With Mental Health Diversion Center Forthcoming, Sheriff Still Wants More Humane Jail Facilities

Sheriff Sally Hernandez has not given up on her dream of new jail facilities. If you ask why, she will point to the women’s psych unit.

The cells are small and stink of body odor. The windows are inaccessibly high on the wall and semi-opaque due to frosted glass, though women stand on their cots to look through the relatively clear scratches in the panes. Screams and moaning cries are near constant. Because the Travis County Sheriff’s Office is short on corrections officers, those staffing the unit consider working 50 hours a good week. I spent less than an hour in the unit, and when I asked a corrections officer how she was doing, she started crying.

“The [Austin] State Hospital can say, ‘We’re short-staffed, we don’t have any more beds, you can’t come,'” says TCSO spokesperson Kristen Dark. “The hospital can say, ‘We don’t have any room in the emergency room.’ We never have the option to say we’re short-staffed or we’re short on beds.”

Hernandez has made improving mental health care in jail one of her top priorities since being elected in 2016. That desire drove her years-long push for a new women’s jail, imagined as a more humane facility that could accommodate more robust mental health services. The progressive Travis County Commissioners Court shot that plan down. As County Judge Andy Brown told the Chronicle, “The jail here is the largest mental health facility. But deputies did not become deputies to work with people with mental health issues.”

Brown and other commissioners and advocates who opposed a new jail argued the county’s money would be better spent on mental health care to prevent jail stays than on mental health care for those already in jail. Now, a county mental health diversion center partially funded by the city is in the works, with plans to start designing it in 2024. Brown says the county doesn’t need to divert every person with mental health problems away from jail to vastly improve conditions for those in jail. “If that population was halved or a third of what it is,” Brown told us, “that’s more counselor time with each person.”

Hernandez supports the county’s mental health diversion plan, arguing that lowering the jail population is good for the community and for her overwhelmed staff. But she still hopes to see existing jail facilities torn down and new ones put up. “People come into new offices with progressive ideas about how to reduce the number of people in our jail, and while they’re working through this and trying to figure out how to reduce that number, we’ve got women suffering and that number is growing,” Hernandez says.

The county’s mental health public defender, Melissa Shearer, is one of the people most closely acquainted with people currently incarcerated in the jail’s psych units. “Obviously conditions should be improved,” Shearer said. “Being confined in a jail cell, without automatic access to free phone calls and appropriate hygiene supplies, is inhumane to begin with. Then add feeling suicidal, and you lose access to clothing and human contact for 23 hours a day. These basic acts of humanity should have been remedied a long time ago.” But as for a new facility, she believes it would be the wrong kind of investment. “If we had several crisis stabilization units in Austin and appropriate and dignified long-term options for healthy living, there would be a lot less people with serious mental illness ever setting foot in the jail.”

Less Punitive, Less Penal

Hernandez says as long as anyone in the county is going to be incarcerated, they should be in a facility built with healing in mind. For example, they should have access to a playroom to visit their kids in. Currently, only a limited number of inmates benefit from a play space at the jail, as moving people between buildings while following jail standards (and with limited staff) is often impossible, she says. She also believes cells should have eye-level windows that their occupants can see out of, people in open areas should have quiet rooms to go to when they’re overstimulated, and everyone should have some level of privacy when showering and using toilets.

With that vision in mind, TCSO has created a small unit for traumatized incarcerated women. The trauma-informed unit, as it’s called, sits in Building 9 and can accommodate about 40 people. There are small cosmetic differences – among them, a mural in pastels, posters of beaches, and curtains so women can shower in relative privacy.

The larger difference is part of a culture shift that Rutanya Pearson-Mitchner has observed during her last 15 years working with TCSO. Pearson-Mitchner has been incarcerated three times, including a stint in the Travis County Jail. Now, she is the executive director of the nonprofit Truth Be Told, through which she acts as a teacher and peer to incarcerated women. She’s been running programs through TCSO since 2007, and what she sees now is “a lot less punitive, a lot less penal.” She attributes much of that culture shift to Hernandez’s leadership.

