Spotlight on JMHCP: Fayette County, Texas

Each month the Justice Center spotlights collaborative criminal justice/mental health initiatives that have received funding from the Bureau of Justice Assistance’s Justice and Mental Health Collaboration Program (JMHCP). Justice Center staff members ask the practitioners in these programs to discuss some successes and challenges they have encountered in the planning and implementation process. This month’s profile is from Fayette County, Texas, a 2009 Planning grantee.

Brief background on the jurisdiction

Fayette County, Texas, is a rural community roughly halfway between Austin and Houston. It encompasses 950 square miles of land area, with a total population of 22,521. The collaborating entities on this grant are Bluebonnet Trails Community Mental Health Mental Retardation (MHMR) Center (the local mental health authority) and the 155th District Criminal Court. Our proposal centered on the development of a mental health court initiative at the county level, but we were cognizant at the beginning that the strategies we implement will likely go beyond the court level, which has proven to be the case. This area has virtually no history of mental health and criminal justice collaboration, but team members were eager for solutions.

How did your jurisdiction realize that there was a need (or an additional need) to respond to the prevalence of individuals with mental illnesses in the criminal justice system?

The idea for this grant application evolved from a “conversation” between the District Court Judge, who was frustrated about the lack of alternatives for an individual client, and a mental health professional knowledgeable about national mental health jail diversion strategies.

Who initiated the grant application process? How were relationships formed between criminal justice and mental health agencies to prepare for this process?

The grant application process evolved over a period of two years. An initial grant application was submitted in 2008, covering the three counties under the jurisdiction of the 155th District Court and served by two different local mental health authorities. We later recognized that the scope of this proposal was too large, and modified it to a single county approach.

What is the initiative your task force is currently planning? What will be the “end product” of the planning process?

Our initial approach focused on court based strategies, but it has evolved from there to implementation across a variety of intercepts. Discussions, for example, have included implementation of a specialized police strategy and utilization of tele-medicine to improve access to care at the jail, in addition to a broad based mental health court strategy.

How did your task force educate yourselves about available resources and processes in the behavioral health system?

In February of 2010, we conducted a systems mapping exercise to identify issues across our system from a law enforcement, jail, court and housing and supports perspective. This helped to identify needed data elements to address those issues, currently in development. We recognized early in the process that, while informal data and discussions did take place, there were few systematized approaches to deal with difficult cases.

What resources or analysis have been most useful for your planning group in considering and evaluating different approaches to this issue?

In addition to the information I provided above, we developed a Mental Health/Criminal Justice Attitudes Survey, which we administered at the beginning of our planning as a pre-test, and will re-administer as a post-test at the end of our planning period.

What has been your biggest challenge and how are you addressing it?

Lack of housing resources is a formidable challenge. A representative from the Corporation for Supportive Housing agreed to come to our meeting on April 30, 2010, to help us work through those issues. Treatment resources are also extremely limited in both our area and our state, but the local match from the Texas Department of Criminal Justice to implement tele-medicine early on in the process has helped to combat cynicism about the potential for system change.

Provide an example of a particular success your program has had to date.

On March 3, 2010, we hosted a conference titled “Rural Strategies for Jail and Hospital Diversion.” This conference was co-sponsored by Bluebonnet Trails MHMR Center, the 155th District Court, and the Texas Department of State Health Services. Dr. Hank Steadman and Dan Abreu, experts from the CMHS National GAINS Center, provided an overview of jail diversion strategies from a national perspective, and particular advantages and challenges to implementing these practices in rural communities. The day ended by using the conference as a first public forum on a statewide initiative to implement system change around state hospital capacity issues that largely relate to criminal justice/mental health interface.

Have you identified steps your initiative will need to take to move from planning to implementation? What do these steps look like?

We are already in the process of implementing tele-medicine systems to increase timely access to care for individuals in both the adult and juvenile justice system. This includes strategizing about ways to implement a specialized law enforcement response for individuals with mental illness. Also, we are formalizing court-based processes to better address mental health issues. Finally, we are working with the Corporation for Supportive Housing to address barriers to access to permanent housing for individuals in our target populations.

Point of contact information

Susan A. Stone, J.D., M.D.

Project Consultant

sstonejdmd@attglobal.net