Mental healthcare has been an area of contention among East Texas civil servants and residents. In response, elected officials, organizational leaders, healthcare providers, social workers and law enforcement are streamlining each organization’s functions and improving overall partnerships.
“As we began our quest to improve the mental health care in our amazing community, we were essentially all in silos,” Smith County Judge Neal Franklin said. “We’ve come a long way … and our communication among the players has dramatically improved. We’re all focused on the same goal, which is improving our mental health care delivery.”
In September 2022, stakeholders met to work through the Sequential Intercept Model (SIM), a model communities use to assess available resources, determine service gaps and plan for change. The model identified several areas of strain, including the interactions between people in mental health crises, the legal system, and the collaboration between mental health and law enforcement.
Since January, quarterly meetings have been held to discuss Emergency Detention Warrants (EDW). The latest meeting was on Aug. 10 at the Andrews Center. Franklin and Keisha Morris, Andrews Center Chief SIM Officer, led county judge offices, assistant district attorneys, local Emergency Room heads and other community stakeholders in legislation updates, jurisdiction scenarios for cities and counties, voluntary versus order or protection and group discussion.
According to the Texas Health and Safety Code, under an emergency detention statute, a person with mental illness or who, because of mental illness, is at risk of serious harm to themselves or others may be detained by a peace officer or through a court-ordered warrant.
“Today’s meeting was about EDWs, but it’s about mental health in general. This is, to me, what I wanted to get across was Smith County is working hard. We’re all coming together. We even had people from other counties and cities come in today to see what we’re doing,” Franklin said.
Clinical Director Danny Sammons, of Avail Solutions Inc., attends the quarterly meeting to discuss Emergency Detention Warrants on Aug. 10 at the Andrews Center.
Thomas Wilson, Smith County Assistant District Attorney, told the group about Senate Bill 2479 updates regarding procedures regarding people with mental illness or intellectual disabilities.
There were five amendments to SB 2479 following the 88th Texas Legislative Session.
Section 1 allows licensed mental health professionals with advanced training and education to request electronic warrants requests from a judge for emergency mental health detention and allows for including Class C misdemeanors in the early identification process.
Section 2 reconciles conflicts inadvertently created between offenses that permit release on personal bond. This law resolves the conflict and allows for the clear resumption of the release of people charged with certain non-violent crimes and eligible for a mental health personal bond.
Section 3 clarifies a law enforcement officer’s duties upon presenting an individual for mental health services. This law states that law enforcement officers do not have a duty to remain at a healthcare facility or emergency room once the officer responsible delivers someone under a warrant for emergency detention.
Section 4 allows blood draws for patients receiving court-ordered medication. Medical personnel must monitor the medication level of a patient receiving involuntary medicines to determine whether the dosage is correct when patients are unable or unwilling to consent. This law permits blood draws for people subject to involuntary psychoactive medications.
They also discussed jurisdiction scenarios for cities and counties.
Three main scenarios are happening where protocol needs to be clarified; hypothetical scenarios include:
Lieutenant Stuart Alexander, of the University of Texas at Tyler, University Police talks about the procedure and policy for voluntary, versus order of protection.
A person is picked up in the City of Tyler and transported to a Tyler hospital.
A person in a rural area like the City of Whitehouse is transported to a Tyler hospital.
A person is picked up in Cherokee County and transported across county lines to Smith County.
Area law enforcement agencies engaged in honest, open and transparent dialogue about their policy for handling similar cases. Through conversations, everyone becomes aware of the reasons behind each department’s processes, and solutions can be reached.
Wilson talked about the judicial role in voluntary versus order of protection custody.
An order of protective custody may be issued by a judge upon the request of a county or district attorney to continue to hold a patient in a mental health facility pending hearing on an application for court-ordered temporary mental health services.
“The individual can sign it voluntarily. To be honest, once that happens, that brings us in my office out of the loop of that process,” Wilson said. “You’re no longer involved in that unless the person decides they don’t want to be in the hospital any longer, but the hospital says they do.”
A Troup Police Department officer said often, a person goes voluntarily and then changes their mind. Officers don’t have first-hand knowledge of what occurred if they go voluntarily and law enforcement isn’t notified. He said signing a protective order without first-hand knowledge is tricky. This is a prime example where inter-organizational communication is critical.
When someone hears how one department is handling things, they’ll take that information and take it back to their community and put it in place, Franklin said.
Morris said people spoke frankly and had solid questions about the barriers to receiving treatment, access to care and the desire to change.
“We’re working together, and we’re working hard to improve the mental health delivery service; we want to make a difference there for our citizens,” he said.
