Harris County (Houston), Texas

During the booking process at the county-wide inmate processing center, the arrestee is interviewed by booking officers, representatives of pre-trial services, and medical personnel who conduct a mental health screening.  If the individual gives a response to any of the interviewing personnel that would indicate a potential mental health issue(s), the individual is formally referred for an immediate, on-site, psychiatric evaluation. If the individual presents mental health issues such that he or she needs treatment, such mental health treatment—including voluntary administration of psychoactive medication—is instituted by the end of the booking process (the jail contains a 400-bed infirmary).  Daily, all criminal history information on arrestees is merged with county mental health data to generate a “special needs sheet”, which is forwarded electronically by the sheriff’s office to the assigned court.  This information includes prior mental health contacts, history of psychiatric hospitalization, current and prior diagnoses and medication history, as well as whether the defendant is subject to a guardianship.  At the first court appearance—within 24 hours—the court and counsel have access to this information. Similarly, if the individual presents potential mental health issues (for the first time) at the probable cause hearing that is conducted during the booking process, the individual is likewise referred for a psychiatric evaluation.

Mentally ill defendants are placed by sheriff’s department classification into units within the jail based upon acuity, including a psychiatric intensive care unit or medical infirmary unit, when required.

Lubbock County contracts with a mental health authority whose mental health professionals screen every new arrival to the jail. If a person presents a potential mental health issue, and there is no known mental health record for the individual, he or she is referred for a further mental health assessment. Once information from the assessment is gathered, the case and information are forwarded to the courts for assignment; the judge has this information before him or her at the defendant’s first appearance.

A private entity within the public defender’s office assigns cases of individuals who present potential mental health issues to attorneys who have met qualifications to handle mental health cases. In addition, two caseworkers in the private entity assist the defendants with linkages to social services, and assist the appointed attorney in gathering and understanding the defendants' illnesses.