Alcoholism and mental health
Project Recovery, County Judge Nancy Hohengarten presiding, is designed for homeless, chronic drunks. The program, which established funding in 2005 and drew its first client in 2006, is meant to give mostly Downtown alcoholics – many of whom rotate in and out of jail on a cycle of public intoxication charges – a chance at sobriety, stable housing, and employment. It's an ambitious program and (depending on how you measure such things) has had limited success. The program, which works in cooperation with Austin Travis County Integral Care (formerly the Mental Health and Mental Retardation Center), provides housing for up to 10 men for three months and intensive treatment for alcoholism, followed by three months of supportive care and services transitioning the men into independent housing and, ideally, stable employment. According to county statistics, the program has served 113 clients since 2006; before entering the program, the men had collected an average of about 40 public intoxication charges each; after admission to the program, that number has dropped to just under seven each.
Hohengarten says the program has reduced recidivism by about 45 percent. "I think it's successful, but I will tell you, how people define success, it is not easy," she says. "If you can reduce recidivism by greater than 25 percent, that's a successful program." But the stats for Project Recovery match recidivism internally and not against an outside control group, which makes an objective assessment more difficult.
This population, agrees Assistant County Attorney Jason Steans, is extremely tough to serve. "It's tougher than I expected," says the former defense attorney, who has worked with Project Recovery as the county attorney assigned to the project and to the misdemeanor mental health docket for about two years. "We've done some amazing things, on a personal level, and we've saved some people's lives, but it's frustrating sometimes," he says. "We could always be doing more, but it's a step in the right direction. It's the most we've ever done with this population before."
Michael Anthony Cruz, a 27-year resident of Austin, is fairly typical. The 45-year-old has been a heavy drinker since he was a teen and has lived on the streets for years. In 2004 alone, he racked up 20 public intoxication charges. He has tried to sober up several times and absconded from Project Recovery the first time he was admitted, in 2007. Hohengarten and her team have given him a second chance. "I was tired of being sick and tired," he said recently. He is now more than 70 days sober and intends to stay on the wagon: "If you want to get your life back on track," he says, "Project Recovery is the place to do it."
At least equally difficult to serve are the mentally ill in the criminal justice system – and they are many. County statistics reflect that, historically, 14% of the misdemeanor jail population has mental health issues. The goal of the mental health docket, run in the misdemeanor court by Judge David Crain, is to connect people with services and, when possible, divert them from jail. The county has even created a Mental Health Public Defender Office, the first of its kind in the country when it opened in 2007. According to MHPD Director Jeanette Kinard, her office – funded by a combination of county money and grant money from the state's indigent defense task force to handle 400 cases per year – has a 50% case dismissal rate, above what most private practice attorneys can boast.
Part of the program's success, officials say, has been the increased communication between the courts and the Travis County Sheriff's Office, which runs the county's jails. Before the docket was up and running, there was no way for the court to know prior to seeing a defendant that the person had been diagnosed with mental illness – including bipolar disorder and schizophrenia, the two most common diagnoses among inmates. That wasn't because the county didn't have that information – it just wasn't being transmitted from the jail (which does diagnostic evaluations on inmates) to the courthouse. That has changed.
Among those who staff the mental health cases are jail counselor Jeff Futrell and a representative from Integral Care who can tell the court if an individual has a diagnosis or a history with the service provider. The communication is invaluable, says Futrell. "Many mentally ill people have burned all of their bridges," he said recently. "They fall between the cracks and are lost in the shuffle. By us doing this, we keep them from falling through those cracks or getting lost in the shuffle of the system."