Janauary 2015  

Not Enough
(as printed in the Houston Chronicle, November 25, 2014)

Phillip McSwain, a young man diagnosed with schizophrenia, got in a scuffle with the police in 2008. James McSwain, his father and principal of Mirabeau B. Lamar High School in Houston Independent School District, took steps to prolong his son's stay in the Harris County Jail. Private care was prohibitively expensive, and Phillip needed help.

Fast-forward six years: Harris County Jail is still the largest mental health facility in the state. More than 25 percent of its inmates have been diagnosed as needing psychotropic medication.

One in five people suffers from mental illness every year, according to Mental Health America of Greater Houston. Although success rates for treatment are comparable to those who need physical health care, in 2011, Texas spent $39 per capita - $81 less than the national average and $75 less per capita than even Mississippi.

Harris County has adopted some strong programs. Teams of police officers and mental health professionals partner on targeted calls to help ensure that people with mental illness are not arrested unnecessarily. Through its pilot jail-diversion program, judges work with these professionals to keep those with mental illness from cycling through the criminal justice system.

There's much left to do.

The earlier children at risk get professional help, the greater the likelihood of a cure. The Legislature should act next session to increase funding for teacher training to help students who are developing mental illness.

Russell Crowe portrayed a schizophrenic in the film, "A Beautiful Mind." Sometimes we forget that John Forbes Nash Jr., the economist on whom the film was based, won a Nobel Prize. With proper treatment, about 60 percent of people with schizophrenia are able to live a normal life. Unfortunately, Phillip McSwain lost his battle with the disease in 2009, following an overdose of alcohol and medication. "I honestly believe that with better care, Phillip would be alive today," James McSwain said.

Texas can do better.

Harris County Judge Ed Emmett’s Response to Houston Chronicle’s Editorial on Mental Health as Published December 5, 2014

More than 90,000 people in Harris County with severe mental illness can not access either the public or private psychiatric service systems. Many lack health insurance. Our public service systems are operating at maximum capacity. We simply do not have enough services for tens of thousands of mentally ill Harris County residents.

One out of every three of us has a close relative, friend, or business associate who suffers from a mental illness. We are all touched in some way by someone with a mental illness.

The Houston Chronicle editorial printed above addresses the gross underfunding of public services in Texas by noting that in 2011 “Texas spent $39 per capita -- $81 less than the national average.” While Harris County is the most generous in the state in its local funding of mental health services, we, and all Texas counties, must do more.

Despite our inadequacies, Harris County is doing more. One of the great tragedies of insufficient services is the tendency for some people with mental illness to become involved with the criminal justice system, usually for petty non-violent crimes. Many of these people cycle in and out of jail. Acting on this knowledge, Harris County leadership has created an impressive array of best service practices – including comprehensive in-jail psychiatric services, mental health courts, specially trained law enforcement officers and 24–hour crisis services.

Building on these programs, state Sens. Joan Huffman and John Whitmire and state Rep. Senfronia Thompson provided the leadership to win legislative funding for a four-year pilot jail diversion program. This pilot program will develop strategies and services to break the cycle of jail involvement. I am pleased to say that Harris County was chosen to implement this pilot program. It is now under way and showing early success.

Both our Mental Health and Mental Retardation Authority and Harris Health (the hospital district) are serving large numbers of people seven days a week. County leadership is continuously exploring ways to maximize the efficiencies and effectiveness of these services. I am deeply proud of the clinical and other service providers in these two agencies who all work diligently to improve the lives of people with mental illness.

Area medical schools and other institutions of higher learning are aggressively educating future doctors, nurses and social workers to serve people with mental illness. Moreover, they are conducting important research in new, more effective treatments for severe mental illness. Our private inpatient and outpatient clinics also provide significant services to our underserved and uninsured residents.

Texas now stands at a crossroads. The Texas Sunset Commission has extensively reviewed the Texas Health and Human Services Commission and has made recommendations that could greatly improve mental health service delivery in Texas.

I hope the Legislature seizes the opportunity to adopt the recommendations and adequately fund mental health services. We should all join together in supporting our legislators and local officials in tackling this issue.