Texas's recent implementation of a new plan to treat mentally ill inmates at the Grayson County Jail has gone well, according to Jail Nurse Natalie Sims. She said the program that requires all county inmates with mental health issues to be seen by a Mental Health Mental Retardation doctor instead of a private psychologist hasn't been a problem.
Sims said the female doctor was a little hesitant, at first, to enter the jail, but seems to have gotten over that.
The plan to have an MHMR doctor see inmates at the jail for seven hours each week is part of a response to the jail's overcrowding. Grayson County Judge Tim McGraw said inmates with mental health issues are often in the jail longer than any other group. He said it often took days or even months to get an outside doctor's office to make an appointment to see someone who was in the jail. Then, getting reports back about that visit could take even more months.
Tony Maddox, director of Mental Health Mental Retardation Services of Texoma, said the plan has been in the works since May but has just now come to fruition. The plan will allow an MHMR doctor to visit the inmate while in jail and prescribe whatever medication may be needed. Then, the person will leave jail and retain their status as a patient with MHMR.
McGraw said that “continuity of care” is hoped to “stop the revolving door” of patients who get straightened out on their medication while in jail and then fall off again when they leave the jail.
When asked how the county planned to pay for the plan, McGraw said money currently budgeted for the private doctors will be used for now.
That $3,500 a month, McGraw said, will pay for treatment while the inmates are in jail. Once they leave the jail, MHMR will be responsible for helping the patient come up with money for any needed medications. Maddox said that money might come from government programs or from the patient's family or both. McGraw said the county might even have to look at a plan to pay for some of the needed medication to keep people out of jail. He said buying their medication will be cheaper than housing them in the jail.
Keeping people on their medication and out of the county jail, McGraw said, is the key to the plan. Then he noted that doing so is more cost effective for the county and “more humane” for the mentally ill.
The agreement the Court approved last week is the contract for a pilot program that MHMR is considering for other counties in the area.
McGraw said he, Maddox and others involved with the jail and medical staff will meet every two weeks to review the program's progress. Both the county and MHMR can opt out of the program if it proves not to work.
McGraw said this part of the program is a “post jail diversion” effort and hinted that the county might look at a “pre trial diversion” program in the future for people believed to have mental health issues.
He said in the pre trial program, people would be evaluated for mental health issues before they are booked into the county jail. If those issues are found, they could be dealt with in a number of ways that would not result in them entering the jail. One way might be hospitalization while another might be to call the person's family and advise them that the person is off his or her medications.
McGraw said committees of county officials and medical personnel are continuing to look at medical needs in the county. He noted that there are 19,000 people in the county who don't have medical insurance. He said those people are getting a majority of their health care from local emergency rooms and that is the most expensive option.