In hopes of creating diversion program for mentally ill, Douglas County leaders leave Texas with much to consider

SAN ANTONIO — The vast system of help available to those suffering from mental illness or substance addiction in Bexar County, Texas, is impossible to replicate for a community the size of Douglas County. But already officials from Kansas have gleaned ideas and inspiration.

Friday, almost 20 officials from Douglas County government, law enforcement and health care agencies finished a day and a half of presentations, tours and discussions regarding San Antonio’s Center for Health Care Services, a nationally respected mental health system that has kept the nonviolent, mentally ill out of jail. The trip was arranged by Justice Matters, a local group of religious leaders focusing on justice issues.

Douglas County is currently researching how to best react to rising inmate populations and a greater demand to provide mental health care services to inmates in the county jail.

The project’s scope has yet to be determined, but officials expect an expansion of the county jail and the construction of a separate intervention center, where nonviolent inmates can be diverted away from the jail for mental health crises or substance abuse problems.


Among the ideas culled from the trip is including some type of transitional housing for the homeless to use after receiving care for a mental illness or substance abuse problems at an intervention center.

In San Antonio, officials toured a facility named the Restoration Center, which operates much like the crisis intervention center that officials have envisioned. Individuals may be dropped off by law enforcement to receive care; they may voluntarily enroll in a recovery program; or they may be part of a court program that allows them to avoid prosecution.

The facility is across the street from a separately run homeless shelter that can provide other services, such as transportation or obtaining identification. Also within walking distance is an affordable housing unit.

The setup has helped save the city and county governments nearly $10 million a year in jailing and hospital room costs, said Leon Evans, the CEO of CHCS. Bexar County also had the lowest recidivism rate, at 6.6 percent in 2012, in Texas, according to data provided by CHS.

David Hnatow, an emergency medical physician, said the surrounding campus has been crucial in the improvement of people who pass through the Restoration Center. When someone with substance abuse problems is taken to an emergency room and sobers up, “you’re out the door,” he said, whereas at the campus in San Antonio, a range of services is available.

After seeing the facilities, Douglas County Administrator Craig Weinaug and County Commissioner Nancy Thellman both said incorporating something similar might be necessary in Douglas County. They did not know how such an idea could manifest itself in the developing proposal for the project, but both thought it would be important for helping troubled individuals get back on solid ground.

Both expressed a desire to involve members of the Lawrence-Douglas County Housing Authority in future discussions.

“If you just offer treatment, it isn’t going to be successful” in helping people get better, Weinaug said.

Police training

One aspect of a fluid system that keeps nonviolent mentally ill individuals out of jail is already a coming certainty in Lawrence.

That comes in the form of having a police force that understands how to recognize and deal with a suspect suffering from a mental health crisis and where that suspect belongs — a jail cell, emergency room or a mental health facility.

All San Antonio police are required to take 40 hours of crisis intervention training (CIT), which teaches them how to recognize and deal with mental health crises. Lawrence Police Chief Tarik Khatib said local law enforcement and health care professionals have been meeting for the past year to develop a training curriculum.

In September, it will be made available to all Douglas County law enforcement officers “who are interested,” Khatib said. Eventually it will be mandatory for Lawrence police.

“We’ve recognized the importance of it,” Khatib said.

Members of the San Antonio Police Department told the group of Douglas County officials that CIT will go a long way toward reducing physical force used by officers and building community trust. But in order for troubled individuals to have a chance at reversing their fortunes, a mental health intervention center is imperative.

“A facility like (the Restoration Center) is paramount,” said SAPD officer Joseph Smaro.

Gaps that need filling

During an hours-long discussion Friday among all the officials who made the trip, several people outlined a clear need to create a diversion program and what obstacles will have to be negotiated to create one.

District Attorney Charles Branson said his office tries to place those with mental illnesses in the right environment. But it’s a struggle without a facility like San Antonio’s Restoration Center.

“We will have someone that we think doesn’t need to be in jail, but that’s where we leave them because they don’t have a (place) to go to,” he said.

Branson said it’s “fairly” easy for his office to identify someone who doesn’t belong in a jail cell, but it’s difficult to “cobble together” an alternative arrangement.

“Frankly, we’re not good at that,” he said.

Municipal Court Judge Scott Miller said he sees mentally ill people dealing with nonviolent misdemeanors on a daily basis. He does not have a social worker or case managers to work with, so if a mental health court were established, he said he would need more funding to support a larger staff.

Gene Meyer, the CEO of Lawrence Memorial Hospital, also said the Lawrence area is suffering from a lack of psychiatrists, despite recruiting efforts. For a facility like San Antonio’s Restoration Center to work in Lawrence, the city would have to find a way to reel more in.

Much of the group was also in agreement that forming a mental health consortium would need to be done quickly. Meyer said that although mental health care resources are “limited” in Lawrence, there is a still a duplication of efforts between various providers. The creation of a diversion program and crisis intervention center would require greater efficiency among the area’s mental health care agencies, he said.

A funding source for the project will not be determined for several more months. The Douglas County Commission is considering a sales tax referendum (if approved by the Legislature), raising property taxes or issuing bonds through a public building commission. One commissioner, Jim Flory, said in February he would be reluctant to use a public commission for the project.

Leaders of Justice Matters will host a debriefing for members of the public to learn more about the facilities in San Antonio. It will be held at Lawrence Free Methodist Church, 3001 Lawrence Ave., at 6:45 p.m. on April 14.