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Kyle, Texas
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March 16, 2011     Hays Free Press
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Hays Free Press March 16, 2011 M~ Page 3A Patient or Prisoner:. Texas system failing the mentally ill Continued from pg. 1A + suspected schizophrenia, which runs in her husband's family. "Before he goes into his mood change, be's a really nice kid," Marti- nez said. "He's fun to be around, he's got a good sense of humor. When the mood comes around, all of a sudden he'll withdraw." A thick file folder shows just a frac- tion of the treatment that Martinez sought for her son, both outpatient and inpatient. It's been a frustrat- ing battle that often left her feeling helpless. As small-business own- ers running a tortilla factory in San Antonio, the family had no insurance that would cover mental health care, and absorbed most of the cost out-of- pocket. For many years, that meant a budget psychiatrist who was liberal with the prescription pad, a course of action that Martinez now regrets. "I did the best I could do," Martinez said. "I don't know if it did him more harm than good." The family moved to Kyle about seven years ago, hoping the small- town atmosphere would help keep their son out of trouble. He had recently qualified for social security disability, and Martinez believed that her son could finally get some real help. The day before he was arrested, her son switched to an extended release Xanax, Martinez said. Though Xanax is commonly prescribed for anxiety disorder and typically leaves the pa- tient feeling calmer, Martinex says it has a reverse effect on her son. "Xanax makes him think he can do anything," Martinez said. "It changes him into a completely different person. He'll do things you would never dream he would do in a million years. The things he's done wrong in the past have always started with this drug." On the morning of March 12, the new medication was starting to kick in. "He came to the car and he was all out of it," Martinez recalled. "He gave my daughter-in-law a hug and he told us, 'I love you guys, I'm probably go- ingto end up in jar.' I told him, 'Elan, just stay home.' I saw the look on his face, and at that point there was no reasoning with him." Despite his mother's protests, Mar- tinez left, and he didn't come home. 'WE TRY TO GET THEM HELP' Last week, two of Bo Kidd's officers in the Buda Police Department made the four-hour round trip to Kerrville to transport a suicidal subject to a mental health center, lypically, they "Xanax makes him think he can do anything. It changes him into a completely differentperson. He'll do things you would n er dream be zoould do in a million years. The things he's done wrong in the past have always started with this drug." -Jill Martinez, mother of Eian Martinez try to bring patients into Austin, but the nearby psychiatric wards are frequently full, Kidd said. "That was the nearest facility that had room," Kidd said. "The challenge is finding a bed for them." In 1996, Texas had 2,800 beds in state mental hospitals to serve a population of about 19 million. Today, as the population approaches 25 mil- lion, the available beds have declined to 2,400. "Just about every community center in Texas has a waiting list," said Gyl Switzer, public policy director for the non-profit Mental Health America of Texas. Currently, there are about 10,000 individuals on wait lists for commu- nity mental health centers, Switzer said, but added that true tmmet need is likely far greater. Many individuals might not sign up for services when they learn they could sit on the wait list for many months, while others might be receiving a low level of out- patient services, though their situa- tion is catastrophic enough to require a full hospitalization. For those who don't get neces- sary mental health care, the chances increase that they'll cross paths with law enforcement. But in light of the current budget crisis, limited resourc- es are likely to grow even scarcer. That worries Hays County Sheriff Gary Curler. "First of all, a jail is not a place for an emotionally disturbed person," Cutler said. Currently, the Hays County Jail has one doctor on staff to screen patients for mental illness; a new program called Continuity of Care Quality flags prisoners that have previously been treated for mental health issues. The county also works with groups like Hill Country MHMR and its Scheib Mental Health Center. But Cutler said that he and many law enforcement leaders across the state worry that budget cuts will mean fewer beds in facilities like Scheib, meaning more mentally ill patients in county lock-up. "More people could end up in local jarls throughout Texas, andis that re- ally where they need to be? No it's not. They need specialized help," Cutler said. Current budget proposals could cut more than $1 billion from commu- nity-based mental health programs, eliminating some and drastically reducing others. The state cur- rendy spends just $36 per resident on mental health care, compared to the nation-wide average of $100. Critics say it's an