In Building 9, one nonprofit or another visits occupants every day for programming – some of it more structured, some of it more loose to encourage connections between the women there. Pearson-Mitchner’s visits are of the looser variety, as she comes in once per week to talk, cry, and do crafts with inmates. Hernandez wants to work up to providing this kind of daily programming for every incarcerated person in the county, but for now, she says, “I’m pleased with the results so far and look forward to seeing this grow.” On a recent visit to the building, Hernandez said women housed there commented on the atmosphere, while officers told her it’s their preferred unit to work in. Officers have left an impression on Pearson-Mitchner, as they “show humanity … I have not experienced a kinder set of people running a facility before.”

As much as Pearson-Mitchner believes in the spirit of the Building 9 project, she doesn’t believe new jail facilities should be a priority. Rather, Pearson-Mitchner says, the public should invest in “healing centers” where people can spend time figuring out, “How did I get here – not how I broke the law, but what led up to that? That’s where the investment should go, not necessarily into the facility.”

But TCSO staff, like counseling director Danny Smith, point out that it would take a robust overhaul of the entire local mental health care system to prevent all unnecessary jail stays related to mental illness. “We have to have availability 24 hours a day,” Smith told us. “And we need to have facilities that can manage the care [people] need. Taking someone who’s in an acute crisis, who’s aggressive, to an [emergency room] is just not appropriate. Granny’s having a heart problem next door and somebody’s in there – you can’t put the two in the same environment.”

A full overhaul of mental health services would involve a collaboration between the city, county, state, and nonprofit entities that make up our community’s mental health care system. A redesign of that scope isn’t in the works, but change is coming. A redesign of ASH is nearing completion, though Dell Medical School‘s Stephen Strakowski points out that it won’t increase capacity. And, more to the point, “There’s always a big debate about how many beds you need, and it can’t be answered because it all depends on the quality and access of your nonhospital services,” he says. “We need a substantial kind of [step-down] nonhospital residence to move people into a less expensive and more appropriate setting. That’s not unique to Austin, that is probably the missing component throughout the state.” Just as important, he says, is an expansion in outpatient care to prevent crises. He argues the community may need to shift our understanding of what kinds of crises require a bed, and what kinds require intensive outpatient care.

The county’s mental health diversion plan, still being hammered out, isn’t set to provide that step-down facility, at least in its initial phases. Outpatient care, including delivery of antipsychotic medications, is currently handled by Integral Care – the county’s local mental health authority, which has its own share of organizational issues. Shearer said her office’s involvement with any given client was meant to end around 90 days after the conclusion of a legal case. “Instead we have found we have to remain on their cases because they’re not getting the level of support they need from [Integral Care]. We have to continue to advocate and intervene and make sure they get those services,” she said. “When the ball is dropped people sometimes get hurt, and others get arrested and start the revolving door again.”

Brown and Travis County Commissioner Ann Howard, both leaders of the effort to launch a mental health diversion center, agreed that the county could improve its monitoring of Integral Care. “We’re looking at how we can hold ourselves accountable. We [commissioners] have to do a better job of asking questions,” Howard said, while Brown said the county will “take a fresh look at what metrics we’re measuring.” Whether Integral Care, Central Health, or another entity will run the facility is still up in the air. But both commissioners emphasize the need for a continuum of care, and eventually the introduction of space for involuntary care for those who are aggressive or resistant to care during a crisis.

Karen Ranus, the head of TCSO’s trauma-informed program, is a relatively new hire. In her previous work with nonprofit NAMI Central Texas, she talked with families about their experiences with incarceration. “It’s a sad testament to [Travis County’s] system of care how often I would hear families say to me, ‘I hate that my son or daughter is in jail, but at least I know where they are and that they’re safe.’ Because everybody else tells them no. No, we won’t take insurance. No, we’re full,” Ranus told us. “So they say, ‘At least I know where they are.’ But that is heartbreaking. Because they know as well as we do that that is not the ideal setting to achieve healing.”

This article appears in December 29 • 2023.