By Brittany Anderson

HAYS COUNTY — The mental health system and criminal justice system are two very intricate entities, and often intersect — but what happens when they are not working together cohesively?

This is a concern that some Hays County residents have, including Elaine Brown. Brown has been an attorney for over 30 years and a licensed professional counselor for over ten. Based in Dripping Springs, she has practiced family law, juvenile law and criminal law, and has also offered online mental health services.

In her years of experience, Brown has seen the “mutual ways” in which mental health is impacted by the legal system, and vice versa.

According to data from the Hays County-Vera Institute Jail Dashboard, as of Oct. 2, there were 638 inmates, with 81% of the inmate population being held pretrial for an average of three and a half months.

Brown said that with the jail’s current problems with overcrowding and understaffing, there are people incarcerated “not because they should be there, but they have a mental health problem and [authorities] don’t know where else to put them.”

“I think it’s really important that people understand we have people in jail who have an intellectual disability; they might not have the capacity to understand why they’re in jail, or what got them there,” Brown said. “There are also people who have mental health issues associated with that situation. It’s important to try and get these people out of jail, address overcrowding and the overlying issue of mental health.”

In September, the Hays County Commissioners Court approved the creation of a Mental Health Specialty Court, three years after its resolution was initially signed. This specialty court will offer individuals an alternative to jail when mental health problems played a role in their arrest, helping to manage their treatment and provide additional supervision and support to reduce their involvement in the criminal justice system.

Hays County Court-at-Law #3 Judge Dan O’Brien is presiding over the court and Kaimi Mattila was appointed as the court administrator. A mental health caseworker also started their position on Oct. 11.

“The purpose behind having specialty courts is to divert those from the criminal justice system who would be better served by another avenue,” Brown said. “By having a true mental health court that is actually working well and is successful, what we would do is divert a lot of these individuals out of the jails, so you would hopefully have less people sitting there, and can address other cases in a more timely manner.”

“When people are involved and engaged in treatment and having that extra layer of acknowledgement — “I see you” — that has been shown to be very effective,” Brown added.

Brown, however, wants to ensure that the court is being run as a “separate docket” from other courts to ensure it is operating as effectively as possible and “bring strength to what is occurring in the system.” Additionally, more community outreach is needed, she said, so the community, defense lawyers and attorneys and mental health providers are all aware of its existence and what it can do for them.

For Brown, seeing a coalition between the jail, court system and mental health providers in the county is one solution that can start locally.

“But that’s an issue; there are not very many providers that will help with indigent people, or people who don’t have insurance,” Brown said. “We obviously cannot force state hospitals to hire more staff or have more beds available. However, we can look at options into bringing inpatient clinics to the county. … That will be a whole coalition of different groups working together to benefit the community as a whole.”

Discussion of mental health and the legal system often coincides with the topic of drugs. One of Brown’s mental health concerns lies in the fact that inside jail, there are some individuals who are detoxing as a result of inadequate medical treatment, or not receiving their prescribed psychotropic medications.

Shawn Jackson, a resident who was incarcerated in the county jail for a year, said that if a person goes into the jail with a preexisting condition, it’s “really hard” for them to get antidepressants, anti-anxiety medication or medication for chronic pain. Jackson said he received BuSpar as an alternative medication for his anxiety, which wasn’t as effective.

“If you can’t get in touch with your provider or anyone on the outside and get a hard copy prescription, then you’re pretty much guaranteed you’re not getting your medication,” Jackson said. “That can throw somebody into a straight psychosis.”

According to Hays County jail administrators, when inmates report taking mental health medications, jail medics will contact the pharmacy to verify the medication. If they are unable to be verified, inmates are then scheduled with a psychiatrist for further evaluation and prescriptions.

Administrators also said that when an inmate reports using substances that could have potential threats while detoxing, they are placed on “detox protocol,” and orders are provided by the nurse practitioner to treat their symptoms and monitor them.

In his experience, however, Jackson said that inmates have to rely on each other much of the time.

“If a guy was withdrawing from heroin, I’d give him Jolly Ranchers out of my commissary to help him stop the shakes,” Jackson said. “There’s got to be something else better than that.”

“We need to make sure that people are getting psychotropic drugs, physical and mental medical treatment and access to therapy if they need it,” Brown said. “When you’re in jail, if that’s not being treated, that can easily worsen. … It can snowball into becoming a much worse situation. A lot of that could be avoided if we have [administrative] training in dealing with this within the jail system.”

While the creation of the county’s mental health specialty court is a big step forward in the right direction for the community, there is still work to be done in order to ensure that every person — whether they are incarcerated or not — is receiving the level of mental health care they need in order to be healthy.

“We need to be aware that justice delayed is justice denied,” Brown said.