513 – Mental Health Diversion Center

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The Issue

Diverting individuals with serious mental illnesses, developmental disabilities, neurocognitive disorders and substance abuse from incarceration into treatment is one of the most important issues facing criminal justice today. Harris County’s jail diversion efforts started with the opening of the NeuroPsychiatric Center (NPC) in 1999. The NPC is a facility for individuals in mental health crisis. Over 100,000 individuals have been brought to the NPC by law enforcement since the facility’s opening. Many of these individuals would have been booked into jail if the NPC did not exist.

The Houston Recovery Center (Sobering Center) opened in May 2013. Individuals with alcohol and substance use issues may be diverted from jail to the Sobering Center. In 2010, the Houston Police Department arrested and incarcerated over 20,000 individuals for public intoxication. That number dropped to 835 in 2017. An astonishing 96% decrease in the number of arrests for public intoxication.

In September 2018, the Judge Ed Emmett Mental Health Diversion Center (hereinafter referred to as The Diversion Center) will open. This is the third facility in Harris County’s jail diversion strategy. The Diversion Center offers alternatives to incarceration for people with mental illness, developmental disabilities or neurocognitive disorders who come into contact with the criminal justice system for low level offenses. [CALEA Standard 1.1.3]

Incorporated into the new Joint Processing Center (JPC) is a Triage/Diversion Desk. This is the fourth component in Harris County’s jail diversion strategy. Deputies in the field may call the Triage/Diversion Desk for a check on the mental health history of suspects in custody for committing a low level offense when the deputy believes the suspect has psychosocial issues that are related to the commission of the crime.

Jail diversion specialists at the Triage/Diversion Desk will advise the deputy if the suspect is an appropriate candidate for jail diversion. HIPAA laws prevent the jail diversion specialists from providing law enforcement personnel with the suspect’s specific mental health history.

Additionally, the intake process of the JPC will identify suspects who may meet criteria for diversion.

These suspects will be directed to the Triage/Diversion Desk where the jail diversion specialist will conduct a quick check of the suspects’ mental health history and may conduct a brief assessment to determine if the suspects are candidates for diversion

Examples of specific issues related to the incarceration of individuals with mental illness and the need for jail diversion include the following:

  1. Mentally ill inmates are incarcerated longer. Overall, Harris County inmates average 31 days in jail. Mentally ill offenders average 110 days.
  2. Mentally ill inmates cost more than other prisoners.

In Harris County, it costs:

  1. $57 a day to house an inmate in general population,
  2. $67 a day to house an inmate in general population receiving psychotropic medication, and
  3. $232 a day to house an inmate in the Jail Mental Health Unit.

A high percentage of inmates have mental health problems. In 2016, 4,585 persons were arrested and placed in the Harris County Jail for trespassing. Of these, 2,390 (53%) were identified as having a mental health issue.

Inmates requiring an evaluation or restoration of competency experience longer incarcerations. In Harris County, between March 2016 and March 2017, there were 170 cases in which a defendant was charged with Class B trespassing and was incompetent and legally unable to proceed. Those defendants spent 11,785 days in jail.

Every day that one of those defendants was in a state hospital Harris County was charged $450.

One hundred and two defendants were sent to a state hospital for an average of 60 days each.

The cost to Harris County was $2,754,000.

The remaining 11,333 days were spent at the Harris County Jail at a cost of $285 per day, for a cost of $3,229,905.

Definitions

Active Aggression: A threat or overt act of an assault (through physical or verbal means) coupled with the present ability to carry out the threat or assault that reasonably indicates that an assault or injury to any person is imminent.

Developmental Disabilities: Severe and chronic disability that is attributable to a mental or physical impairment that begins before an individual reaches adulthood. These disabilities include intellectual disability, cerebral palsy, epilepsy, autism, and disabling conditions closely related to intellectual disability or requiring similar treatment.

Health Insurance Portability and Accountability Act (HIPAA): HIPAA was passed by Congress in 1996. Among other requirements, HIPAA requires the protection and confidential handling of protected health information.

Houston Recovery Center (Sobering Center): Facility utilized by law enforcement personnel for the diversion of individuals who are intoxicated. Provides treatment and long term recovery to people with substance use issues.

Judge Ed Emmett Mental Health Diversion Center: A pre-arrest/pre-charge alternative to incarceration for individuals with a mental illness, developmental disability or neurocognitive disorder who have committed non-violent, low level offenses.

Neurocognitive Disorder: A general term that describes decreased mental function due to a medical disease other than a psychiatric illness. It replaces the term “dementia” in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

NeuroPsychiatric Center: A comprehensive psychiatric facility for individuals in serious mental health crisis.

Serious Mental Illness: Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, Major Depression, Brief Psychotic Disorder.

Triage/Diversion Desk: Desk located in the Intake area of the new Harris County Joint Processing Center (JPC).

  1. Staffed 24/7 by behavioral health jail diversion specialists from The Harris Center for Mental Health and IDD.
  2. Contains a law enforcement hotline for deputies/officers in the field who want to check on the mental health history of an individual in custody for committing an offense.
  3. The jail diversion specialists at the desk also check the mental health history of offenders brought to the JPC who have committed low level offenses and who are flagged as having mental illness, developmental disabilities, and/or neurocognitive disorders.

Policy

When circumstances meet the criteria outlined in this policy, deputies should divert suspects in the target population to The Diversion Center.

