A couple hours before sunset, Laura Howard slid a knife across her wrist after arguing with her boyfriend and mother.
She dropped the knife and left her bedroom with her wrist turned upward to show her mother. There was a lot of blood, which was unusual because even though the then-18-year-old was a cutter, she had never gone deep enough before to cause blood to pour out of the wound.
Howard's mother, Allie Ellington, rushed to call 911, and Howard's boyfriend carried her back to the bedroom and shut the door.
Harris County Jail
A Harris County sheriff's deputy, K.W. Reed, was one of the officers responding to the call. According to the incident report, he knew that Howard had slit her wrist and that she didn't have the knife anymore. Still, the dispatcher had told him that Howard was bipolar and very violent.
Several cruisers with their sirens going pulled up to Ellington's house in a suburban enclave on the northwest side of the county, not far from Cypress Creek High School. Ellington went outside to meet the squad. "I want you to take her to the Kingwood Pines Hospital," Ellington told the first deputy.
"Don't worry, because we know how to handle these situations," the deputy said.
About a year and a half later, in bitter hindsight, Ellington remembers that moment in May of 2007 and blames it for everything that has happened since: "When the police tell you something, I was taught to respect what they say. I didn't know that I should have questioned him, and I wish I had."
The scene outside Howard's window — flashing lights and patrol cars and a gang of deputies — set her off. She bolted from the house through the back door with her boyfriend as the deputies rushed inside.
"The neighbors were all standing out front with me, and the policemen all of a sudden took off toward the back. I couldn't see what happened once they were back there," Ellington says.
From Reed's report: "Deputy Evans jumped the fence and continued pursuing both suspects on foot, I returned to my marked unit and drove the next street over." The report says Reed found Evans fighting with Howard (she was about five feet tall and 110 pounds) while she was "swinging at him with a closed fist." Reed joined the other deputy and restrained Howard with handcuffs, and they put her in the backseat (to hear Howard tell her version, click here).
The deputies drove to the other side of the house and Ellington saw her daughter shackled in the back of the patrol car, her face reddened and scratched from being pushed against the asphalt.
"Can you take her to the doctors now?" Ellington cried.
A deputy told her, "The paramedics have checked her out and we're making the decision to take her to jail."
As it turns out, if the deputies had instead been officers with the Houston Police Department, Howard would have gone to the county's NeuroPsychiatric Center at the old Ben Taub General Hospital.
HPD policy is to take a person who attempts suicide to the NeuroPsychiatric Center, and if it's full, to St. Joseph Medical Center or Methodist Hospital.
Instead, the deputies arrested Howard — she was in handcuffs before the paramedics arrived — and took her downtown to Harris County Jail, where she was charged with evading detention and resisting arrest.
A court-appointed lawyer handled Howard's case, and, without arguing the circumstances of Howard's arrest, "negotiated" for two years of probation.
Drug screenings were required as part of the sentence, and about five months later Howard failed a urinalysis after smoking marijuana.
Judge Robin Brown sentenced Howard to time at the county jail: six months in New Choices, a rehab program in the jail designed as a last chance for addicts. A requirement for inmates is that they need to be mentally stable when entering the program — which by all accounts Howard was not.
"That was like the death sentence," Ellington says.
Howard bounced between general population and the mental health unit inside the jail for a couple months before a spot opened in New Choices. With little supervision from drug counselors or guards, Howard filed paper clips to a point and jammed them into her face. When the puncture holes grew too large for paperclips, she inserted plastic pieces from a shattered comb.
New Choices counselors saw the plastic in Howard's face, and since self-inflicted wounds are a violation of program rules, Howard was kicked out of jail rehab less than a month after she'd enrolled.
She was moved to her own cell where she mentally nosedived, popping the blade out of a plastic safety razor and using it to carve "FUCK LIFE" into her arm.
During a visit, Ellington saw the cuts on Howard's arm, and while they talked on the phone later that night, Howard told her mother, "I'm going to strangle myself with this cord and no one will notice."
