A state mental health system in crisis : recommendations to reduce the forensic mental health population in Texas

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2014-08

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The number of forensic psychiatric commitments has drastically increased over the last decade, now surpassing civil commitments in Texas. This uptick is a result in part of two main policy shifts during the middle of the 20th century: deinstitutionalization and over incarceration fueled primarily by the War on Drugs. Although the Community Mental Health Centers Act of 1963 was meant to replace inpatient services, few centers are adequately funded. As highlighted in the news, the combined effect is illustrated in the numbers: 1 million individuals with serious mental health disorders are booked into local jails each year and half of all incarcerated individuals are experiencing a mental health problem of some kind. To address this growing population and to prevent individuals who are criminally court-ordered to receive mental health treatment from lingering in jail for unconstitutional lengths of time, many states including Texas have been forced to find or create new forensic beds, sometimes even building new facilities. This demand for forensic beds has created opportunities for private prison companies to expand into mental health. GEO Group, one of the largest prison corporations in the world, already owns or operates five psychiatric facilities in the U.S., including one in Montgomery County, Texas, before it was acquired by Correct Care Solutions. Much like in the private prison industry, for-profit private corporations have an incentive to continue to grow the forensic psychiatric population, which contradicts best practices regarding treatment for individuals with mental illness taking place in the least restrictive environment. In order to prevent opportunities where states rely on private prison corporations because of cost savings promises, research and advocacy regarding alternatives for states attempting to curb a growing forensic psychiatric population are needed.

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