Tuesday, December 27, 2005

Mentally Ill Languish: Dallas Morning News

12/24/2005 Day: Saturday
THE DALLAS MORNING NEWS
Mentally ill wait in jail Dallas County: As state hospitals seek funds, more inmates languish JAMES M. O'NEILL Credit: Staff Writer METRO Zone: CENTRAL Edition: CENTRAL Column Name: Series: Page Number: 1B Word Count: 1073 PHOTO(S): Frederick Harris Frederick D. Harris, a homeless man with schizophrenia, has been confined in a jail cell for more than four months, waiting for a state hospital bed to open up.

A judge declared Mr. Harris, 41, incompetent to stand trial on a burglary charge Oct. 6 and ordered that he receive proper medical care so he could eventually be tried. But Mr. Harris remains imprisoned at the Dallas County Jail, lethargic from the doses of Haldol the jail gives him as a stop-gap measure.

Mr. Harris is among dozens of mentally ill inmates waiting for beds in the overloaded state hospital system. The Dallas Morning News first reported the problem in July, when at least 10 inmates declared incompetent to stand trial were on a wait list.

But the problem has only worsened. County officials now estimate that 35 to 50 mentally ill inmates have been waiting for beds, some for six months.

Virgil Melton, the county's felony courts coordinator, said the state hospital system has also refused to take two pregnant women who had been declared incompetent. So the jail - already under intense scrutiny for inadequate health care - must provide the women's care.

'Worse than before'

"Things are even worse than before," confirmed Kenny Dudley, director of the state hospital section of the Texas Department of State Health Services. "We've not had progress increasing capacity."As a result, these mentally ill inmates - many of whom, like Mr. Harris, have been charged with minor offenses - must wait in jail, where health care is spotty. A report by a corrections expert this year noted that some Dallas County inmates did not receive their antipsychotic medication for weeks or even months. Several federal civil rights lawsuits have been filed against the county over jail care. And last month, the U.S. Justice Department announced it was launching an investigation into health care at the jail.

Even if mentally ill inmates do get medication while in the jail, it is nowhere near the comprehensive treatment they would receive in the state hospital system, mental health advocates say.

And often they are held in isolated single cells because they are a risk to injure themselves or others - a setting that advocates say only exacerbates their illness.

Growing demand

Mr. Dudley said that while the hospital system's capacity remains the same, demand keeps growing. Five years ago, mentally ill inmates took up about 300 of 2,200 beds available statewide. They now take up more than 700 spaces, reducing the number of civilian patients the system can treat.

Mr. Dudley said the state Legislature provided virtually no increase in funding this year, despite the backlog.

He said the department has submitted a special request to the Legislature for money to staff a few hundred more beds.

Ed Moughon, superintendent of Big Spring State Hospital, said his hospital took 10 patients from the Dallas jail last week, but the wait for others is likely to extend another month or two.

Mr. Moughon said the demand is driven in part by a dearth of community programs to help mentally ill people, especially those who don't stay on their medication.

Mentally ill patients sometimes fail to take their medication because many antipsychotic medicines have unpleasant side effects, including weight gain, dry mouth, slurred speech, lethargy, sexual impotence and shaking, according to experts. In addition, when someone on such medication starts to feel better, they think they no longer need the drug. Or they self-medicate with illegal drugs or alcohol to try to stem the effects of their mental illness.

When off their medication, mentally ill people can quickly deteriorate and wind up on the street, committing minor crimes that land them in the legal system.

Mr. Moughon said community programs that are sophisticated enough to help such patients are essential to fix the larger problem.

Still waiting

Meanwhile, some mentally ill inmates on the list for a hospital bed end up waiting in jail longer than their eventual sentence. That's a likely scenario for Mr. Harris.

On Aug. 18, close to midnight, Dallas police responded to a burglary in progress at a US Subs restaurant at 190 Continental Ave. According to the police report, they found the glass door on the side of the building broken, observed Mr. Harris coming toward them carrying three boxes and arrested him after a brief struggle.

The three boxes contained frozen hamburger patties.

Mr. Harris' lawyer, Shoshana Paige, a public defender, said she could tell when she first met Mr. Harris that he was mentally ill and probably couldn't stand trial. But an exam to gauge competency costs $300, and defense lawyers can't file requests for such exams until after the case has gone to a grand jury and an indictment has been issued.

Mr. Harris was indicted on a felony burglary charge Sept. 7.

According to court records, Mr. Harris was raised in Celina by his great-grandfather, a wheat farmer.

He attended special education classes in school and dropped out soon after starting high school. He has usually been homeless. At age 20, he began hallucinating, which led to a stay at the Wichita Falls State Hospital. He had many subsequent treatments for schizophrenia.

"Unfortunately and not surprisingly, he has also had ongoing problems with compliance with taking his medications," according to a medical history in his court file.

Dr. Michael Pittman, a psychiatrist often hired to conduct competency evaluations of defendants, met with Mr. Harris on Sept. 23 to determine whether he could stand trial. Dr. Pittman noted that Mr. Harris "rambled about voices that told him to do things, such as cut himself."

He noted that Mr. Harris had an "increased rate of blinking, some rocking to and fro and abnormal mouth movements probably caused by long exposure to older antipsychotic medications."Dr. Pittman concluded that Mr. Harris was not competent to stand trial. On Oct. 6, District Court Judge Mary Miller ordered him to a state hospital for treatment. He's still waiting to go.

On Thursday, Ms. Paige visited Mr. Harris in the jail. He told her he had been off his medications for about a month and hadn't eaten in the two or three days leading up to the burglary incident.

She said he is getting Haldol in jail, but it makes him groggy. He told her he just wanted to get to the hospital. "It makes me want to cry," she said.

E-mail joneill@dallasnews.com















Judge David Finn

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