JOEL MENDEZ
Bandera County, like many rural areas, is faced with a shortage of mental health care professionals and services, but specially trained mental health deputies are working to bridge that gap while keeping people out of the justice system.
Law enforcement officers in Bandera County are often the first to respond to mental health emergencies. The county has three certified mental health deputies, two at the sheriff’s department and one in the marshal’s office.
Law officers make tough decisions when responding to these crises, often determining whether someone should be taken to jail or if there is another way to assist them, said Sgt. Luis Moreno of the Bandera County Sheriff's Office, one of the county’s mental health deputies.
“The easiest thing for us is to incarcerate them, but that's not the answer for that,” said Moreno. “So, we always base it on the individual. What can we do to help this individual.”
According to Mental Health America, Texas ranks last in access to mental health care in the U.S., and out of the 254 counties in Texas, Bandera is one of 246 that have a shortage of mental health care providers. In a mental health desert people in crises can end up going to jail instead of receiving the proper treatment they need.
For people in need of treatment, the nearest providers tend to be more than an hour away in San Antonio, Moreno said.
“We have to travel 45 minutes to an hour away to University Hospital in San Antonio to drop off a mental health patient,” said Moreno. “I can see that for some people who don’t have the means to do that, it just leaves them there.”
Although law enforcement officials are the main responders to these emergencies, they also receive help from outside resources.
Hill Country MHDD Centers is a mental health and developmental disability services agency that serves serves 19 counties in Texas. With no central mental health center in Bandera, the residents tend to seek assistance from the Hill Country centers in Kerr and Kendall counties. However, gaps in coverage continue, as highlighted by the limited number of crises calls handled in Bandera, said Joan Cortez, Hill Country MHDD director of crisis services.
“Last year, we had five total calls in Bandera County. I know there’s more than that, we just aren’t getting them,” said Cortez. “We’re working on filling some of these gaps, especially in rural counties, and even discussing getting a mobile vehicle to reach those areas where transportation is a barrier.”
Cortez noted the importance of collaboration between law enforcement and mental health agencies, emphasizing the need to build a rapport with services in Bandera County.
“I’d like to see better cooperation between probation, the sheriff’s department, and our agency, and even have an actual location where providers could come in and offer better care for the community,” said Cortez.
For Bandera County, limited mental health resources allow for potential solutions to be tested, like a mobile mental health unit that could be used to address the gaps in access to care, Cortez said.
Kendall County is piloting a program that allows law enforcement to video chat with mental health professionals while in the field. Cortez hopes to be able to build a rapport with Bandera officials and eventually bring a similar program to the county.
Hill Country MHDD developed a similar collaborative program with the San Marcos Police Department in Hays County. The program embeds a mental health professional directly with law enforcement to better handle a person having a mental health crisis, said Kelly Castillo, the only co-Responder within Hill Country MHDD. She has seen success in her work with the police department.
“We co-respond to calls together, which allows us to assess the situation in real-time, de-escalate it, and connect individuals to the appropriate resources, instead of resorting to emergency detention or jail,” Castillo said. “So, we're not clogging up the emergency rooms and people don't have to pay as much for care because if we can just direct admit them to a hospital, it saves them time and money.”
Collaboration between law enforcement and mental health professionals is crucial to provide a community the resources it needs for people facing mental health challenges, said Greg Hansch, executive director of the National Alliance on Mental Illness of Texas (NAMI).
“We think co-responder models are kind of the gold standard in responding to mental health crisis situations because you have the different capabilities, tools and skillsets,” Hansch said.
The Houston Police Department has the Crisis Call Diversion Program, which offers an alternative to law enforcement responses for non-violent mental health crises. The program connects callers to a hotline with counselors who can assess the situation and give the appropriate referrals without police involvement, said Sgt. Rebecca Skillern, a licensed professional counselor and supervisor of the Houston Police Department Mental Health Division Training Unit.
“When people are in crisis, their families aren’t calling therapists, they’re calling the police. But if police officers don’t know what they’re dealing with, they have a very difficult time managing those scenes,” said Skillern. “Having programs like crisis call diversion allows us to send a civilian response in non-violent situations, which reduces the burden on law enforcement and Joel Mendez is a journalism major at Texas State University and a contributor to Texas Community Health News, a collaboration between the School of Journalism and Mass Communication and the university’s Translational health research Center. TCHN stories, reports and data visualizations are provided free to Texas newsrooms.