A decade ago, Mental Health America (then known as the Mental Health Association) of Greater Houston created a task force in the hope of developing a system that could protect the mentally ill from wrongful arrest in Harris County.
It was made up of representatives from the Mental Health and Mental Retardation Authority of Harris County, HPD, the sheriff's department and several other organizations.
"That group studied models all over the country for what could be done at the point that a person with mental illness comes into contact with an officer," says MHA Director Betsy Schwartz.
The task force chose a crisis intervention system, which had been made popular in the Memphis police department in the 1980s. A pilot program started in the Houston police department in 1999, coinciding with the opening of the NeuroPsychiatric Center, with 60 officers given eight hours of training, designed in part by Schwartz's organization.
During the years that followed, the city increased its crisis intervention training funding for the police department, and the program grew. Every cadet is now required to take 40 hours of CIT before graduating from the academy.
"We tried to get the sheriff's department to have the same amount of training, but it was very difficult," Schwartz says.
In 2003, state legislators passed a bill that requires all law enforcement officers to complete at least 16 hours of the training by September of 2009. According to Lieutenant John Legg, a sheriff's spokesman, about 70 percent of the deputies have satisfied that requirement.
"Department-wide, it changes the mind-set of our officers, even our non-CIT officers," says Lieutenant Mike Lee, the unit supervisor for HPD's crisis intervention program. "They are going to know that this is what is expected of them as a police officer" (see "Is Harris County Jail the Place for a Mentally Troubled Teen?: Mind-sets").
In May of this year, Houston police officers were dispatched to a house where a Hispanic teenager had threatened his parents and was smashing furniture and punching holes in the walls. The father told the dispatcher that his son had recently been diagnosed with mental illness.
When officers approached the boy, he threw wild punches and fought them. According to a report, the officers became tired from the "extreme physical strength being demonstrated by the suspect in his psychotic state."
He was shot in his chest with a taser, and as he was getting shocked, the teenager told officers "you are the devil" before ripping out the taser darts.
A group of Houston police eventually restrained the boy, but instead of jail, they took him to the NeuroPsychiatric Center for a mental health evaluation, and the police didn't file any charges.
"The families love us and they'll say, 'I'm afraid to call anyone else because if I do, my brother or my sister might wind up dead,'" HPD Senior Officer Michael Chimney says.
Six months before she tried to kill herself in her bedroom, Howard had moved back in with her mother from an apartment she shared with her boyfriend and his buddies.
Single mother Ellington works at a dentist's office not far from her home, and sometimes she works a second or third job to pay Howard's medical bills and, more recently, her legal fines. Child support from Howard's father used to help, but Ellington quit relying on him years ago because, she says, he's an alcoholic who can't keep a job.
Howard feels guilty when she complains or causes problems, she says, because her mother works so hard, but a tension remains in their relationship. Ellington has a hard time identifying the source, but according to Howard, the problems started when her mother forced her to have an abortion when she was 14.
"Once that happened, I wasn't right because I wanted to have the baby," Howard says. "I didn't care how old I was. Fourteen is outrageously young, and I still don't know a lot of things about life, but it was my fault I got pregnant. Why couldn't I take responsibility for what I did? My mom didn't feel like that was a great way to go."
Howard cut herself for the first time in the ninth grade. Ellington asked her about it, but Howard said she didn't remember what happened, so her mother figured it was a bad reaction to a medication. But fresh cuts appeared.
A psychiatrist saw Howard and diagnosed her as bipolar and obsessive compulsive. In the following months, doctors constantly adjusted and fine-tuned Howard's meds; if the dosage was low Howard was erratic, and if she was overmedicated — often the case, according to Ellington — she would sleep all day. Either way, she'd feel sick.
(Tenth grade was the last school year Howard completed. She missed too many days her junior year and didn't take the TAKS, so she couldn't enroll in an alternative school. She later received her GED.)
