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The Revolving Door Between Jail and Mental Health Care in Harris County

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Before the schizophrenia set in, Tyrone Dolphin was on a full-ride football scholarship at Western New Mexico University, studying to become an aeronautical engineer.

He was a three-sport athlete in high school, and he graduated cum laude with big dreams, his mother, Liz Willis says. But once psychiatrists put him on antipsychotic medication during his sophomore year of college, Dolphin had to drop out and come home, often unable to get out of bed.

Her son is now 43 and homeless. Dolphin wants his independence, and so he has refused to live with Willis. He has tried to rent an apartment using his social disability check, but he never stays long, unable to pay. Willis says that, since his diagnosis derailed his college education, the thought of going back to school has become a fixation. At the start of every school year, he visits the Texas Southern University campus to surround himself with ambition. He’s tried to re-enroll, Willis said, but his mental illness always sets him back.

These days, Dolphin pretty much only receives mental health treatment when he is arrested for trespassing. His schizophrenia has become severe enough, however, that doctors have labeled him permanently incompetent, and petty charges against him are always dismissed. Instead of making him serve time, a judge orders that he be committed to the Harris County Psychiatric Center. He may stay for a few days, maybe a week, receive some medication, and then he’s back on the streets — only to be picked up by police the next month, when the process will start all over again. It has happened six times just in the past year.

“The only help that I know is the help that he’s getting, and it’s not working for him,” Willis said. “So what do you do? …Maybe they’re doing the best they can,” she added. “Maybe that’s all they can do.”

Tyrone Dolphin is just one example of the revolving door between the criminal justice system and mental healthcare. He is among the state’s most vulnerable citizens, those whom mental health doctors believe will never return to a level of competency that would allow them to understand the consequences of committing petty crimes, like sleeping on private property.  The Harris County criminal courts are doing, arguably, the best they can for people like Dolphin, by letting them go and transferring them to the custody of mental healthcare providers. But once they do, that’s when both jails and the local mental health authorities run into the big problem: There is no room at the hospital. And so patients like Dolphin will wait in jail until there is — even though they are no longer charged with a crime.

“This is a time of bed scarcity,” said Dr. Floyd Jennings, chief of the misdemeanor mental health division at the Harris County Public Defender’s Office. “And in times of bed scarcity, you have to be real careful about how you use those beds. They’re only going to take the worst of the worst.”

That means that, even while some people wait between ten or 20 days to finally be transferred to treatment, they may arrive for an evaluation at Houston’s NeuroPsychiatric Center only to be turned away. Because even though their mental illness may be severe, their situation may not be urgent enough, Jennings said. Even if chronically ill patients are admitted, they generally don’t stay long enough for the treatment to make any meaningful difference, Jennings claims.

“When you begin to accept the tragic as normal, it’s very difficult to change,” he said. “I don’t think anyone’s doing this consciously. It’s not intentional. This is a comment about our culture in Texas, where we have now diminished the resources available to this population to such a degree that the providers intuitively realize that they can only devote their efforts to those who are likely to benefit the most.”

He compared the situation in Texas to a sinking ship, only with passengers who are mentally ill patients. They all need help, he said, but an unfortunate number will not receive any, due to the lack of resources. “There’s only so much room in the lifeboat,” he said.

It means that people like Tyrone Dolphin, those who suffer from chronic and severe mental illness to the point that they have been labeled “permanently incompetent” in court, are the passengers who may end up left behind.

Source: Why Texas’s Most Vulnerable Mentally Ill Patients Are Waiting In Jail For Help | Houston Press

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