Texas state mental hospitals remain full, hundreds still waiting in jail for beds

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AUSTIN (KXAN) – State health officials say they are examining new ways to reduce the number of people in jail waiting for a bed in one of the state’s mental hospitals, which are brimming. They are also looking at how they can discharge long-term hospital patients more quickly to free up space, according to a Texas Health and Human Services committee meeting Wednesday.

Members of the HHSC’s Joint Committee on Access and Forensic Services said at their quarterly meeting that wait times for a state hospital bed remain high, and a near-record number of individuals are still sitting on the waitlist, according to newly-released state data.

People charged with a crime and found incompetent to stand trial in Texas are generally required to go to the state hospital to be mentally “restored,” so they can participate in their defense. But with no spare hospital beds, those individuals are forced to wait months, and in many cases more than a year, for a spot.

The number of people on the waitlist hit an all-time high of 1,508 last December and has hovered near 1,475 since then, according to newly-released HHSC data discussed at the meeting.

The average wait times for both maximum security and non-maximum security hospital beds have remained high. In May, the non-max wait time averaged 153 days, which was down from 204 the month prior.

Also in May, the average wait time for a max-security bed skyrocketed to 510 days, up 57% compared to the previous month. Hospital officials said they would investigate the cause of that jump and if an outlier was the cause.

Officials at the meeting said the ongoing pandemic has worsened the bed shortage problem. The state normally has about 2,240 beds available. COVID has knocked nearly 300 of those offline since April 2020, but 10 beds came back online in May, state records show.

“We are optimistic that if we can get these beds back open we will see some reductions in the waitlist,” said Logan Hopkins, director of data analytics for the state hospital system.

While bringing 300 beds online may help, KXAN reported in a May 2020 investigation called “Locked in Limbo” the waitlist was ticking upward before COVID-19 existed.

In that previous report, KXAN heard the stories of people like Adan Castaneda, who endured the waitlist and spent years cycling through the state hospital system.

Comal County authorities charged Castaneda in 2011 with multiple felonies, including attempted murder, after he shot nearly two dozen bullets at his parents’ house while they were inside. Nobody was injured. Castaneda was found incompetent to stand trial and was stuck in Comal County jail. He spiraled deeper into mental illness as he waited for a state hospital bed. He ultimately spent four years, including two trips to the state hospital, awaiting justice. He was found not guilty on several charges and not guilty by reason of insanity on the others.

Adan described the time looping back and forth between jail and the state hospital as “purgatory.” Following the not-guilty-by-reason-of-insanity verdict, Castaneda was released from custody but will be under court supervision until 2031. He is currently back in San Antonio State Hospital, because he missed a dose of his medication, he said.

At Wednesday’s meeting, state hospital officials said they are trying to understand why there is a growing number of people staying more than a year in state hospitals. That growth “is something that is a concern for us,” said Shelley Smith with the Texas Council of Community Centers in Big Spring and a member of the joint committee.

The committee also said it is probing why individuals found incompetent to stand trial or who are deemed “not restorable” are staying in state hospitals longer than six months, according to committee documents.

“We have in the upwards of 800 people that are, basically, and I’m going to use the word ‘stuck,’ in the state hospital, because they have been deemed ‘unrestorable,’ or they are waiting for some sort of placement that is not available in the community,” Smith said. “Why is it taking longer than 180 days to be restored back to competency? So, we will be looking at the strategies to be able to discharge people and reduce the number of people that are in the hospital unrestorable.”

KXAN previously profiled the case of James McMeans, a man charged with murder in Travis County who was found incompetent to stand trial in 1999. More than two decades later McMeans remains in the state hospital, incompetent to stand trial, with no clear end in sight.

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