approach that's penny-wise but pound-foolish, as many of those who don't receive treatment eventu- ally wind up getting mental health care through the emergency room or the prison system. Currently, out of the State's 156,000 inmates, about 22,000 of them are re- ceiving mental health treatment, said Texas Department of Criminal JustiCe spokesperson Michelle Lyons. "When we see people that have mental health issues we try to get them help, but as far as law enforce- ment is concerned, we can only force that action if they're a danger to themselves or somebody else," Kidd said. "They can be delusional, they can have a whole host of problems, but there's just not a whole lot ofre- sources out there to get them help." Kidd recalls one success story: an elderly Buda man recently began act- ing in an unstable manner, leading to several police calls for odd behavior. Though he had money, he eventually broke into a Goodwill store and stole a pair of second-hand pants. Kidd said he and his officers recognized signs of mental illness and were able to coordinate with the county and the man's family to get him help; the criminal charges were later dropped. "Because he was a veteran, they were able to get him to aVA hospital and now he's the nicest guyin the world again," Kidd said. "Since he got back from theVA hospital and got medicated, we have not had a single call about him." COURTESY PHOTO :i Elan Martinez started showing signs of mental illness in childhood. But for many others in similar situ- ations, their next stop is the county lock-up. 'HE COULD HAVE BEEN GET'rING HELP' After his arrest, Martinez was charged with assault on a public servant and unlawful possession of a weapon, both third degree felonies; resisting arrest, a Class A misdemean- or; possession of a controlled sub- stance, a state jail felony; and theft, a class C misdemeanor, and landed in jail with bail set at nearly $100,000. His mother let him stay there. "I figured, why risk him getting in trouble again?" Martinez said. 'Tdso, he was getting his time done." The assaulted deputy did not require medical attention. But as the daughter of a 30-year police veteran, Martinez said she was "devastated" to learn that her son had assaulted a law enforcement officer, and knew he would have to take his due punish- ment. However, she hoped that the criminal justice system would also recognize that he needed help. While he was waiting trial in the Hays County Jail, he was kept on a slew of medication: Buspirone, Oxcar- bazepine, Lithium Carbonate, Ben- ztropine Mesylate, Buprenorphine, Seroquel, Zyprexa, Sertraiine, and more. The heavy medication turned him into a zombie, Martinez said. "When he was in Hays County, if you ask me, they just wanted to keep him quiet," she said. Martinez found an attorney who specialized in mental health cases, and located a two-year in-patient program that the judge could approve in lieu of jail time. "He could have been getting help, instead of this," Martinez said. "I just thought that if he would have gotten that two-year program it may have made a difference in his life. Why wouldn't you want to give him a try and see if this program would help him, instead of him going to prison and learning how to be a better crimi- nal?" In October, Martinez pied guilty to assault on a public servant and was sentenced to two years in prison, with seven months of back-time already served. In December, the state trans- ferred him to the Jester IV psychiatric unit, where he remained for two months, before moving him to the Byrd Unit, a temporary facility where inmates are evaluated to see what services they need. He's received therapy and psychi- atric care in jail, for which Martinez is grateful, but she worries that her son will end up in the general prison population where fewer mental health services will be available. While he was incarcerated, his girlfriend gave birth to their baby girl. When he's released from pris- on later this year, Martinez plans to live with his fianc~ and daughter in San Antonio. His mother hopes that his fianc6's nursing back- ground will help her cope with Eian's illness. "He wants to go to church," Marti- nez said. "Right now, in jail, he can get close to God. I said, ']ust don't leave him behind when you walk out that door, because there's a lot of tempta- tions out here.'" She also plans to get him back on social security so he can access therapy and psychiatric care, but she's worried that the state budget crisis will make it hard to find him help. "I know there's cuts that need to be made, but when it comes to mental health it might help society a little bit if they took better care of people," Martinez said. If things don't work out in his rela- tionship and if he can't get the treat- ment that he needs, Martinez knows that she'll probably be caring for her son for the rest of her life. "I see these people on the street, and some are crazy and some aren't, but I don't want that to be my son,' Martinez said. "That's why I can't kick him out of the house. It's not like he's doing this purposefully. He does have a problem. I can't see him on the street comer as long as I'm alive." +