Staffing shortage adding to long waits for mental health assessments for arrestees awaiting trial

“The number of people in jail waiting for treatment to be able to stand trial has more than doubled since 2019.”

By Alexandra HartJune 5, 2023 12:30 pm, ,

The nonprofit Mental Health America ranked Texas dead last in the nation for access to mental health care. Unsurprisingly, receiving mental health assessments and treatment after being arrested can be especially difficult.

Nationwide, mentally ill people accused of crimes are waiting months for mental health care before they’re able to stand trial. Sometimes those waits can be longer than the potential sentences themselves.

Elizabeth Findell is Texas based reporter for The Wall Street Journal and has been covering this crisis along with colleague Dan Frosch. She joined Texas Standard to discuss. Listen to the story above or read the transcript below.

This transcript has been edited lightly for clarity:

Texas Standard: Can you explain the process when someone who’s suffering with a mental illness is arrested?

Elizabeth Findell: Sure. If you’re arrested, of course, your court case begins to move forward. And if your attorney sees that you may not be competent to stand trial – you may have some mental illness and not be able to understand the charges against you – they have to request a competency evaluation. Then, if you are indeed not found to be competent, you need to be stabilized in a psychiatric facility and your court case is, at that point, completely on hold until you are competent to move forward.

So someone’s left waiting for months. Can you say a bit about how widespread this issue is in Texas and the effects that it has on people awaiting evaluation and treatment?

Yeah, absolutely. We found that essentially since the pandemic, there have been significantly more arrests of people with mental health issues and so more referrals for this kind of care. And in some states, including Texas, there has been a workforce shortage that has kept extra beds from being added. So people are waiting at essentially two junctures there: waiting to receive that initial evaluation on their competency, and then they’re waiting again – sometimes months or longer – to get admitted into a facility for treatment.

You mentioned Texas, and you write that the problem is particularly bad here. Can you tell us more about the numbers and what factors might be contributing to this disparity?

Yeah, absolutely. Texas has certainly the longest waiting list from any state. The number of people in jail waiting for treatment to be able to stand trial has more than doubled since 2019 to 2,466. And that is almost a thousand more people waiting than even the total number of beds available in the state. The state has a little more than 1,500 beds online right now. And Texas has tried to add more beds, but they have been affected by staffing a little bit. There’s a new unit in Kerrville that was built and then unable to open for about six months because they couldn’t find staffing. And now they’re starting to use it. But still, the state told me they only have about nine of 70 beds online right now due to staffing.

When it comes to staffing, is the issue people who are not qualified or they just don’t have enough people applying for the jobs, or what?

I believe it’s the latter. I know there has been some effort this session in the Legislature to put more resources into encouraging people to go into psychiatric nursing, as well as to study the state’s needs for those beds.

What else has been proposed to help with this backlog? And are you hearing about any reforms that might be in the works beyond what the Legislature has talked about there with trying to increase opportunities for potential staff members?

Many states are trying to add beds, but that is a process that, of course, takes money – it takes time. And some are having trouble staffing those new beds, as I mentioned. In several states, there have been lawsuits in the past to force the state to admit people to a hospital within a certain amount of time. But even in some of those states, they’re struggling to abide by the court orders that were issued just because of the increase in admissions since the pandemic.

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