City and county join forces for mental health diversion center plan

The words of Travis County Judge Andy Brown reflect the disturbing reality that, right now, the county jail is the largest mental health facility in the county for people who have needs that would be better addressed with other resources, instead of the extended suffering of incarceration.

“Providing people with the services they need – from mental health to housing – can’t be done in a jail,” Brown said. “For that we need a separate facility, a separate atmosphere that focuses on helping a person get stabilized, not on the punishment side of the criminal justice system.”

City Council voted unanimously April 13 to move forward with developing a funding and design plan for the Travis County Diversion Center that was approved by the county on March 21. The diversion center is among the five key recommendations made after a 10-month-long forensic mental health project conducted by Dell Medical School. 

City Council members heard from a variety of community leaders who expressed their support for diversion in the county and discussed the financial resources necessary for a partnership between mental health diversion services and a bridge housing program. 

Council Member Natasha Harper-Madison spoke about the connection she’s observed in her district between the lack of mental health resources and the housing problem.

“Urban renewal, or as some folks call it, ‘urban removal,’ has accounted for dozens of housing projects being torn down and never rebuilt,” Harper-Madison said. “And then during the era where we tore down all the state facilities for mental health and rehabilitation – where do those people go? They live on our streets, and are being pushed into the woods.”

She described the program as part of a broader rallying cry for institutions in which people can safely be treated, rather than punished in jail.

“As a society, we need to have more spaces for people who may not be able to take care of themselves,” she said.

Bill Brice, of the Downtown Austin Alliance, said the diversion center is, simply put, “good public policy,” not only for the people it serves but for public safety citywide.

“Today, people with behavioral health issues who become engaged in the criminal justice system are released back into the streets, quickly reoffend and enter a cycle of reoffending, arrest, release, repeat,” Brice said.

Council Member Zo Qadri echoed the sentiment that “the jail should not be the largest mental health facility in our community.”

“We need to do better by our unhoused folks,” Qadri said. “And while the Housing First approach is a good first step, if we’re not getting them the mental health and substance use help that they deserve and need, we’re not really helping them.”

“We’re a big city now,” said Andrea Brauer, with Central Presbyterian Church downtown. “We have big-city problems and we need a big-city solution and big-city resources.”

With the vote by Council members, the city joined Travis County in an effort that the Commissioners Court officially approved the month prior.

Brown said he has been studying models of success in other cities around the country. Last week, he and his team visited the diversion facility in Miami, where they spent two days attending seminars and reviewing how they developed their system.

“We have asked them to come here from Miami in June to help us develop our program,” Brown told the Austin Monitor. “We’ll continue working with them to look at the services we have planned and figure out what we’re missing and what our next steps should be. The second part is the actual building of the Travis County Diversion Center, a process which we’ve directed to county staff.”

He pointed to Nashville, Tenn., as another example of success, where a person who is arrested is screened to see if they qualify for the mental health diversion center. If so, a psychiatrist determines how long they spend in the facility, which averages 14 days. Their charges are then expunged and they’re placed in some sort of housing.

Nashville’s diversion program has reduced the city’s recidivism by a whopping 70 percent.

“Their diversion program has a policy that prohibits returning anybody to these streets with an unhoused situation,” Brown said.

The return to a stable living situation is extremely important to many advocates who spoke at the City Council meeting.

Quiana Fisher, director of Homelessness Response System Strategy at the Ending Community Homelessness Coalition (ECHO), said she’d like the county to prioritize the ability to provide a sufficient amount of time to people in the program in order to ensure they are being connected to all of the various services they need for a successful reintegration into the community. 

“Once they are in the program we want to make sure that people are not exited without their will without all of their various needs (mental, health, housing, etc.) being addressed. The time they are allotted is important because it will allow those participating to really connect with case managers and peer support specialists to create a comprehensive treatment plan,” she told the Austin Monitor.

Fisher also recommended that the diversion program engage with the people who are actually experiencing homelessness to incorporate their feedback on the services they need from this program – noting that ECHO has been successful in using this strategy over the last couple of years. 

She said she liked the idea of the county collaborating with not only mental health services but also with homeless intervention organizations, in order to make the pilot program effective.

According to Brown, the biggest challenge at this point is funding the diversion center. He said other states with successful diversion centers have opted into Medicaid expansion to take advantage of federal aid to pay for nearly 80 percent of their facilities.

“We don’t have that same opportunity in Texas because, for reasons I don’t understand, our statewide leadership has not opted to expand Medicaid.”

Instead, Brown said, the county is having to piece together resources by applying for a bond to build the facility, and then seeking ongoing funding through partnerships, including with Central Health and Integral Care.

Now that the resolution has been approved by City Council, county staff has until Sept. 1 to identify sustainable funding options for the pilot program and provide recommendations for a program design and construction plan. 

“I think as a community we’ve been trying to move to a space where we’re bringing the right resources to the right person at the right time. The next step is to not only think about what the best quality of care looks like, but the most effective solution from a cost and resource perspective,” said Council Member Allison Alter. “I’m really looking forward to seeing where this collaborative conversation as a community and city can go with respect to mental health diversion.”

Photo by Denise Chan, CC BY-SA 2.0, via Wikimedia Commons. This story has been changed since publication to correct a misspelling.

Editor’s Note: Andy Brown is on the board of the Capital of Texas Media Foundation, the parent nonprofit of the Austin Monitor.

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