The Dallas County public defender's office plans to hire social workers to help keep its mentally ill clients out of jail.
It's one more attempt to end the cycle of hospitalization, incarceration and homelessness caused by the criminalization — rather than treatment — of mental illness. Nonprofits and county administrators have launched a host of programs to stem the crisis, from special police units to emergency housing.
But in this case, the state had to swoop in and fund the widely lauded program's continued expansion after the county refused the office's repeated requests for more case managers.
In January, the Texas Indigent Defense Commission awarded the county nearly $600,000 to attach a team of social workers to the mental health division of the public defender's office. They'll be responsible for connecting clients with housing and other community resources to reduce the odds that they re-offend.
The office has 11 attorneys assigned to the mental health division, as well as five case managers who screen clients and then follow up to make sure they're complying with court orders and staying out of trouble. But they're currently "overwhelmed," said Lynn Richardson, the county's chief public defender.
"That's why we asked for the social workers — which we've been asking the county for years to give us — so that they can totally be focused on getting [our clients] support like housing and treatment," Richardson said.
Her request for more case managers was denied most recently in 2018. Ryan Brown, the county's budget director, blamed "limited funds" and said the county had prioritized adding another attorney.
Meanwhile, the mentally ill continue to flood the Dallas County jail. It's one of the biggest providers of mental health care in the state, second only to the Harris County jail in Houston.
The problem can be traced back to the middle of the 20th century, when policymakers decided to "de-institutionalize" the country's mental health treatment system. The aging, prison-like asylums were torn down, supposedly to be replaced by community treatment services.
By and large, this didn't happen.
Programs were underfunded across the nation. But it was particularly bad in Texas. According to the Kaiser Family Foundation, Texas ranked 48th in per capita funding by state mental health agencies.
As a result, less than a third of people with severe mental illness receive treatment from the state, according to a 2014 report from the Meadows Mental Health Policy Institute.
The state has increased investment in recent years. Still, about a quarter of the inmates in Dallas' jail have some kind of mental illness. Richardson called that a "conservative" estimate.
Those inmates — many waiting for court-ordered treatment before seeing a judge — are a significant financial burden to the county, which pays around $70 a day for the cell as well as the additional costs of medication. That's far more, advocates say, than it would cost to treat those conditions in the community.
To help address this issue, the Mental Health Division was created within the public defender's office in 2005 with another grant from the Texas Indigent Defense Commission. It was the first of its kind in Texas, and it began with only a single attorney and a pair of case managers.
Traditionally, Richardson said, defense attorneys don't keep up with their clients after they walk out of the courtroom. "In the very beginning — across the board — even the public defenders kind of rolled their eyes. 'It's not my job to get them drug treatment if they don't want it.'"
The grant helped change things, at least in Dallas. Specially trained attorneys were assigned to clients with symptoms of mental illness, and staff members kept tabs on them for months after they walked out of the courtroom. If a client was homeless, a case manager would call around to local shelters and find them.
It worked. A 2010 report from the nonprofit Council of State Governments and Texas A&M University found that the program significantly reduced recidivism and helped mentally ill clients get treatment rather than jail time.
Similar programs popped up across the state, and the county picked up the division's budget after the grant ended in 2009.
Richardson said she is confident the county will also pick up the tab for the four new positions — three social workers and a secretary — when the funds run out late next year. The results, she said, will speak for themselves.
"We are able to show, based on our numbers, how many people we represent and how we get them out of jail quickly," she said.
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Ron Stretcher, Dallas County's former criminal justice director and now senior director at Meadows Mental Health Policy Institute, said he was "very supportive" of the division's expansion.
"It can take a lot of time and effort to put all the pieces together to get someone out. It can mean connecting them with treatment, housing, transportation and a variety of other services," he said. "And so having more people that are able to do that is just a help to the system."
While he was with the county, Stretcher frequently fielded calls about people "stuck in the system" and not getting appropriate mental health treatment. He praised the work of Richardson and her office's mental health division, which is assigned to nearly half of Dallas' cases involving people too poor to afford private counsel.
"If I ever had a difficult case and could see that there was a public defender assigned," he said, "I knew I would be OK and that the right thing would be done."