Tale of Two Counties: Bexar County Texas Acted, Fairfax County Virginia Talked


6-8-15 During my travels, I’ve discovered that most communities with good jail diversion programs got them because of a strong leader, usually a judge, a sheriff or a mental health advocate. Yesterday (Sunday June 7), the Washington Post published an Op Ed piece that I wrote about the difference between a community where leaders took action and Fairfax County, Virginia, where I live. Where does your community fit? Is it moving forward or are your leaders sitting on their hands?

What Fairfax can do now for the mentally ill

There’s been enough talk about treatment for the mentally ill. It’s time for Fairfax County to act!

The Washington Post Local Opinion Page
By Pete Earley

If Natasha McKenna had lived in Bexar County, Tex., instead of Fairfax County, the 37-year-old would have received treatment for her schizophrenia rather than dying after being stunned by a deputy sheriff four times with 50,000-volt shocks from a Taser while her arms and legs were shackled and her face covered with a hood.

More than a dozen years ago, Fairfax and Bexar County officials decided to investigate jail-diversion programs that would direct people such as McKenna into community treatment for mental disorders instead of into jail.

Bexar County, which contains San Antonio, created a system that is heralded as a national model. In 2002, its first year, nearly 1,000 people with mental illnesses were diverted from jail and emergency rooms into community treatment facilities. Today, the program diverts more than 4,000 individuals each year and is saving at least $5 million annually in jail costs and $4 million annually on inappropriate admissions to emergency rooms.

What has Fairfax County done?

Its leaders have held meetings, compiled reports and talked, talked, talked.

Meanwhile, each day roughly one-fourth of the more than 1,200 inmates at the Fairfax Detention Center who have serious mental illnesses such as schizophrenia, remain incarcerated at a cost to Virginia taxpayers of more than $50,000 per inmate per year. Fifty percent of jail inmates have mental health and/or substance abuse disorders. Many are charged with trespassing and other minor crimes related to their illnesses.

A key component of the Bexar model was the creation of a 24-hour Crisis Care Center — a 10-bed facility in San Antonio staffed by therapists that serves as a drop-off alternative to the jail and emergency rooms. Most of the 14 patients admitted there each day can be stabilized within 24 hours. Those who can’t are moved to private hospitals or state facilities.

The Virginia legislature set aside $1.8 million to add six crisis drop-off centers to the 18 in the state. There has been talk of building a Fairfax drop-off center on the site of the county-owned Massey Building. But Fairfax officials announced that they would apply for a state grant to fund such a center only after McKenna’s preventable death.
The Bexar County judiciary uses a mental-health court to cull people with mental disorders from its criminal caseload and direct them into treatment. Virginia has mental-health dockets in four jurisdictions, most recently in Prince William County. Not Fairfax, even though a study by Old Dominion University found that the Norfolk mental-health docket translated into fewer repeat offenders, less jail time, improved mental health through treatment and a jail-costs savings of $1.63 million over 18 months. In Petersburg’s court, only four of 50 people (8 percent) in the program re-offended, in sharp contrast to the 60 percent to 75 percent recidivism rate in Petersburg.

Fairfax General District Court Chief Judge Penney Azcarate launched a veterans docket this year, but her Circuit Court colleagues have stubbornly refused to implement a mental-health docket.

Incredibly, after McKenna’s death, the Fairfax-Falls Church Community Services Board, which oversees mental-health services, moved to eliminate a staff position in the jail to save money. The board relented after advocates protested, but it concocted another cost-cutting scheme that will remove an on-site supervisor from the jail, weakening its already insufficient services.

A mental-health advocate and Bexar County judge were responsible for bringing law enforcement, the judiciary, mental-health providers and community leaders together to create that county’s diversion program. That cooperation included cost-sharing. Although the Fairfax Sheriff’s Office is legally responsible for medical services in the jail, it pays nothing for inmate mental-health care. Neither does the Fairfax County Police Department. The Community Services Board shoulders those costs alone — using funds badly needed for community mental-health treatment programs.

Sharon Bulova, chairman of the Fairfax County Board of Supervisors, should follow Bexar County’s example and use her bully pulpit to require Fairfax Police Chief Edwin C. Roessler Jr., Sheriff Stacey Kincaid and the Community Services Board to pool finances to fund a Bexar County model. The Fairfax judiciary should be pressured by taxpayers to get on board.
Bexar County, Orlando, Seattle, Miami and Ohio’s Franklin County , which contains Columbus, have implemented successful jail diversion programs that save lives and tax dollars. Fairfax County missed its opportunity once. It would be unconscionable to repeat that mistake.

The writer is a member of Fairfax County’s Ad Hoc Police Practices Review Commission and author of “Crazy: A Father’s Search Through America’s Mental Health Madness.”

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.