The recent death of Sandra Bland in a Texas county jail is tragic. At CPPP our prayers and thoughts are with Ms. Bland’s family and friends.
As the authorities investigate the details surrounding Ms. Bland’s death, it’s important to point out that over the last decade or so, sheriffs and other local officials have been very vocal about the high number of individuals with serious mental illness who rotate in and out of local jails and emergency rooms. Although mental health has received positive attention from the Texas Legislature in the past three years, it’s time to review the policies and procedures required in Texas to evaluate individuals’ mental health when booked into Texas county jails. Remember that, because of our public policies, Texas jails and prisons are currently the number one mental health providers in Texas. Jails and prisons need to take their mental health obligations seriously.
Once in a county jail, there are two ways in which a local sheriff’s office can learn about someone’s mental health.
First: Public Service Match
*The Texas Health and Safety Code requires that the Department of State Health Services (DSHS), the Department of Public Safety (DPS) and the Community Mental Health Centers (CMHCs) share data so that staff members at county jails can obtain real-time public health service mental health data when someone is booked into the jail.
*The new data-sharing process replaced a previous public service data match process that CMHCs had to perform manually within 72 hours of receiving the inmate’s name from the local jail upon booking (referred to as the “CARE check system”). The new data-sharing process is supposed to happen in real-time (not 72 hours) and is known as the Continuity of Care Query (CCQ).
*In 2013, over 40 percent of bookings into Texas county jails were for individuals who had either an “exact” or “probable” CCQ match, indicating some prior contact with the public mental health system (either, at a CMHC or a state hospital).
*The data match process helps to flag individuals who may need mental health services while detained in a local jail and upon release. As of 2013, all counties were using the CCQ data match process.
Second: Mental Health Screening
*The CCQ is supposed to be complemented by a mental health screening conducted for every inmate at the point of booking into the local jail.
*The screening instrument, provided by the Texas Commission on Jail Standards (TCJS), is called the Screening Form for Suicide and Medical and Mental Impairments.
*The screening form includes staff observations by Texas Licensed Jailers and self-report questions related to mental illness and suicide. As of 2014, the Texas Commission on Jail Standards was providing training materials to county jails to help jail staff recognize mental illness and fill out the form correctly.
*If the individual responds that they do need mental health services or demonstrates signs and symptoms of mental illness, the sheriff must notify a magistrate within 72 hours.
Whether through self-reporting or jail staff observation, if an individual reports a history of mental illness or is currently experiencing symptoms related to mental distress, the jail staff are responsible for promptly recommending further evaluation by a mental health professional as well as ensuring the individual is safe and in a protected environment while in custody. Unfortunately, despite these regulated checks and balances, there are far too many deaths by suicides in Texas county jails – 141 since 2009.
Now is the time for Texas to reduce suicides in jail by doing the following:
1. Explore intake and screening best practices such as the Brief Jail Mental Health Screen recommended by the Substance Abuse and Mental Health Services Administration Gains Center for Behavioral Health and Justice Reform.
2. Enhance observation and monitoring best practices for individuals who are at-risk for suicide.
3. Provide in-depth mental health training for County Corrections Officers (jailers). Although mental health and suicide are incorporated in the initial and on-going training for licensed Jailers, the training is minimal.
As we all mourn the death of Ms. Bland and others who have died while in jail, our hope is that these tragic events can spark a much needed conversation that results in effective and efficient policy and procedural solutions that affect individuals with a lived experience of mental illness.
For more information on mental health and the Texas criminal justice system, read our 2014 report From Recidivism to Recovery: the case for peer support in Texas correctional facilities.