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By keeping a constant eye on its mentally ill clients, an ACT team heads off all sorts of troubles

By Brian Wallstin 

Chris doesn't recall much of what happened that day in December 1996, when he was arrested for aggravated assault with a deadly weapon.

"I can't say it happened, or it didn't happen," he says. "I think I'd had a 12-pack of beer and a bottle of wine."

Apparently Chris had viciously cursed and threatened a neighbor at his Pasadena apartment complex. Forewarned and frightened, the man called police. When officers came to his door, Chris vaguely remembers, he told them to get a warrant or go to hell. Then he went to bed.

The apartment manager notified Chris's mother that trouble was brewing. She arrived to find a dozen or more officers, some outfitted for riot-control duty, setting up a command post in the parking lot. Helicopters buzzed overhead. Television news crews were on the scene, reporting the story that an armed madman had barricaded himself in his apartment.

"The police knew he had mental problems, but I could have got him out of there. His sister could have got him out of there," says Chris's mother. "They didn't need to go to all the trouble they did."

A small battalion of officers eventually stormed the apartment. They arrested Chris and took him to Harris County Jail in his boxer shorts. In the kitchen, police found a small knife that Chris apparently had brandished at his neighbor.

In person, it's hard to reconcile Chris with the image of a man so dangerous it took half the police force to bring him in. Well-mannered and eager to please, he's 27 years old now, stocky, with a round, fair-skinned babyface and short strawberry-blond hair. He's taking computer courses at Houston Community College and doing well. He seems happy, and so does his mother, Patricia, a fact they both attribute to Chris's involvement with Harris County's Assertive Community Treatment program.

"If this hadn't happened," Patricia says of ACT, "I'd have buried him or he'd be in the penitentiary for life."

More than 283,000 mentally ill people were incarcerated in the nation's prisons and local jails in 1998, according to the latest figures compiled by the Department of Justice. Another 550,000 were on probation that year. At any one time, between 600 and 800 people are receiving "forensic" psychiatric care in Harris County Jail or have been referred to community clinics, according to the Mental Health and Mental Retardation Authority, which operates the jail's third-floor psychiatric unit. Some seek help while they're incarcerated; others have been identified through the pretrial screening process.

Sometimes a defendant's illness is brought to the court's attention before trial by an attorney. Defendants thought to have a mental illness are evaluated for fitness to stand trial, as well as to determine their state of mind when they allegedly committed their crimes. It's not a daily occurrence in Harris County to have someone found incompetent or not guilty by reason of insanity. But it happens often enough to present "many logistical problems," says George Godwin, the administrative judge for Harris County's criminal courts.

For one thing, MHMRA's third floor is perpetually backed up; the agency is supposed to evaluate an inmate within five days, but that rarely happens. Not long ago Baylor College of Medicine offered to help Godwin and the courts with the evaluations but wanted the sheriff's department to transport defendants to and from the Medical Center.

"Of course, we disabused him of that notion real quick," Godwin says. "I said, 'You just tripled or quadrupled the cost of that right there.' "

Defendants found incompetent or not guilty by reason of insanity typically go to a state hospital for treatment and then are released to be supervised by the sentencing judge. Some judges order the person to outpatient services at MHMRA. However, many don't. Apparently the agency has no mechanism in place to keep track of the former defendant's compliance with the court order, and many of them fall through the cracks until they show up in the criminal justice system again.

The bottom line is "there are probably people who do not need to be there, if we can give them a viable community alternative," Godwin says. "You don't have to be a trained psychiatrist or a psychologist to recognize that."

Sometimes it takes a while, though. After Chris's arrest, he was incarcerated with the county jail's general population. He immediately started brawling with other inmates and was removed to protective custody. Meanwhile, Chris's mother and his lawyer pressed the sheriff's office to have Chris looked at by MHMRA's jail-based clinicians.

Chris was a hyperactive child who started taking Ritalin at age 11. His father, who had divorced his mother, suffered from a mental illness, and by the time Chris was a teenager, he had been admitted to psychiatric hospitals numerous times. In 1987, while at Austin State Hospital, Chris was diagnosed with bipolar disease and schizoaffective disorder, the symptoms of which caused him to spin out of control with mania or withdraw into an almost catatonic daze.

Chris's illness usually was kept in check with medication. But in the fall of 1996, a doctor told him to throw his pills away. "He didn't lower [the dosage] or nothing," Chris recalls. "When I told him I was feeling 'manicky,' he said I was just young and excited. He didn't think I was bipolar."

Off his meds, Chris was arrested four or five times over the course of a few weeks for minor crimes; once, he ate a steak dinner at a Montrose restaurant and was arrested when he couldn't pay for it. Sometimes Chris was picked up by police at his mother's behest -- she had seen him wandering the streets, and his behavior toward her was sometimes frightening. By the time Chris was arrested for aggravated assault, just before Christmas 1996, his mother decided jail might be the best place for her son -- for the time being, anyway.

"He didn't belong there," Patricia says, "but we weren't going to bond him out."

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