Transcript Senate Criminal Justice Committee Interim Charge 1 June 21, 2006 Public Mental Health System in Texas • DSHS mental health services are only.

Senate Criminal Justice Committee
Interim Charge 1
June 21, 2006
Public Mental Health System in Texas
• DSHS mental health services are only part
of the public mental health system in Texas.
• Law enforcement, education, Medicaid,
CHIP, the criminal justice system, hospitals
and other entities all play major roles in
treating Texans with mental illnesses.
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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State Mental Health Hospitals
• 10 Mental Health facilities provide inpatient
hospitalization for persons with severe mental
illness who need intensive treatment
• North Texas State Hospital—Vernon campus,
serves as the statewide maximum-security unit
• The Waco Center for Youth is the only stateoperated residential treatment facility in Texas for
youths
• All facilities are JCAHO Accredited
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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State Mental Health Hospital Capacity
Beds - By Psychiatric Facility Type
State
Hospitals
2,260
Non Profit
408
For Profit
FoForr Profit
1,526
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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Population Growth Compared
to Funded State Hospital Beds
Funding for State Mental Hospital Beds has declined while the Texas
population has grown
30
25
20
15
10
5
0
State Hospital Beds
Est. Pop. In Millions
.
40
35
25.0
20.0
15.0
10.0
5.0
FY '92
FY ' 98
FY '05
3,560
17.7
2,774
19.8
2,268
22.5
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
0.0
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Growth in Forensic Patients
Total Forensic Patients as a percent in Texas Mental Health Facilities
30%
25%
20%
15%
10%
5%
0%
% Forensic
Patients
2001
2002
2003
2004
2005
16%
21%
23%
26%
27%
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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State Mental Health Hospital Daily
Census for FY2005
2,500
2,400
2,300
2,200
2,100
Sep
Oct
Nov
Dec
Jan
Actual
Feb
Mar
Funded
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
Apr
May
Jun
Jul
Aug
Average
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State Mental Health Hospital Capacity
• In February 2006, the LBB approved $13.4 million in
additional expenditures for state mental health hospital
capacity. These funds were transferred from DSHS’ FY07
appropriations to FY06.
• As a result, statewide hospital system capacity was
increased by 96 forensic commitment beds and 144 civil
commitment beds.
• This increase in state hospital capacity has greatly
enhanced our ability to meet the needs of local
communities.
• We continue to plan for long-term, community-based
solutions to address the hospital capacity issue.
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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Individuals with Criminal Justice Involvement Experienced Positive
Clinical Outcomes at DSHS Community Mental Health Centers, All
of which Implemented Jail Diversion during FY2005
96%
AVOIDED CRISIS
IMPROVED/STABILIZED RISK OF
HARM
85%
IMPROVED/STABILIZED
FUNCTIONING
80%
IMPROVED/STABILIZED
EMPLOYMENT
81%
IMPROVED/STABILIZED
HOUSING
78%
IMPROVED/STABILIZED COOCCURRING SUBSTANCE USE
90%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Percent Who Experienced Positive Outcome
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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Crisis Services Redesign
• Crises do occur—but we should do all we can to avoid them.
• February 2006, DSHS established the Crisis Services Redesign
Committee to develop recommendations for a comprehensive array of
crisis services.
• Members of the committee include medical experts, citizen stakeholder
groups, law enforcement representatives, county probate court judge
representation, and county representatives, as well as individuals from
professional organizations and provider groups.
• A redesign of crisis services will build on, and is a part of, the service
improvements made by the evidence-based Resiliency and Disease
Management program.
• A thorough review of the current crisis system was conducted,
including holding public hearings around the state, reviewing current
research and consultation with experts.
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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Crisis Services Redesign (cont.)
• The committee plans to finalize its recommendations in June for an
evidence-based crisis services model that will increase access to
appropriate and cost-effective services.
• Initial conclusions for recommended services include:
– 24-hour hotline
– Mobile outreach
– 23-hour hold capacity
– On-call psychiatric services
– Crisis residential services
– Respite
– In-home crisis resolution services
• The committee will also put forth recommendations regarding DSHS
staff support, coordination and training to local professionals (e.g., law
enforcement crisis intervention training).
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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Behavioral Health Issues Impact
Other Systems
• 75% of children placed in foster care have parents with
behavioral health problems
• 75% of kids in the juvenile justice system have behavioral
health problems
• 30% of kids in the juvenile justice system will end up in
the adult justice system
• 46% of all ER visits have behavioral health issues as a
basic or contributing factor
• 30% of all truancy is related to behavioral health problems
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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Mental Health Transformation
• Overarching goal is to improve the mental health of all
Texans and meet the President’s New Freedom
Commission goals
• New Freedom Commission Goals are shared by those
participating on the Transformation Working Group:
– The Governor’s Office; Department of State Health
Services; Texas Health and Human Services
Commission; Department of Family and Protective
Services; Criminal Justice Department; Juvenile
Probation Commission; Texas Youth Commission;
Consumers; Family Members; Texas Education
Agency; Aging and Disability Services; Workforce
Commission; Veteran’s Administration; etc.
Senate Criminal Justice Committee  DSHS Presentation  June 21, 2006
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