County Attorney V. State, MHMR
Newspaper Tree—May 15th, 2006
El Paso County Attorney Jose Rodriguez filed a lawsuit April 27, and amended May 6, against the state Department of State Health Services and its Commissioner Dr. Eduardo J. Sanchez, the El Paso Psychiatric Center and Executive Director Zulema Carrillo, and El Paso Mental Health and Mental Retardation Center and its CEO Gary Larcenaire.
The lawsuit seeks to force the state to fund and oversee the system of emergency mental health care, which Rodriguez calls in his filing a “failure of the responsible agencies to provide adequate mental health services.”
The lawsuit seeks temporary and permanent injunction, and declaratory relief. An official with the County Attorney’s office said they have requested a hearing for the first week of August. The Defendants have until May 22 to respond to the County Attorney’s filing.
The filing calls the current system of handling people in a mental health crisis a violation of Texas Health and Safety Code 571.
Police are often first responders when someone suffers mental health crisis. “The duty of mental health agencies to provide for the timely care of these individuals in an appropriate environment is the focus of this suit,” states the filing, in Section D, sentence 13.
The next sentence states that El Paso Mental Health and Mental Retardation Center (MHMR) is responsible for screening and assessing a person with a mental health crisis, and that the Texas Department of State Health Services (TDSHS) is responsible for ensuring delivery, and for allocation and oversight of services. After screening and referral by MHMR, admission to the Psychiatric Center, and pending a hearing, a person who is danger to themself or others is temporarily committed to the Psychiatric Center or to a private facility. “This is how the system should work,” states the lawsuit.
In 2005 MHMR initiated a policy of refusing to accept people for screening because of a lack of beds at the Psychiatric Center. At the direction of MHMR, police began to take patients to emergency rooms, states the lawsuit. “Many of the patients have been forced to languish for countless hours or days in emergency rooms where they wait for admission to the Psychiatric Center,” wrote the County Attorney’s office in the lawsuit.
In one case, patient waited for 5 days at Thomason. “The failure of the responsible agencies to provide adequate mental health services in the least restrictive, appropriate environment for consumers is a violation of law that must be remedied by this court,” the lawsuit states.
As background, the lawsuit states: The El Paso Psychiatric Center opened in 1996, with the duty to provide 24-hr emergency services, and inpatient services, and was originally designed for 85 beds; the state took control in 2004; MHMR is the designated mental health authority and serves as the “front door” for inpatient and outpatient services, for which it is required to provide crisis assessment services, then make treatment recommendations and referrals. “Notably, this ‘front door’ is located 3.5 miles from the psychiatric center,” states the lawsuit.
Prior to September, 2005, the budget allocation to MHMR and the Psychiatric Center was 64 beds, and was reduced by eight beds after that, according to the lawsuit. “This inadequate allocation has essentially amounted to the closing of emergency services for the majority of days since September 1, 2005,” states the lawsuit.
The lawsuit seeks: That TDSHS immediately take action to halt the practice of diverting patients presented by law enforcement to local emergency rooms; that TDSHS and MHMR reinstate “by whatever means” the level of service available before Sept 1, 2005; that MHMR provide “appropriate and timely emergency screening and assessment and referral”; that MHMR and the Psychiatric Center cease diverting law enforcement with mentally ill persons in their custody to emergency rooms; That MHMR provide physician services within 24 hours; and that people be admitted to the Psychiatric Center within 24 hours.
It also asks for a declaratory judgment that the “practices engaged in by the named Defendants are illegal,” and that the defendants are legally obligated to provide mental health services in this region.
Newspaper Tree presents the May 6 Amended Petition as a matter of public record.
