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Several mental health agencies in Houston send clients who have been busted for drugs to Jenkins for legal counsel.
"My bipolar guys, a lot of times you can tell where they are in their cycle by what they're using," he says. "When you're depressed and can't get out of bed, that's when you're doing the speed and the cocaine and the meth, but when you're manic, flying along already, the cocaine makes you more paranoid. That's when they use the weed and the booze and the downers, to pull it in a little bit. You can see how their drug use changes, and that's one of the clues that they're self-medicating."
For Howard, marijuana seemed normal, something she smoked to level out and stay out of the doldrums, but Xanax made her high, happy and social.
Xanax became her drug of choice and she started crushing the pills and snorting it, and on days when she partied with friends, Howard would sometimes snort the equivalent of 25 two-milligram pills of Xanax.
Her boyfriend went to jail for marijuana possession, and Howard quit Xanax cold turkey. After two withdrawal seizures and a lecture from a neurologist in the emergency room, Howard was able to stay off the pills but she kept smoking marijuana.
Her behavior became more violent.
"If she was set off, she would walk through the house with those arms out, and for about 15 minutes her eyes looked like a wild animal," Ellington says. "I have a barstool that's not real light, and she picked it up one time and threw it about five feet. That's how strong she was when she had the bipolar rage."
One day at the house, about a year before Howard's suicide attempt, she became angry and punched a hole in her mother's bedroom door.
Ellington drove to the nearest sheriff's department substation and requested that a mental health warrant be filed so deputies would take Howard to a psychiatric hospital.
When Ellington returned, Howard threatened her and broke a flower vase against a wall in the kitchen. Ellington called 911.
Harris County constables came to the house, but the mental health warrant couldn't be served because the hospital didn't have an available bed. A deputy constable, David Nolan, suggested she press criminal charges, but according to his report, Ellington said she "wanted her daughter in the hospital where she will get help, not in jail."
The deputy offered to take Howard to the NeuroPsychiatric Center, but Howard had fallen asleep and they decided it was better to keep her home.
It's unclear why Judge Robin Brown sentenced Howard to New Choices, because the judge wouldn't answer any questions about the case.
According to Howard, "My judge says I'm young and there's a chance for me and that's the reason she put me through all this."
New Choices has operated in the jail for more than ten years, and the program employs six drug counselors to serve 180 inmates — men and women — who are usually sentenced to six-month terms by the court.
According to the sheriff's department, the program includes detoxification under medical supervision, preparation for release into the community and links to agencies and other correctional facilities.
The sheriff's department tracks inmates who complete the program for a year after they get out of jail, and 77 percent of New Choices graduates aren't rearrested during the first year. Inmates like Howard who are kicked out for violations aren't tracked.
The program cost $332,000 this year, with $152,000 coming from the county and the rest paid for by the state.
"If a person is harmful to themselves and others, they need to be in a safe place, not jail, and even for a person with a drug problem, jail shouldn't be an option," says Marcia Baker, the director of Phoenix House, a rehab clinic in the Heights. "In our society that's what we do, but it is not what they need."
There aren't many alternatives for someone once they're arrested, Baker admits, and a program like New Choices, with teaching and counseling, is better than locking someone up just "for their own good."
Treating drug addiction in a person with mental illness, without attention to the mental health component, is almost pointless, she says.
For example, in 2003 Harris County launched the STAR program, a special court designed to keep felony drug criminals out of jail through intensive probation. Mary Covington, the court's program manager, thinks about 75 percent of women who are kicked out of STAR court and sent back to jail don't succeed because their mental illness isn't treated.
"We haven't been able to keep them stable on their medication long enough, and we lose them pretty quickly," Covington says.
Howard was able to get psych drugs during her first couple months in jail.
Doctors hadn't evaluated her, but she found a woman with Seroquel, a drug she had taken when she was younger, who didn't take the med because of its side effects. Howard traded for the pills with coffee and candy she purchased with commissary money from her mother.
One day when Howard went to swap, the woman asked for more food to give to a friend, but Howard said no. A shouting match quickly turned physical and the older woman grabbed Howard's hair and slapped the side of her face over and over.