Mental Cases

Philip Grantham counts on his meds and his MHMRA doctor to stay straight. Too bad Texas is slashing funding.

On a recent afternoon, Philip Grantham sat in a crowded but quiet waiting room at the Ripley Clinic, an outpatient center operated by the Mental Health and Mental Retardation Authority of Harris County, and told the story about the crime that sent him to prison.

It started with Grantham, now 48, fleeing Slidell, Louisiana, in the late 1990s with 37 warrants out for his arrest. He left the state with a burglar who shared Grantham's affinity for smoking and shooting cocaine, and a woman who frequented Grantham's crack house in Slidell.

By the time the group reached Memphis, the trio had gotten quite skilled at casing houses one day and making quick break-ins and stealing stuff during the middle of the next. But the drugs sometimes blurred their judgment, to the point that they robbed a house even after learning it was around the corner from a police substation.

MHMRA allows Philip Grantham to get his pysch meds mostly for free.
Austin Miller
MHMRA allows Philip Grantham to get his pysch meds mostly for free.
Harris County Sheriff Adrian Garcia took over a jail in 2008 that was already the largest provider of mental health services in the state.
Austin Miller
Harris County Sheriff Adrian Garcia took over a jail in 2008 that was already the largest provider of mental health services in the state.

It proved to be a poor decision. As Grantham struggled to get a large television set into the back seat of their getaway car, a mass of police officers showed up, yelling, with weapons drawn.

"They were telling me to get my ass on the ground and everything, and of course I did," Grantham said, speaking at a manic pace. "The professional burglar dude was still inside trying to get a shotgun — he really liked guns — and when he walked outside and saw all the cops, he threw down the shotgun and started running and everyone took off after him and he jumped the fence and..."

The story was cut short by Grantham's MHMRA psychiatrist calling him from the waiting room, but before he went in for treatment, Grantham said, "Those times held a certain amount of excitement, but it's something I could never do again. I wouldn't want to."

Grantham continued, "I don't have a problem with the way things ended up. It's actually the best thing that's ever happened to me. It's been a goal of mine since then to always make the best of my life."

During the three years Grantham has lived in Houston, he's been homeless twice, the second time starting about two weeks back. The lifestyle has landed him in jail three times — a couple times for sleeping in a public park, another for failing to pay a ticket he got for trying to ride the Metro rail for free — but considering Grantham's past rap sheet and lifelong struggle with alcohol and drugs, his time in Houston has been impressive.

In fact, he even feels successful in keeping his mantra: "At best, I want my life to add something to society, but I certainly don't want to make it worse."

The "linchpin," as he calls it, of Grantham's success in Houston is MHMRA. It's the first agency he found when he got here, via bus with about $60 to his name, and it wasn't long before Grantham, diagnosed with bipolar disorder and major depression, was regularly seeing a psychiatrist who could prescribe him the mood stabilizers and antidepressants that keep him out of crisis and, ultimately, jail.

"I didn't have anything like this in Louisiana. I didn't know it existed," Grantham says. "Now I'm very partial to my doctors, and even through this homelessness, I believe they're the difference of why my life has gone so well."

MHMRA has fought funding battles for years and has another big one ahead. In July, state officials announced a reduction of about $90 million to mental health funding, along with an additional $34 million in cuts to the state's mental health hospitals. According to Steven Schnee, MHMRA's executive director, about $9 million of those cuts would hit Harris County. While the agency doesn't know exactly which programs or services would suffer, Schnee estimates that MHMRA would serve about 1,500 fewer people each year.

The effects could be disastrous, because in a mental health system that's already spread incredibly thin, MHMRA has continued to provide some level of care. The agency has endured its own level of cutbacks (the number of caseworkers was drastically reduced a few years ago, for example), but in most instances it's been even worse for private hospitals that have closed down or cut the number of available beds for people in mental health crises, opting to treat patients for things that Medicaid will actually pay for.

Even places that specialize in mental health are struggling. This summer, for example, the Harris County Psychiatric Center, run by the University of Texas Health Science Center and one of the largest mental health providers in Houston, cut a contract with its outpatient services provider. Meaning, once the psychiatric center's patients are out of crisis and stabilized, they are basically on their own.

Schnee calls it "flawed public health policy." Grantham hopes what's left will be enough to help him keep his tenuous hold on a credible life.

About seven years ago, the Texas Legislature, caught up in another multibillion-dollar budget shortfall, directed its attention to the state's mental health funding. Words like "streamlining" and "consolidation" became the buzz, and the plan, formalized in House Bill 2292, made community agencies funded by state dollars, such as MHMRA, stop focusing on direct treatment and instead help manage privatized care.

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