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Dan and Mary Wilson give him pills and send him home. Sally Walden, director of network services at Spindletop MHMR, refused to discuss Will Wilson’s case due to confidentiality requirements, but she defended the center’s handling of mentally ill patients in crisis. “Not everybody meets the criteria for being held against their will every time they’re brought in,” Walden says sitting in Spindletop’s southside offices that still show signs of flooding from Rita. “You can’t keep holding them just because you know when you release them they’re going to start doing poorly again. Holding them won’t prevent all that.” Nevertheless, the Wilsons complained to state officials in Austin about Spindletop’s handling of mental health crisis services. After the complaint, the Texas Department of State Health Services opened an investigation into the center in November 2004. The resulting report, obtained by the Observer, cites Spindletop for multiple deficiencies in its handling of patients in crisis, including turning people away or hurrying their release when the center’s in-patient beds are all occupied. The report noted one recent incident in which police brought in a man who “thought he was Jesus.” Spindletop couldn’t find an appropriate place for him. The photo by Dave Mann man was released and hanged himself the next day. Advocates and bureaucrats agree on the source of problems at Spindletop MHMR: a dearth of resources. The center has a limited number of beds for the mentally ill who need inpatient care. There is a 16-bed local crisis center, and the center can send a few patients to nearby Rusk State Hospital. But a handful of times each year, the patients in crisis outnumber the small number of available beds. That’s when Walden and her colleagues at Spindletop must get creative: calling local hospitals to check for free beds or paying a staffer overtime to sit with a suicidal patient, perhaps all night, until a bed becomes available. And sometimes, according to the state report, police are asked to hold mentally ill patients in the local jail on trumped-up charges until a bed becomes free. In these overcrowding situations, Spindletop officials also will release patients from the crisis center earlier than they should to make room. “With fewer beds, you’re cycling people through the system a little faster,” Walden concedes. Spindletop MHMR’s situation is emblematic of a statewide problem. State officials completed a scathing report on Austin-Travis County MHMR earlier this year that identified continued on page 20 DECEMBER 2, 2005 THE TEXAS OBSERVER 13