Trouble in Mind

Texas's mentally impaired used to go to treatment centers. Now they go to prison.

But even as state authorities move to shut down the Rose Garden, resident Roger Pirkle, a sort of lawyer without portfolio, plots Slaton's own legal move to have the former residents returned to the halfway house. While serving time for murder, Pirkle became one of the original writ writers in the Ruiz lawsuit and may be better at filing legal actions than some attorneys. In a filthy room at the Rose Garden, he sits surrounded by stacks of legal briefs and newspaper clippings. His hair is slicked back; his frame is lanky. He listens simultaneously to a police scanner and a boom box playing the Righteous Brothers.

For both Pirkle and Slaton, Hankins's death is all too reminiscent of a similar raid in 1989, when the state revoked a contract he'd won two years before, and removed several residents. Among them was 47-year-old Mildred Weaver, a schizophrenic.

Two years later, Slaton filed a lawsuit in which Weaver was the lead plaintiff. The lawsuit challenged the Texas parole system's treatment of the mentally disabled. Specifically, the suit contended that TDCJ's parole division did not have an adequate number of officers trained to deal with the special needs of the mentally impaired. As a result, the suit claimed that an inordinately high number of mentally ill and mentally retarded parolees were returned to prison. After the suit was settled, the parole division more than doubled the number of officers with expertise in working with the mentally handicapped.

At the Hodge Unit: Ruben Morales, a second-time offender serving ten years.
At the Hodge Unit: Ruben Morales, a second-time offender serving ten years.
"If I have to go back, I'll either let them kill me or I'll kill myself": Aaron George, temporarily out of prison, with his sister and mother, Beverly.
"If I have to go back, I'll either let them kill me or I'll kill myself": Aaron George, temporarily out of prison, with his sister and mother, Beverly.

Slaton now blames the Rose Garden's troubles on the suit, saying that the state resented his victory. The suit didn't seem to do much for Weaver, either: Following her eviction from the Rose Garden and relocation to another halfway house, she found her way back to prison. Weaver committed suicide.

Rose Garden resident Joann Jones did time with Weaver. Like the rest of the parolees and mental patients who remain at the halfway house, Jones remains devoted to Slaton.

"I have a freedom here that I wouldn't have somewhere else," says Jones, whose garage apartment is neatly kept. "Al doesn't give up on me. He has never turned his back on me. He has never thrown me away. And believe me, I know what it's like to be thrown away."Thirty or so years ago, mental patients were mostly corralled into a few large hospitals. But the civil liberty laws of the mid-'60s granted the mentally impaired the right to expect treatment in their own communities. At the beginning of the movement toward deinstitutionalization, government funding was supposed to follow the patients back to the individual communities. But according to a spokesperson for the Mental Health Association in Texas, it didn't turn out that way.

"That was really a myth," says Melanie Gantt. "The money did not follow the patients. And so, as they were deinstitutionalized, these people became homeless. And as new people came into the system, the number of beds had been reduced, so there was no longer the capacity in the institutional setting to serve them. Nor have community services been augmented to the point to be able to take on the new capacity. And so, in Texas, our prisons have become our largest mental health institutions."

According to the Mental Health and Mental Retardation Authority of Harris County, the county jail is currently Houston's largest repository for the mentally impaired. But late this summer, the MHMRA — with a mandate to provide mental health care for the indigent — will open a 40-bed hospital dedicated to mentally ill people in crisis, the first of its kind in the Houston area. The neuropsychiatric center, located in the Texas Medical Center, will treat many people who would now be sent to the Harris County Jail.

Besides reducing the level of human misery, similar intervention programs could save the county and state significant sums of money. Dr. James Baker, MHMRA's medical director for adult mental health, laments that in the last ten years the state of Texas has built two prisons to deal exclusively with psychiatric patients. Those same patients, he says, could have been handled by agencies like his own for a fraction of the price.

"For the cost of three days in prison, I can manage a patient for an entire year in the community, if he's kept out of trouble," says Baker. "But the state's not into building community health centers. It's into building jails."

Baker points to alternatives such as the MHMRA's Assertive Community Treatment program. ACT treats mentally challenged parolees in their communities, assigning each one to a team of counselors, social workers, nurses, case managers, vocational specialists and substance-abuse specialists. The client-to-team-member ratio can't exceed ten to one; each patient is seen by at least one team member at least once a day.

"We get to know them as people," says Tom Mitchell, an ACT team leader, "and they get to know us."

So far, the program has provided intensive care for 205 patients. The result, he says, is a recidivism of rate of almost zero. Mitchell estimates the cost at between $7,500 to $10,000 per patient per year. While critics may say it's too expensive, Mitchell doesn't see it that way, especially when all the costs of sending mentally disturbed offenders to prison are factored into the equation: the cost of the initial arrest, the cost to the victim, court costs, and the cost of long-term incarceration and treatment. "The problem," he says, "is we could use 20 ACT teams in Harris County alone."

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