More than a year after Texas enacted landmark legislation to improve care for mentally ill inmates, rural jails face significant challenges meeting the standards of the Sandra Bland Act, according to testimony by Texas sheriffs and other local and state officials before the House County Affairs Committee.
Signed into law in June 2017, the Sandra Bland Act is named for a young African-American woman who hanged herself at a county jail in 2015 just days after being arrested at a traffic stop. A subsequent inquiry uncovered errors in the handling of her arrest, processing, and detention. Jail employees were found not to have completed required mental health training.
The Act revised Texas jail standards and mandated new training for jail administrators. It set a “good faith effort” standard requiring jailers to try to divert people suffering a mental health crisis or substance abuse issue out of jail and into a treatment center better equipped to handle the situation.
Also called SB 1849, the Sandra Bland Act was one of four Texas bills (alongside SB 1326, SB292, and HB 13) passed in 2017 to address the nexus of mental health, substance abuse, and the criminal justice system.
Some of the new standards are already in effect while others are not actually compulsory until September 2020. Progress in implementing them varies county by county. To date, mental health screenings are not always done at intake, according to Jim Allison, General Counsel for the County Judges and Commissioners Association of Texas. “I think there’s some unevenness out there on how well they’re being done, how quickly they’re being done and the implementation,” he told the committee hearing Wednesday.
“It is not uncommon once they determine that an inmate is to be committed to a state facility that they sit in our jail for three months.”
Expert witnesses also told legislators of gaps in funding, training, and the availability of mental health services. Limestone County Sheriff Dennis Wilson said, “the Sandra Bland Act requires law enforcement to make a good faith effort to divert people from the criminal justice system, but options for diversion are very limited. For example, crisis stabilization unit services, extended observation unit services, and other community-based alternatives to the state hospital are experiencing significant demand.”
Tiffany Witherspoon, the jail administrator of rural Robertson County, said inmates at her jail have been kept waiting for weeks before getting psychiatric medicines or a medical transfer. “It is not uncommon once they determine that an inmate is to be committed to a state facility that they sit in our jail for three months,” she said. “It is traumatizing already for them – especially when they are in a crisis – to sit in a facility where we really don’t have the knowledge to deal with them because we’re not mental health (experts).”
In one case, Witherspoon said, a prisoner in a crisis “caused a great disturbance without her medicine,” while in another case a prisoner awaiting months for a transfer to a mental health facility became increasingly withdrawn and isolated.
Witherspoon’s boss Sheriff Gerald Yezak, who is also president of the Texas Sheriffs Association, backed up her testimony, saying, “As far as the implementation of some of the aspects already of SB 1849, I’m going to defer to my jail administrator.”
Yezak noted that his county, which is located about 120 miles northeast of Austin, does not have its own emergency room, complicating efforts to get inmates medical care in the event of a medical emergency in the jail. House Member Tomas Uresti (D-San Antonio) suggested that the telepsychiatry component of the Bland Act should be able to help address this problem by ensuring that prescriptions can be issued quickly to inmates at rural jails.
New equipment, trainings
Allison of the County Judges Association contends that the telepsychiatry component of the Bland Act is one area in which counties are making good progress. “You gave us telepsychiatric services 24-7 – we’re going to implement that, we’re way ahead on that,” he told the lawmakers. “There are many jails that have already found that service and accessed it.”
But Allison described the rollout of telepsychiatry at the rural level as a process rather than an overnight switch. “Frankly, the market is just now catching up, particularly for smaller counties. One of the reasons we asked you for a time lag to impose that as a requirement is that we need to make sure that that service is reasonably available at a reasonable cost throughout the state – not just in the larger jails.”
‘Sandra Bland implementation has been challenging but successful.’
He continued, “I’m confident that we can report to you that telepsychiatry is catching up and that service will be available and at a competitive cost – it will be at a cost – but the market is producing enough… interest to bring that service online.” Allison added that counties are also making progress implementing electronic monitoring systems for safety checks on inmates.
In the meantime, the Texas Commission on Law Enforcement says it has trained thousands of county officers under the requirements of the Bland Act. Since the law took effect, it has trained 10,985 officers in deescalation techniques to reduce use of force by officers, 1,500 officers in crisis intervention, and 6,300 jailers in a basic mental health course, according to Michael Antu, director of special services at the commission.
Another state agency, the Texas Commission on Jail Standards, is charged with running a Prisoner Safety Fund created under the Act. The fund assists counties that operate a jail with 96 beds or fewer. Grants are used to buy electronic sensors, computers for telepsychiatry, or other equipment.
Executive Director of the Commission Brandon Wood testified that grant amounts have ranged from about $1,200 to almost $8000 dollars. Chairman Rep. Garnet Coleman (D-Harris County) questioned why the grants have been so small,saying, “So, really what that means is we didn’t put enough money in the account. No, I mean, I’m serious, we didn’t. If it (only) goes to $8,000, we didn’t put enough money in the account.”
Wood replied that the cost of the equipment “is a lot cheaper than I think some people were afraid of at first.” For example, a medical cart that has a computer that meets all the security and privacy requirements of the telepsychiatry program can be purchased for under $2000, he said. Overall, Wood said, implementation of Sandra Bland Act has been “challenging at times but… successful.”
‘Priority for the 86th Legislative Session’
A lasting impact of the Sandra Bland Act could be closer cooperation between county sheriffs and mental health practitioners. Sheriff Yezak says that his jail is now working more closely with the Local Mental Health Authority (LMHA) covering his county: “In Robertson County we have an excellent working relationship with our LMHA. We truly do. When an individual comes into our jail and it’s obvious he’s in need of mental health services we contact them, and they’re actually in another county but 70-75% of the time they’re there the same day that we contact them. And they screen this individual if needed to get them into their services.”
But lack of funding and shortages of mental health practitioners remain critical issues in many rural counties. “There’s not the resources. There’s not the mental health resources there to get them the medication they need. And it’s a funding (thing),” says Dawn Elder, who represents a private drug and alcohol clinic located west of Comfort, and also cooperates with government-funded Local Mental Health Authorities. “I think the piece that needs to be addressed or recognized is how mental health and substance use disorder go hand-in-hand and they’re almost always a self-medicating situation.”
‘Unless the legislature invests new funds, jails will struggle to meet requirements.’
Sheriff Wilson emphasized, “Local jails need resources to meet mental health needs of people in custody.” He added, “Texas may want to consider strategies such as legislation recently passed by the state of Maryland which provides a mechanism for state reimbursement to local detention facilities that incur housing costs of defendants with mental illness that wait beyond a reasonable time for a state hospital bed. Unless the legislature invests new funds, jails will struggle to meet requirements for ensuring 24-hour access to mental health when the commission on jail standards rules kick in in 2021.”
The legislature next meets in regular session in January. In the meantime, the House County Affairs Committee has a directive from Speaker Joe Straus – known as an interim charge – to monitor implementation of the Sandra Bland Act.
A member of the committee, Representative Kyle Biedermann (R-Fredericksburg), said in statement after Wednesday’s hearing, “Meeting behavioral health needs for criminal justice and community mental health programs will continue to be among my priorities in the 86th Legislative Session. I remain committed to exploring possible solutions regarding access to care… state and county grant programs, training law enforcement officers and helping to educate our communities.”
Photo (top): A police facility in Hempstead, the town where Sandra Bland died in 2015 (Patrick Feller via Flickr – CC BY 2.0)
