Senate Criminal Justice Committee

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Senate Criminal Justice Committee

• Interim Charge 1
• June 21, 2006

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Public Mental Health System in Texas

• DSHS mental health services are only part of the
  public mental health system in Texas.
• Law enforcement, education, Medicaid, CHIP, the
  criminal justice system, hospitals and other
  entities all play major roles in treating Texans
  with mental illnesses.

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State Mental Health Hospitals

• 10 Mental Health facilities provide inpatient
  hospitalization for persons with severe mental
  illness who need intensive treatment
• North Texas State HospitalVernon campus, serves
  as the statewide maximum-security unit
• The Waco Center for Youth is the only
  state-operated residential treatment facility in
  Texas for youths
• All facilities are JCAHO Accredited

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State Mental Health Hospital Capacity
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Population Growth Compared to Funded State
Hospital Beds
Funding for State Mental Hospital Beds has
declined while the Texas population has grown
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Growth in Forensic Patients
Total Forensic Patients as a percent in Texas
Mental Health Facilities
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State Mental Health Hospital Daily Census for
FY2005
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State Mental Health Hospital Capacity

• In February 2006, the LBB approved 13.4 million
  in additional expenditures for state mental
  health hospital capacity. These funds were
  transferred from DSHS FY07 appropriations to
  FY06.
• As a result, statewide hospital system capacity
  was increased by 96 forensic commitment beds and
  144 civil commitment beds.
• This increase in state hospital capacity has
  greatly enhanced our ability to meet the needs of
  local communities.
• We continue to plan for long-term,
  community-based solutions to address the hospital
  capacity issue.

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Individuals with Criminal Justice Involvement
Experienced Positive Clinical Outcomes at DSHS
Community Mental Health Centers, All of which
Implemented Jail Diversion during FY2005
10
Crisis Services Redesign

• Crises do occurbut we should do all we can to
  avoid them.
• February 2006, DSHS established the Crisis
  Services Redesign Committee to develop
  recommendations for a comprehensive array of
  crisis services.
• Members of the committee include medical experts,
  citizen stakeholder groups, law enforcement
  representatives, county probate court judge
  representation, and county representatives, as
  well as individuals from professional
  organizations and provider groups.
• A redesign of crisis services will build on, and
  is a part of, the service improvements made by
  the evidence-based Resiliency and Disease
  Management program.
• A thorough review of the current crisis system
  was conducted, including holding public hearings
  around the state, reviewing current research and
  consultation with experts.

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Crisis Services Redesign (cont.)

• The committee plans to finalize its
  recommendations in June for an evidence-based
  crisis services model that will increase access
  to appropriate and cost-effective services.
• Initial conclusions for recommended services
  include
• 24-hour hotline
• Mobile outreach
• 23-hour hold capacity
• On-call psychiatric services
• Crisis residential services
• Respite
• In-home crisis resolution services
• The committee will also put forth recommendations
  regarding DSHS staff support, coordination and
  training to local professionals (e.g., law
  enforcement crisis intervention training).

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Behavioral Health Issues Impact Other Systems

• 75 of children placed in foster care have
  parents with behavioral health problems
• 75 of kids in the juvenile justice system have
  behavioral health problems
• 30 of kids in the juvenile justice system will
  end up in the adult justice system
• 46 of all ER visits have behavioral health
  issues as a basic or contributing factor
• 30 of all truancy is related to behavioral
  health problems

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Mental Health Transformation

• Overarching goal is to improve the mental health
  of all Texans and meet the Presidents New
  Freedom Commission goals
• New Freedom Commission Goals are shared by those
  participating on the Transformation Working
  Group
• The Governors Office Department of State Health
  Services Texas Health and Human Services
  Commission Department of Family and Protective
  Services Criminal Justice Department Juvenile
  Probation Commission Texas Youth Commission
  Consumers Family Members Texas Education
  Agency Aging and Disability Services Workforce
  Commission Veterans Administration etc.