AUSTIN, Texas — The Centers for Disease Control and Prevention states that more than 50% of Americans will be diagnosed with a mental illness or disorder in their lifetime.
Now, imagine not being able to get the psychiatric treatment you need after that diagnosis. That's what more than 2,500 defendants in Texas county jails are experiencing as the wait time for them to get state help can be years long.
It can be devastating for families.
But Williamson County plans to open a new facility to help cut down on that wait.
Williamson County's new initiative is called the jail-based competency restoration program. It's for defendants charged with a crime but declared incompetent to stand trial. The goal is to get these pre-trial inmates mental health treatment so they get their day in court.
Williamson County leaders like Sheriff Mike Gleason say that process is taking too long.
KVUE asked Sheriff Gleason, "What happens when an inmate has to wait two years before getting mental health treatment?"
"They get worse and worse and worse," he said.
At a certain point, Gleason said some of those defendants may never be competent enough to stand trial.
"Their mental illness gets to where you can't bring them back. They won't, they can't, come back to a competent level to help in their own defense," Gleason said.
According to the Williamson County Sheriff's Office, there are eight inmates waiting for state psychiatric care.
Out of that group, the shortest wait time is 295 days, or about nine-and-a-half months. The longest wait time is 618 days, or about a year and eight-and-a-half months.
Gleason said it wasn't until COVID-19 hit in 2020 that the waitlist became an issue.
When he took office the following year, he said he started conversations with other county and mental health leaders about how to fix it.
"Nobody should be sitting in jail waiting to be found competent," Gleason said.
How the program works
"This is the pod," jail administrator Kathleen Pokluda announced as she gave the KVUE Defenders the first public look at the facility.
Next to the Williamson County Jail sit six pods, the site of the county's first competency restoration project. Each pod contains six rooms and each room contains eight beds.
Initially, the program will start with one inmate per pod. Each large pod comes with a recreation room. All areas will be monitored by staff and cameras at all times.
Lt. Douglas Wheless is the medical supervisor of the Williamson County Jail.
"They're allowed to do regular physical activity as long as it's not hurting them … You have fresh air," Wheless said.
The facility is where the defendants will get the psychiatric care they need so they can stand trial.
Lt. Jorian Guinn oversees the Crisis Intervention Team.
"They need help to maybe become stable, and somebody who can understand and get them the treatment that they need to get them back to competency, to where they're able to stand trial if trial is what's necessary," Guinn said.
Bluebonnet Trails Community Services provides those experts. Andrea Richardson is the CEO.
"They're not coming in with just a worrisome or bothersome issue. They're coming in with crisis. And so making sure that we have an immediate response from a professional team has been critical," Richardson said.
Williamson County commissioners approved moving forward with the competency restoration program at their Jan. 17 meeting. County leaders said while the State has already approved $1 million for a 12-month period, they are waiting for additional funding.
"We're also talking to the Legislature about continuing and having continual funding for this project," Commissioner Valerie Covey said.
A welcome change
Before the new program, Williamson County's Felony Mental Health Docket provided mental health care for those who couldn't get or didn't know about available resources. People like Gabriel Benedict.
"I felt heard for the first time ever," Benedict said.
The 47-year-old said it wasn't until his eighth arrest that he finally got the help that changed his life.
In 2019, Benedict was charged with felony possession of meth and his third DUI in Williamson County. He said it was the first time a probation officer made the link between his arrests and mental health.
"She said, 'I can't believe you've been arrested this many times and no one has noticed that your mental health and your arrest record coincide,'" Benedict said.
Benedict said he was diagnosed with major depression, post-traumatic stress disorder and dissociative identity disorder, once known as multiple personality disorder.
He credits his probation officer, counselor and other county staff for turning his life around.
Benedict recently moved into his own apartment as he continues working on his second book.
He supports the restoration competency program.
"I feel like I can finally exhale, like, 'ah,'" Benedict said.
Outside Williamson County
Kristi Taylor is the executive director of the Texas Judicial Commission on Mental Health.
"I think every county would benefit from a jail-based competency restoration program," Taylor said.
She said the 14 competency restoration programs in the state are doing well.
"There is just an absolute overwhelm for the system," Taylor said. "I would say it's absolutely a crisis."
Let's take a look at that crisis in numbers.
According to Texas Health and Human Services, the average number of individuals on the state waitlist for January is 2,531 – a slight decrease from December when the waitlist was 2,544. But a look at all of last year and you can see how the number increased every month, with the exception of March to April, when it decreased by eight.
Average number of individuals on waitlist – Texas Health and Human Services:
- January 2023: 2,531
- December 2022: 2,544
- January 2022: 2,081
- February 2022: 2,196
- March 2022: 2,310
- April 2022: 2,302
- May 2022: 2,356
- June 2022: 2,395
- July 2022: 2,469
- August 2022: 2,497
- September 2022: 2,531
- October 2022: 2,539
- November 2022: 2,549
Taylor said some of the factors behind that big waitlist include population increase, staffing shortages and not enough state psychiatric beds.
In 2021, the Texas Judicial Commission on Mental Health and the Texas Health and Human Services Commission launched the Eliminate the Wait campaign – a checklist of strategies for courts, law enforcement and mental health professionals to help reduce the wait.
This legislative session, the Texas Judicial Commission on Mental Health is also recommending several changes to civil and criminal laws that would streamline mental health services for adults and juveniles.
Taylor said mental health affects all Texans.
"There may be a day when you have a family member who needs treatment and they can't get into a voluntary program because some of those voluntary commitments, those beds, are being taken by these criminal cases," Taylor said.
But inmate advocacy groups like the Texas Jail Project, Mano Amiga and Fierce Madres are against jail-based competency restoration programs.
"That is not going to solve our health care problems," said Krishnaveni Gundu with the Texas Jail Project.
Instead, they and inmate family members are asking lawmakers to invest in mental care treatment, housing and prevention.
"Nobody can get well in a cell, and we're lying to ourselves if we say that that's the case," said Karen Muñoz with Mano Amiga.
Williamson County leaders aren't waiting that long.
They hope to launch the new competency restoration project in the spring, helping defendants get their day in court and get them out of the system.
The Travis County Jail is also experiencing long wait times. According to the Travis County Sheriff's Office, the longest wait time for a pre-trial defendant to get state psychiatric care in 2022 was 833 days.
- In 2021, the longest wait was 524 days.
- In 2020, the longest wait was 691 days.
- In 2019, the longest wait was 628 days.
- In 2018, the longest wait was 432 days.
- In 2017, the longest wait was 390 days.
Travis County already uses a jail-based competency restoration program in its jail.
Daniel Smith is the director of Inmate Mental Health and Programs with the Travis County Sheriff's Office.
"Through our normal process of treatment right now, we restore about 9 to 10 individuals to competency each month. The primary thing is that they just need time and medication management to get on that road to recovery," Smith said. "The other side of it is that many of the individuals that are waiting on a comprehensive bed may not even restore to competency and they need long-term care and facility."