Tuesday, May 18, 2010

Veterans' mental health needs moved to the forefront


Veronica Flores-Paniagua - Web Posted: 05/18/2010 12:00 CDT

How does Bexar County go from the backwater to the forefront of mental health services for veterans?


In one fell swoop.

With last week's green light from District Attorney Susan Reed to develop a pretrial jail diversion program for certain combat-affected veterans, the county has a unique opportunity to lead the pack on mental health care.

In what some regard as a too-low-under-the-radar move, the Center for Health Care Services is developing a grant-funded program to offer post-conviction jail diversion and treatment to veterans with trauma-related mental health needs. According to Aaron Diaz, director of crisis and diversion services for CHCS, the state recognized Bexar County for its effective mental-health and substance-abuse jail diversion programs and sought it as a pilot for the veteran-focused services.

The grant, from the federal Substance Abuse and Mental Health Services Administration, is an annual renewable award of $394,000 to the CHCS. The program covers a five-year period from fiscal year 2010 to 2014 and would serve about 120 veterans annually.

Diaz said CHCS should be ready to start screening arrestees in about two months, and county officials are fine-tuning the adjudication process.

If the pattern seen in the county's drug and mental health courts is any indication, the combination of a pretrial veterans court programand post-conviction services targeting veterans holds great promise for addressing the root causes of mental illness among this group.

The recidivism rate among those who've been processed through one of the county's three drug courts is 8 percent. In the newer mental health court, in place for two years, recidivism rates among the 108 people who've been served is about 25 percent.

Not impressed? Consider that the recidivism rate for the total jail population is 80 percent.

Reflection on the trends in these courts is essential because there are parallels to the experiences of mentally ill veterans in the criminal justice system. An estimated 60 percent of incarcerated veterans have a substance dependency and nearly 30 percent have a serious mental illness. In most cases (70 percent), the incarcerated veterans are doing time for nonviolent crimes.

After months of lobbying Reed to drop her opposition to a pretrial jail diversion program for veterans who have a mental illness or traumatic brain injury tied to hazardous duty, now there is momentum. Last week, Reed's office agreed to be part of a hybrid pretrial and post-conviction program targeting veterans. The pretrial element will apply only to veterans acutely affected by hazardous duty who are accused of “low-level” misdemeanors.


Reed's approval “was imperative, and we're very happy that happened,” Diaz said.

There still are some valid fiscal concerns for county lawmakers going forward. The courts and adult probation department, for instance, won't share in the grant funding to support the veteran-focused efforts.

For now, though, there's an uncommon opportunity to make a difference in the lives of mentally ill veterans. Let's seize it.

About Me

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Serves as the Director for Bexar County's new Mental Health Department created in December of 2013 by Commissioners Court. Previously he was the Director of Communications and Diversion Initiatives,The Center for Healthcare Services, Mental Health Authority. • Gilbert Gonzales has more than 29 years of experience in the field of substance abuse and mental health crisis prevention and in treatment provision as a clinician, university faculty member, project/program director and policy advisor. Gilbert Gonzales has led strategic planning, treatment, training and policy development. He continues to lead new systems initiatives that help mental health and substance abuse service providers promote collaboration and build service capacity in support of diverse populations.