Texas' notoriously porous mental-health system is in the news even more than usual this week. At Parkland, the psychiatric ER is yet again facing allegations of patient abuse. Last weekend, Dallas Police shot and killed Jason Harrison, a 38-year-old severely schizophrenic man who'd been medicated back to "competency."
And earlier this week the Sunset Advisory Commission, which reviews the performance of state agencies, released a report detailing what severe shortcomings in the state health system, with a particularly harsh takedown of the Department of State Health Services.
With chapter titles such as "DSHS Has Not Provided the Leadership Needed to Best Manage the State's Public Health System" and "DSHS' Numerous Advisory Committees Lack Strategic Purpose, Limiting Their Effectiveness and Wasting Resources," the Sunset Advisory Commission's evaluation of the DSHS is, in a word, excoriating.
Matt Roberts, President of the Greater Dallas chapter of Mental Health America, says the report, while appreciated, is hardly surprising.
"My initial reaction was that it appears the Sunset Commission staff captured something we have seen in the local Dallas area for some time," Roberts tells Unfair Park. Roberts says public mental health services and resources in Dallas are facing burdensome financial struggles, despite lawmakers' increase of funding for mental health services last session.
In Dallas, he says, that additional and sorely needed money apparently never came. "We worked very hard with the state budget during the session, only to later find that the funds we expected to arrive in Dallas didn't arrive," Roberts says. "When we look at Sunset Commission's report, we found this was a pattern across Texas."
In fact, the report stresses inefficiency and inaction within the DSHS, possibly because of the sheer size of the organization, which claims more than 360,000 affiliated workers and facilities. While the Sunset Commission is not yet drawing any conclusive recommendations regarding the dissolution of the 15-year-old DSHS, they make it clear that it could be an imminent possibility:
Numerous plans and studies attempting to correct pervasive state hospital system issues have yielded few results, and the success of future plans is questionable ... The state hospital system is essentially unchanged from the last Sunset review 15 years ago.
"The report made us aware that it was a situation that was statewide, and that it was a situation where the DSHS received multiple instructions by legislatures that they did not implement," Roberts says. "We hope Sunset uses this as opportunity to really improve care that mental health patients are receiving. ... As an advocate, I have been frustrated."
The Sunset Commission will meet next week for a public hearing on the DSHS. While its future existence is secure for the moment, the greater question will come when the Commission completes its review of all state health and human service organizations this fall. After that, the DSHS's future may be more precarious, as the Commission's current improvement recommendations can only be drawn from incomplete information.
But advocates are adamant that something has to change within the DSHS. "I'm not sure that if the average Texan looked at mental health system in depth, they'd be proud of how we're helping these people," Roberts says. "I don't think we do enough in the mental health process of prevention to illness to crisis to healing to recovery. And we're not providing enough resources or options for treatment and recovery."