When Doug McSwane’s son Patrick died by suicide in 2012, it triggered a need to turn tragedy into service.

In 2014, McSwane helped organize a mental health awareness conference featuring powerful testimonies of clergy, psychologists and advocates.

Peace of Mind Tyler aimed to get people talking in a transparent way that hadn’t been done before in East Texas. Last fall, the conference returned with just as much interest and fervor.

McSwane, with the help of Samaritan Counseling Center of Tyler Executive Director Fonda Latham, began mulling ways to put talk to action.

The Smith County Behavioral Health Leadership Team was born. The group gathered for its first meeting in June, with more than 20 people attending.

“In the aftermath of the first Peace of Mind Conference, it became a movement for all the stakeholders in the mental health field to come together in a collaborative effort to see what we could do to improve the delivery of the behavioral health services,” McSwane said.

“One of the things that BHLT is trying to do is figure out where there are gaps and how we can improve it. It’s not going to happen overnight. It’s the first time a collaborative group has come together.”

McSwane had been working with Meadows Mental Health Policy Institute, a nonprofit organization that helps communities implement policies and programs to improve the access and delivery of mental health services.

“We help communities look at gaps and priorities to bring about local change,” said Thomas Luce, board member and former chief executive officer at Meadows.

The Institute has worked with others to establish similar teams, including in Denton and Brazos counties.

 

FORMING THE MOVEMENT

Ms. Latham calls the forming of the group an evolution. Members knew they needed to do something different in Smith County to improve mental health services, but what that would ultimately look like still is formulating.

While they have defined goals and established bylaws, the leadership team isn’t as formal as a typical nonprofit organization. They hope to address the most pressing needs of those having an acute mental health crisis, but the group also intends to focus on crisis prevention and awareness.

There is no board of directors and they recruit specific people – such as hospital, law enforcement, mental health and elected officials – who represent constituencies in the community.

McSwane and Ms. Latham are leading the efforts as co-chairmen.

The group’s efforts not only focus on mental health, but also addiction and substance abuse, which is a common dual diagnosis.

They hope to establish a crisis stabilization unit, which addresses the immediate needs of a person going through a crisis.

It’s important because many going through a crisis will enter jail or prison, exacerbating their mental illness, creating restrictions that make it more difficult to function in society.

“It’s not effective for the individuals who are having a crisis,” Ms. Latham said. “It’s not effective for their family members, and it’s not effective for the systems that are involved. What we’re doing now, it’s not effective, and it’s costly in lives, and it’s costly in dollars and cents being spent to keep people in jail who really should be getting treated in another way. Everybody knows it, but this is what the system allows for right now.”

 

SEEKING SUPPORT

The Smith County Behavioral Health Leadership Team’s main task now is to review or perform new assessments to identify priorities. At a most recent meeting Tuesday, they voted to create resolutions asking for support from Tyler’s City Council and the Smith County Commissioners Court.

Among the team’s possible solutions include nudging the county to establish an assisted outpatient treatment court. Similar programs have worked in other cities such as San Antonio. The program identifies residents with serious mental illness who may be going in and out of the judicial system or who have frequent mental health crises. The court then orders them into a treatment program.

The value of the leadership team, Ms. Latham said, is to urge policy change quicker than an individual person or entity could.

“By the behavioral health leadership team becoming an entity, if and when we revisit the assisted outpatient courts, it would be the whole saying ‘now is the time for this to happen,’ she said. “At that point, I expect it would be well received.”

The influence, Ms. Latham said, can also attract those who may fund projects to fill in gaps left open from a lack of state funding. The group reached out to Houston-based Episcopal Health Foundation, applying for a grant that would fund a project manager to lead an initiative. The Meadows has been providing consulting services.

“The Episcopal Health Foundation or the Meadows aren’t going to fix our problems in this community financially, but they might help us fund necessary pieces until we can get it going.”

 

PAYING FOR CARE

Mental health funding is low statewide. Expenses for counties may include matching funds to mental health authorities, direct services, processing emergency detention warrants, providing public offenders, transporting patients to inpatient facilities, and providing medications and other services in jails.

Texas was ranked 49th for mental health spending in 2010 and bumped up to 48th for 2013, according to the Henry J. Kaiser Family Foundation data. In 2013, the state spent $40.65 per capita, compared to Maine’s $345.36. So, few funds make it to East Texas.

According to a 2014 report by East Texas Council of Governments and Morningside Research and Consulting, Smith County spent $149,013 on mental health in fiscal year 2012, which included an $85,000 match to the local mental health authority.

Some smaller counties had larger expenditures, such as Cherokee County, which spent more than $159,000 and Harrison County, which spent more than $193,000 on mental health. Gregg County spent more than $1 million on mental health services. Collectively, a 14-county area served by the East Texas Council of Governments spent $2.3 million of county resources on addressing behavioral health needs. The report does note, however, that these costs may be underreported, as some counties don’t track some of the mental health expenses incurred.

The report found that state funding for the four local mental health authorities in the region, which includes the Andrews Center, is not sufficient to meet the needs of residents here.

 

 Twitter: @cdillard_TMT