Workforce Shortages In Texan Psychiatric Hospital Makes Longer Jail Time For The Mentally Ill

The state has added more beds for jail inmates who need psychiatric treatment to be considered competent to face trial. But at least a third remain empty because the state can’t hire enough people to staff them. Ronald Singer was arrested and charged more than a year ago for the murder of his ex-wife and the kidnapping of their child. He remained in the Denton County Jail all that time, unable to be tried for the crime because a judge found that he was mentally incompetent, meaning he is unable to fully understand the charges against him and assist in his own defense.

More than 2,500 mentally ill defendants are in a similar predicament. They wait in Texas county jails for months and sometimes more than a year for the kind of intense therapy and medication treatment available only through the state’s psychiatric hospital system. And while they wait, their conditions, if not treated locally, deteriorate. These long wait times continue despite the fact the state has poured millions of dollars into upgrading state psychiatric hospitals, adding what are referred to as “forensic” beds so those jailed individuals who are seriously mentally ill can receive the treatment that will allow them to be competent to stand trial. The beds are ready and open. But state officials can’t take this specialized group of patients, they say, because they don’t have enough workers to manage them.

“We simply have significantly more people who need treatment than we can currently provide for, and the involuntary inability to comply with that order is a complete defense to contempt,” said William Wassdorf, an assistant attorney general who was representing Texas Health and Human Services during Singer’s case, told the judge, according to a Dec. 9 transcript. Over the past 20 years, the state has reported a 38% increase in people who are found incompetent to stand trial.

The rise is anything but a surprise. In fact, Texas Health and Human Services warned in 2017 that the state psychiatric hospital system’s reduced capacity, an increase in demand, and staff recruitment and retention challenges were leading to lengthy waits for these beds and were putting pressure on jails, emergency rooms and community-based psychiatric hospitals. What officials did not foresee was a global pandemic, which not only exacerbated mental health workforce shortages but also kept those with serious mental illness from treatment. Experts agree that mentally ill individuals are not more violent than the general population but even so, they can be arrested for more minor crimes like loitering.

When these same individuals can’t understand the charges against them, they might be locked up longer than what their eventual sentence might have been due to a lack of available beds in the state hospital. And in turn, their detainment can now last months or even a year before they enter a courtroom because of a lack of treatment.