused efforts on creating the program in Hidalgo County, bringing in mental-health workers to screen inmates for mental illnesses and requesting in court that certain nonviolent offenders go into mental-health services instead of jail.

"It's been slow, because there are so many people you're working with," said Tropical Texas manager Caryl Chambliss. "We're meeting with the judge, with the DA's office we're trying to figure out exactly what our role is."

The center also is cross-referencing inmate lists with MHMR records to identify those who have received services in the past, so they can be reconnected with services once released from jail, Chambliss said.

Hidalgo County Sheriff Lupe Treviño said he's had limited contact with the center so far about the jail-diversion program.

"They call us, we e-mail them a list of people who are incarcerated, and they match their consumer list with our inmate list," Treviño said. "They also come and talk to (the inmates) most of the program happens before (offenders) get to us."

Tropical Texas officials are working to begin a jail diversion program in Cameron County as well. Remi Garza, executive assistant to Cameron County Judge Gilberto Hinojosa, said the county and Tropical Texas should have an agreement together in a few weeks.

So far, Tropical Texas has screened about 370 inmates in Hidalgo County, said Cory Morlock, supervisor for the center's jail diversion program. Morlock said he didn't immediately know how many of those screened qualified for services.

Crocker, Tropical Texas CEO, said he hopes in future years that the counties might pitch in to the program, easing the burden on the mental-health center.

"I'm hopeful that after we're able to demonstrate the effect these services can have, it will be apparent that helping with resources will be beneficial for (the counties)," he said.

Lovelace, who is with the National Alliance of the Mentally Ill of Texas, said collaboration among counties and the mental-health center could help the jail diversion program be successful, even without additional state funds. But state money would help, too, he said.

"You can only improve your model to a certain point before you have to put more money into it," Lovelace said. "We need more money."

More money in the jail diversion program could help mentally ill patients like Craig Kowalsky get the care they need -- before the consequences become drastic.

"Right now, he's doing well," Ruth Kowalsky said. "I don't know what I would do if it happened again."