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Tarrant County mental health: 'We need to do better'

Fort Worth Star-Telegram - 2/28/2018

Feb. 28--A report presented on Tuesday offers a partial solution for the lack of psychiatric beds in Tarrant County -- if it can get funded.

The report on John Peter Smith Hospital and Tarrant County's health needs by the Citizens Blue Ribbon Committee had this key mental health recommendation: a new behavioral health facility with 298 beds. Now, JPS has 132 beds, with just 96 on site. The Tarrant County Commissioners Court established the committee back in December 2016.

The committee not only met with local stakeholders, but toured the JPS Hospital facilities -- including the infamous 10th floor, which houses the hospital's behavioral health ward. The committee consistently saw dedicated staff operating in substandard facilities, said co-chair Lorraine Miller.

"We had to wait when they were bringing a prisoner in with handcuffs -- we had to wait in a holding cell," Miller said of her visit to the 10th floor. "It was alarming to see what people have to endure to get psychological services."

The committee followed the route behavioral health patients take: down the elevator from the 10th floor, across a dark underground tunnel and back up to the hospital's Trinity Springs Pavilion. Miller's co-chair, Randy Moresi, said he might like to return to the tunnel -- in the event of a tornado.

Among the other recommendations are a new patient tower and four new community health centers. But what the committee heard again and again, said Moresi, was the need for better behavioral health care.

"We need to do better," Miller repeated. Miller previously served as clerk of the U.S. House of Representatives and was interim president and CEO of the NAACP. "You can't piecemeal it. Piecemeal isn't working, especially when you have a million more people who will need these services."

But voters -- and hospital board members -- haven't liked that idea in the past.

Back in 2015, a proposal that included a five-story psychiatric hospital for JPS was shot down.

Why?

A price tag of $809 million.

Warren Norred -- a member of JPS's board of managers and an Arlington lawyer who serves as a GOP precinct chair and points out on his LinkedIn page that as a native-born citizen over 35 years of age he is a potential candidate for president -- raised similar objections.

He objected to the idea that patients had a "right" to a private room, questioned the bed numbers the committee arrived at and talking points Miller and Moresi used and reminded the committee the hospital's charge was to serve the indigent -- nothing more.

"I don't like when we say we match the private hospitals," he said.

The committee was not charged with price tagging its capital projects (and, quipped Moresi, a former hospital CEO, actively avoided it).

"I know the environment we live in -- which is don't go there, don't raise taxes." He chuckled. "And I'm one of those people. But sometimes, you've gotta raise taxes."

County Commissioner Roy Charles Brooks preferred to put that conversation off until they'd explored every other avenue of financing. "Let's leave the t-word to the side for now," he suggested.

While the need for additional psychiatric beds isn't new, the Blue Ribbon Commission looked at the problem through impending population growth. Over the next 20 years, Tarrant County is expected to grow by 46 percent--up from 2 million in 2017 to 2.9 million in 2037.

The 298 bed proposal wouldn't even be meeting 100 percent of the county's needs. To meet the population needs, JPS would need to add 1,032 beds in 20 years, according to consultants. But the committee knew that even half that goal was unfeasible.

The Commissioner's Court plans to meet with the hospital's board of managers and have a plan about what parts of the report they plan to move forward with -- and how to finance them -- by mid-August.

Had experience with the mental health care system in Texas? Email reporter Sarah Smith at ssmith@star-telegram.com

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