Target Population

The target population is defined as suspects who have committed low level offenses and who have mental illness, developmental disabilities, and/or neurocognitive disorders that are believed to be contributing factors to the offense. Examples include the following:

  1. Trespassing because they are homeless, mentally ill, and need a place to sleep.
  2. Trespassing because they are mentally ill and fixated on a location.
  3. Shoplifting because they have a neurocognitive disorder (dementia) and are not aware of their criminal behavior.
  4. Disturbance because they are autistic and have a verbal outburst and are displaying aggressive behavior due to sensory dysfunction.

Persons Not Eligible for The Diversion Center

The following persons are not eligible to be transported to The Diversion Center:

  1. Individuals less than 18 years of age.
  2. Individuals who are unconscious, bleeding from a head injury, or experiencing a serious medical condition.
  3. Individuals displaying active aggression.
  4. Individuals meeting the criteria for an emergency detention. These individuals shall be transported to the NeuroPsychiatric Center or hospital emergency department.
  5. Individuals who cannot be identified.
    • Deputies should use the department’s computer system, mobile computing device, etc. to confirm the validity of the personal information provided by the person in custody.
    • Individuals without satisfactory identification, but known to the deputy, may be transported to The Diversion Center based on the deputy’s familiarity with the individual.
  6. Individuals with a warrant.
  7. Individuals suspected of driving under the influence of alcohol or other drugs.
  8. Individuals arrested for the offense of public intoxication with no apparent mental health issues will be transported to the Sobering Center.
  9. Individuals with an Immigration and Customs Enforcement detainer.

Procedures for Diversion From the Field

The suspect is being detained for a low level offense, is not in crisis and does not meet the criteria for emergency detention, but appears in need of psychosocial services and the offense appears to be a result of a possible mental illness, developmental disability, or neurocognitive disorder:

  1. Call the Triage/Diversion Desk at 346-286-1299 to determine if the suspect in custody has a mental health history and is a candidate for diversion.
  2. No Mental Health History: Advise the complainant the suspect does not have a mental health history but appears to be in need of psychosocial services (food, clothing, hygiene, mental health treatment, etc.). Discuss charging options including the option to transport the suspect to The Diversion Center to receive services.
  3. Mental Health History: Advise complainant the suspect has a mental health history (do not provide specifics). Discuss charging options to include the transportation of the suspect to The Diversion Center to receive services.

Call DA Intake and inform the ADA of the totality of the circumstances including mental health status and history (from desk), investigation, etc. The goal is to give the ADA as much information as possible to make an appropriate charging decision.

  1. Charges Accepted: Transport to JPC for processing
  2. Charges Denied: Transport to The Diversion Center.

Procedures for Diversion at the Joint Processing Center (JPC)

The suspect has been arrested for a low level offense but no psychosocial issues are apparent to the deputy.

  1. The suspect is taken to the JPC.
  2. The suspect’s mental health status will be checked at four points during the intake process.

If the suspect does have a mental health/psychosocial history, and if the suspect meets the criteria for possible diversion, the deputy will be directed to take his suspect to the Triage/Diversion Desk. The jail diversion specialist will conduct a brief review of the suspect’s history and may conduct a brief assessment. The suspect is:

  1. Not a Candidate for Diversion: Proceed to book into the JPC.
  2. A Candidate for Diversion: Advise complainant (if available) suspect has a mental health history and is a candidate for diversion.

Discuss charging options to include the transportation of the suspect to The Diversion Center to receive services.

Call DA Intake and inform the ADA of the totality of the circumstances including mental health status and history (from desk), investigation, etc.

The goal is to give the ADA as much information as possible to make an appropriate charging decision.

If charges are denied, transport to The Diversion Center.

The Diversion Center

Location

The Diversion Center is located at 1215 Dennis Street, Houston, TX 77004.

Search and Transport

When transporting individuals to The Diversion Center, deputies shall handcuff, search, and transport them in the same manner as prisoners.

If the individual is found to be in possession of illegal weapons, illegal narcotics, or contraband, deputies shall contact the District Attorney’s Office and seek appropriate charges.

Deputies shall tag all firearms, illegal weapons, illegal narcotics, and contraband according to department policy and complete an incident report.

Property

The Diversion Center personnel shall be responsible for the inventory, safekeeping, and return of all property to individuals processed through The Diversion Center.

Medical Screening

All individuals transported to The Diversion Center will be subject to a brief medical evaluation.

If medical issues are present that are beyond the scope of the center’s services, The Diversion Center personnel will assume custody of the individual and arrange for medical transportation.

Deputies will not be required to wait while medical transportation is arranged.

If the person goes into mental health crisis, The Diversion Center personnel will assume custody of the individual and arrange for transportation.

NOTE: Deputies will not be required to wait while transportation is arranged.

Documentation

Officers utilizing The Diversion Center shall complete the Center’s one-page Jail Diversion Form.

Deputies shall make an incident report on all individuals taken to The Diversion Center.

Document the name of the person at The Diversion Center who took custody of the person being diverted.

Security

On-duty deputies from the Harris County Sheriff’s Office (HCSO) will provide security for the facility 24/7.

All incidents occurring on the premises of the Diversion Center requiring an incident report will be completed by the on-duty deputies assigned to the center.

Revision

This policy has been revised on the below listed dates:

August 31, 2018

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