Getting Out

Too scared to leave her house, Sandy has one last chance: a county crisis team that will come to her

"I think with some of them," Mitchell says of the legislators, "it's flat not caring"; the mentally ill are "just 'crazy people.' "

Texas consistently ranks low in state spending on mental health, according to the National Association of State Mental Health Program Directors. In fiscal year 2001, the most recent data available, the state spent $797 million on mental health care, the fifth-highest amount in the country. But that translated into just $38 per person, placing Texas at 46th in per-capita spending.

But Texas, like other states, is facing serious budget woes. In order to make up for a $9.9 billion shortfall, Texas -- like 28 other states, according to the National Alliance for the Mentally Ill -- has had to cut mental health expenses.

Sandy and Jennifer were made to eat on the floor like 
dogs.
Sandy and Jennifer were made to eat on the floor like dogs.
Without consistent care, clients lose track of their 
meds.
Without consistent care, clients lose track of their meds.

MHMRA hopes to trim $4 million to $5 million, starting with the closure of clinics in north Houston, Humble and Baytown last year. The clinics served about 1,900 adults and 240 children. MHMRA also laid off more than 100 employees in the last year. Funding a new crisis unit was out of the question.

The closures could leave many without consistent care. Mitchell says the team has been especially busy in the north end, responding to people who suddenly found themselves without their doctors. Many are already starting to decompensate, he says, putting mental health resources into red-alert mode.

"Unfortunately, we're geared for crises now," Mitchell says of MHMRA, "because we don't have the services to maintain people…If that's the tack you have to take, then MCOT seems to be the best way to go, 'cause at least you're out there on the streets with the people."


Rise (pronounced "Ree-sa") Collins and Rashaan Harris are driving to the Star of Hope. Harris, 31 and wiry, is behind the wheel. He was a psych tech for years before joining the team in April. He plays soprano and tenor sax because he likes to. He works with the mentally ill because God wants him to.

Collins, riding shotgun, is a licensed clinical social worker who's been with the team since its February inception. She has a flair for the dramatic and is elusive about her past. She has a seen-it-all attitude that makes her especially cut out for this kind of work.

Before they reach the Star of Hope, they make a quick stop in the Third Ward to check on a female client, a 37-year-old recovering cocaine addict married to an octogenarian. Harris waits in the car while Collins talks to the woman on the sidewalk outside the house. She wants to make sure the woman's been to MHMRA's Eligibility Center to check on her benefits. She also wants to see if the woman is looking for a job.

Afterward, it's on to the Star of Hope, where they plan to check up on Mark and Warren, who've been talking to the devil and Luther Vandross.

They walk through the shelter's check-in point, where a few clients are sitting with their legs extended and backs to the wall. A man turns to look at Collins, out of place because of her gender and her loud red hat.

"Are you a counselor?" he asks.

"I'm a social worker," she says.

He's not sure what to make of it, but he perks up, thinking he may be in the market for a social worker.

"What do…," he starts.

"What do you need to do to see me?" she finishes. "You need to have a mental illness."

The man quickly folds his arms and presses his back closer to the wall.

"Yes, ma'am -- I mean, no, ma'am."

Collins and Harris continue through the check-in and head to the office of Louis Durden, a shelter manager. Durden has a good working relationship with MCOT, always letting them know of clients who need their help.

It turns out Warren has slipped away, so Collins and Harris won't be able to do their assessment. But Durden wants them to speak with Charles (not his real name), who has returned to the shelter after a brief stay at his mother's house. Charles is saying that woman isn't really his mother -- she's an impostor who tried to kill him while he was in the shower. The only other family Charles mentioned were his kids -- R&B divas TLC, former child rappers Kriss Kross and Philadelphia 76ers guard Allen Iverson.

Durden leads Collins and Harris to one of the shelter's small intake rooms, where they wait for Charles.

After a few minutes, a tall man with caramel-colored skin and a tangle of curly black hair piled on an unusually large head shuffles stoop-shouldered into the room. He plops into a chair opposite the desk from Collins.

Collins starts by asking him the basics: Why does he think he's here?

"I get out of mind," Charles says through clenched teeth. He tugs absentmindedly at his wispy mustache and chin hair.

Charles says he spent 12 years in the pen for aggravated assault with a deadly weapon. He's stayed periodically at his mom's house, but he recently discovered that the woman in the house is an impostor. She's trying to kill him in order to get her hands on the $48 billion in his bank account.

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