Senate Criminal Justice Committee Interim Charge 1 June 21, 2006

Senate Criminal Justice Committee DSHS Presentation June 21, 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, State Mental Health Hospitals 10 Mental Health facilities provide inpatient hospitalization for persons with severe mental illness who need intensive treatment North Texas State HospitalVernon campus, serves as the statewide maximum-security unit The Waco Center for Youth is the only state- operated residential treatment facility in Texas for youths All facilities are JCAHO Accredited

Senate Criminal Justice Committee DSHS Presentation June 21, State Mental Health Hospital Capacity

Senate Criminal Justice Committee DSHS Presentation June 21, Population Growth Compared to Funded State Hospital Beds Funding for State Mental Hospital Beds has declined while the Texas population has grown

Senate Criminal Justice Committee DSHS Presentation June 21, Growth in Forensic Patients Total Forensic Patients as a percent in Texas Mental Health Facilities

Senate Criminal Justice Committee DSHS Presentation June 21, State Mental Health Hospital Daily Census for FY2005

Senate Criminal Justice Committee DSHS Presentation June 21, 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, Individuals with Criminal Justice Involvement Experienced Positive Clinical Outcomes at DSHS Community Mental Health Centers, All of which Implemented Jail Diversion during FY2005

Senate Criminal Justice Committee DSHS Presentation June 21, Crisis Services Redesign Crises do occurbut 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, 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, 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, Mental Health Transformation Overarching goal is to improve the mental health of all Texans and meet the Presidents New Freedom Commission goals New Freedom Commission Goals are shared by those participating on the Transformation Working Group: –The Governors 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; Veterans Administration; etc.