At high school and parties, however, her classmates gave her weed and Xanax, drugs that were fun to take and made her feel better than the psych drugs prescribed by her doctor. (to watch Howard talk about her drug use, click here)
"When you have a mental illness, your body is craving medication," Houston attorney and former MHMRA counselor Phil Jenkins says. "There are two ways to get medication. You can go down to the MHMRA clinic, wait six weeks on the waiting list, be herded through like cattle, then get these medications with all these bad side effects, or, there's a man on the corner who sells something that makes you feel better."
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.
An inmate witnessing the fight pulled the woman off Howard. Apart from some deep bruises and swelling, Howard escaped without serious injuries.
Soon after the fight, Howard was transferred to the Harris County Psychiatric Center, evaluated by doctors and given psychotropic drugs, but since it doesn't offer long-term care, after 28 days Howard was sent back to the jail.
One morning at about 3 o'clock in her cell, Laura woke up, and was inspired to write poetry. She entitled one poem "Pure Heart," and it included these lines, which show pretty clearly her mental state:
"I fell so low that I was pure dirt / and all I accomplished was making you hurt / I'm disgusted that I could play such a game / and now I'm tortured with nothing but shame" (to see full text of poems "My Life" and "Pure Heart," click here).
After Howard said she planned to kill herself with the telephone cord, Ellington frantically searched through files at work for the phone number of a Harris County judge she knew was a patient at the dentist's office. She contacted the judge at his home and persuaded him to listen to what had happened to her daughter.
"If I am crossing the line, please let me know," Ellington told the judge, "but I don't have any money to deal with this and I don't have anywhere to go."
Wanting to stay anonymous and not step on another judge's case, the judge called in a favor with an attorney he knew who pulled weight at the courthouse and jail.
The lawyer contacted Ellington and told her to write her daughter's story and send it to Harris County Sheriff Tommy Thomas. The lawyer also went to Brown's office at the courthouse.
The next morning, Ellington received a phone call from a court liaison.
"The judge has released your daughter to your custody," she told Ellington. "She needs to go to the hospital for one month."
Howard walked out of a side door of the jail that evening. Ellington picked her up in the street and drove her back to their house on the other side of the county.
Howard has struggled to comply with her new guidelines from the court.
Judge Brown ordered Howard to enter a halfway house after her release, but she tried to enroll at several places and had to report back to the judge that none would take her because she wasn't addicted to drugs.
Substance abuse classes are also court-mandated, and the first center Howard was sent to was in downtown Houston.
"I'm 19 years old, and everyone else there was older than 40, and they're talking about smoking crack and meth, and I raise my hand to talk about my pot problem and they look at me like I'm crazy. I'm not sleeping for pot or anything," Howard says. "How does that make them feel? It's not helping them either."
One day after class, Howard went outside during a cigarette break, and "these two black women were talking about their age, and there's one white woman who was alone but kind of standing by them and she said, 'Yeah, I'm 43,' and one of them said, 'We didn't ask your white ho ass about anything.' This woman was a prostitute — that's why she was there — and she starts bawling and runs off."
"For me being 19, I've seen a lot of things I shouldn't have seen," Howard says (to see Howard discuss her experiences in jail, click here).
Eventually she switched to Kingwood Pines psychiatric hospital, where she is going three nights a week for co-occurring treatment — chemical dependency and psych classes. In group sessions, the other patients are Howard's age.
The hospital is a long drive from their house and it's hard for Ellington to make the trip on the nights parents are asked to visit.
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"I tell my mom I need her to go to counseling with me," Howard says. "I've been sober and I need more than me to stay that way."
Howard will be on probation until summer of next year, and she's required to take two random drug tests a month, and if she violates her probation again, Judge Brown told her she'll go back to Harris County for another stay in New Choices.
It's been almost ten months since Howard was released the last time, and the words she carved in her arm have dulled to pink and faded, but the scars are still visible if held under a certain light.