Texas’ Underfunded Mental Health System About to Get Worse

In January, I wrote a feature story about Otty Sanchez—the 33-year-old San Antonio woman who murdered her three-week-old son and then consumed parts of his body in the early morning hours of July 26, 2009.

The story opened this way:

“The first police officers at the crime scene were so shocked they could barely speak. When they arrived at the white-paneled house on San Antonio’s north side at 5 a.m. on July 26, officers found a bedroom doused in blood, the decapitated and mutilated body of a baby not even a month old, and his mother, 33-year-old Otty Sanchez, screaming that the devil made her do it.

Sanchez had left the baby’s father after a fight and was staying with her mother and cousins. Around 4:30 a.m., while the rest of the family slept, she’d attacked her infant son with a large kitchen knife. Police officers would describe the crime as one of the most gruesome they had ever seen. Some of them later needed counseling.”

Sanchez is a paranoid schizophrenic who was suffering from postpartum psychosis, a severe form of postpartum depression that often prods new mothers to violence (think Andrea Yates) She had been enduring a mental-health crisis for at least a week before the killing. But when she reached out for help—like so many Texans with severe mental illness—she was left to fend for herself.

The story went on to document at least three instances when Otty Sanchez came into contact with Texas’ mental health system, including a last attempt to get help just days before the killing. Each time she was either turned away or eventually dropped from services due to lack of resources. (Sanchez, who was working a string of low-paying jobs, couldn’t afford treatment herself.) So she went untreated.

That isn’t unusual. Texas has one of the most miserly public mental health systems in the country. Most years, the state ranks anywhere from 47th to 50th in per capita spending on mental health

Several hundred thousand severely mentally ill Texans go without treatment every year simply because the state has refused to provide the necessary resources.

And it’s about to get worse.

With Texas facing a projected $18 billion deficit, cuts to mental health services are inevitable. The Department of State Health Services has already proposed $134 million in cuts to mental health, denying care to 20,000 people. That’s likely just the beginning.

The looming cuts also threaten to wipe away the minor progress of recent sessions. The Legislature—having recognized the problems caused by a meager mental health system—actually raised funding for mental health in recent sessions, including an increase of more than $80 million for crisis services (though the system still let Sanchez fall through the cracks). Those modest gains likely won’t survive this budget cycle.

Meanwhile, Sanchez—who proved she could be a productive member of society when she was getting her medications and receiving outpatient counseling—instead was denied those services repeatedly and eventually committed an unimaginable act of violence.

Prosecutors in San Antonio had charged Sanchez with murder and announced they would seek the death penalty. But in late June, she was ruled not guilty by reason of insanity. The charges against Sanchez were dropped, and she will remain in a maximum security mental health facility, although a judge will review her case every year, according to the San Antonio Express-News.

She will probably be institutionalized for a very long time.

Unfortunately, it took a horrifically violent act for Sanchez to receive care from the state of Texas. With budget cuts coming, more Texans may suffer her fate.