Selasa, 03 April 2012

Reality check on mental health funding lacking at lege hearing

Dr. Floyd Jennings, who is special resource counsel to the Mental Health Division of the Harris County Public Defender, posted an account on Karen Franklin's In the News blog of his first experience giving invited testimony to the House Criminal Jurisprudence Committee last month. Grits happened to be in the room when Dr. Jennings gave his testimony, and at the time I didn't have a chance to comment on an odd and telling discussion he referenced in his account:
I learned that the lucidity of the argument may have little consequence. I was upbraided for failing to provide the legislature with specific means of cost savings through transfer of mental health services to the "private sector", although there is no private sector entity with the duty to provide mental health services to the chronically mentally ill on a statewide basis. And even if existing, no private sector entity has the resources to provide such. The tone of questions made it plain that legislators would prefer to have government provide all the goods and services that governments rightly provide, but at no cost, or with private sector funding.
Rep. Wayne Christian was the main legislator pushing Jennings for a "private sector" solution for mentally ill defendants in the justice system. It was at times an almost abusrdist discussion: Around the room, looks of befuddlement flashed across most faces in the audience as the same questions ran through everyone's mind: What "private sector" services is Christian talking about? Does he understand Jennings is discussing mentally ill homeless people cycling in and out of the jail? Who believes there is a "private sector" solution for that? The private sector needs customers to be economically viable, and the only customer in sight who might pay for treatment of indigent, mentally ill defendants is government. I can understand Dr. Jennings frustration; the exchange was flat out surreal.

I get that Rep. Christian doesn't want to spend more money, but that particular discussion needed a serious reality check. Since he and others on the committee at times didn't seem to grasp Jennings' key points, I'll close by reiterating them here in his own words:
the charge of the committee was to address whether alternative sentencing for mentally ill persons would be desirable. I argued simply that no changes in sentencing were needed -- because it would be difficult to craft, impossible to implement as it would trade on definitions of applicability, and moreover, courts already have the option of considering a defendant's state of mind as either mitigating or exculpating.

On the other hand, diversion strategies for the lower-level misdemeanor offender could have enormous cost benefits and not compromise public safety. As well, pre-trial jail psychiatric services could be provided at modest direct cost through the use of physician extenders, and provide just that opportunity for stabilization necessary to enable rapid disposition of the matter, shortening any period of confinement. Finally, I argued that opportunities for post-disposition placement tiered to the acuity of the person would dramatically reduce recidivism.
Jennings was sensibly suggesting counties and the Lege spend pennies to save dollars. Christian, by contrast, would have the state save pennies today, even if it means the dollars required tomorrow are compounded. Ironically, Jennings' is actually the more fiscally conservative view.

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