At an awards breakfast for Houston-area social workers on Friday, Harris County Sheriff Adrian Garcia highlighted ways the Harris County Jail system is working for social justice and called for treating mental illness outside the jail system.
“It is their disease that has put them in harm’s way and in nexus with law enforcement,” Garcia said. “Sometimes the only place they can find reasonable treatment is within the four walls of the county jail system. … That’s not fair and it’s not right.”
Garcia was the keynote speaker at the 12th Annual Greater Houston Social Work Awards Breakfast, at the University of Houston. His address, called “The Harris County Jail: The Largest Mental Health Provider in Texas,” was less about the jail’s current role as a mental health provider than about Garcia’s efforts to divert the mentally ill from the jail and to create a more fair and humane jail system.
Garcia opened with a tragic story that illustrated what can happen when mental illness and criminal justice collide. In his early days as a patrolman, Garcia encountered a “mountain of a man” named Jerome. Jerome was at a bar, hallucinating dead people and frightening other patrons. Garcia and the rookie he was training managed to get Jerome outside, but they were frightened and unsure how to handle the man in his delusional state. “He would stop and move and do certain things, and several times I found myself with my hand on my gun,” Garcia said. But he managed to get Jerome into the back of the police car—he was so big that handcuffs wouldn’t fit around his wrists—and drive him home. Garcia saw Jerome several times after that, learned how to manage him and always got him safely home. One night, after Garcia had been promoted to the criminal intelligence division, he saw on the news that Jerome had been shot and killed by police. He had attacked them with a sledgehammer. “I kept saying, I know I could have done something,” Garcia recalled. “I know I could have gotten him into the car. It always, always stayed with me.”
Now, Harris County has a crisis intervention team, which partners county deputies with mental health professionals to respond to emergency calls that may involve mental illness. Garcia says that in just four months, the crisis intervention team has diverted 72 people to mental health treatment who ordinarily would have gone to jail, saving the county an estimated $200,000 in jail space and medication costs. But, he said, “The best outcome of this is that they’re not being criminalized.”
Garcia praised the growth of the Harris County Jail’s chaplaincy project. Rather than 20-30 paid chaplains, they now have more than 400 volunteers “who are helping us bring a calmer, more humane environment overall, not only with our inmates, but with our staff.” And Garcia bemoaned the scarcity of mental health resources for Harris County law enforcement employees. When he came in as sheriff, he said, employees got only two mental health visits free through their insurance. “Now they get five,” he said. The room full of social workers chuckled a little, recognizing that it’s still not enough. “So we depend on our chaplains,” he said.
The sheriff also touted the county’s improvement to its competency restoration process, which starts treating the mentally ill in the jail, rather than waiting for space to become available at a state mental hospital. Garcia says plans are underway to have prisoner health files managed electronically, so it’s easier to track patients’ past medications and provide better continuity of care.
But Garcia acknowledged there’s plenty of room for improvement. A quarter of the jail’s 10,000 prisoners receive psychotropic medication, one reason the jail is often called the state’s largest mental health facility. And while conditions may have improved within the jail, Garcia says there’s an 80 percent drop-off in treatment once prisoners are released. “Until we recognize that it is cheaper and better to do things outside of a correctional environment,” he said, “then we still have a long way to go.”
In remarks to reporters afterward, Garcia emphasized that more funding for community-based mental health care was crucial to his initiative’s success. “But if we build up our capacity and nothing changes on the community side, or we lose on the community side, the whole scheme of that concept is compromised.”
“At what point does the system let go of these people?” one reporter asked Garcia after the speech.
“I’m not sure I know the answer to that,” Garcia said after a pause. “We are our brother’s keeper.”