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Trouble in Mind

Andre Thomas: The Mentally Ill, From Asylums to Jails

Texas has a long and unhappy history when it comes to mental health care. From the days of state-run asylums to underfunded local mental health services, those who have mental illness have faced daunting challenges finding care.

Andre Thomas in a photo taken during his teen years, left. Danny Thomas, Andre Thomas' father, top right. The State Insane Asylum in Austin, bottom right.

Trouble in Mind

Trouble in Mind is a six-part series exploring the intersections of the mental health and criminal justice systems in Texas. It examines the case of Andre Thomas, a death row inmate who began exhibiting signs of mental illness as a boy and committed a brutal triple murder in 2004. Blind because he pulled out both of his eyes while behind bars, Thomas awaits a federal court's decision on whether he is sane enough to be executed. This story is part of a collaboration with Texas Monthly magazine. Read the long-form narrative tale of the Andre Thomas case here.

 More in this series 

SHERMAN, Texas — Wanda Banks remembers Andre Thomas and his brothers from the Sunday school classes she taught at Harmony Baptist Church, a modest brick building that welcomes parishioners with a plaque reminding them it’s a place “Where Everybody is Somebody.”

Sitting in her office behind the church, Banks said she is still troubled by what became of Thomas, who for years manifested signs of mental illness before being convicted and sentenced to death in 2005 for the brutal murders of his estranged wife and her two children — one of whom was his son. (Click here to view an interactive timeline of the case.)

Banks, who would drive Thomas and his brothers in the church bus on Sundays, knew that their mother’s behavior was unusual and that the boys were regularly left to fend for themselves. But as she racked her mind to think of clues she might have missed that could have helped her steer Thomas on a better course, she came up blank.

“I’m part of the village that raised him,” she said. “I feel like I, personally, failed him that I didn’t know.”

It is little consolation to Banks that the region’s mental health system didn’t stand much of a chance for serving Thomas either. 

Texas has a long and pocked history when it comes to mental health care. From the early days of state-run “lunatic asylums” to the current era of underfunded local mental health services, those who have mental illness — adults and children alike — have faced daunting challenges finding sufficient care. Adding to the trouble in more recent years is the uneven distribution of mental health workers, who are nearly nonexistent in the far reaches of rural Texas.

“What you’re really looking at is a failure of the system to provide adequate services,” said Deborah Fowler, deputy director of Texas Appleseed, a nonprofit organization that advocates for criminal justice reform.

State Rep. Garnet Coleman, D-Houston, said that he and other legislators are working to direct more funds to Texas’ mental health care system and develop a more comprehensive approach that reaches low-income families like Thomas’. Recent mass shootings, Coleman said, have spurred lawmakers in both parties to consider ways to improve mental health care.

“I think it requires a comprehensive approach,” Coleman said, “but more funds in the system that exists would be a great start.”

Interactive by Becca Aaronson

"Sold Short"

What amazed Banks about Thomas and his brothers was how well-mannered they were despite an apparent lack of adult supervision.

“I think they kind of got sold short because of a lack of parenting,” Banks said.

Danny Thomas, Andre Thomas' father, left his mother, Rochelle Thomas, when Andre was about 3 years old and was an ephemeral presence in his life. Rochelle Thomas was never officially diagnosed, but in court documents family members and others describe symptoms that indicate she suffered from mental illness. She often walked around the house naked or scantily clad, refusing her sons’ appeals to dress. Relatives said she seemed obsessed with what God told her to do, and they worried about her mental state and transience — trooping the boys back and forth between Texas and Oklahoma. Attempts to find or speak to Rochelle Thomas for this story were unsuccessful; lawyers for Andre Thomas were similarly unsuccessful when they tried to find her to testify at his trial.

Banks and other church members loaned Rochelle Thomas money to pay her bills, but the family’s home still often lacked running water and electricity. Parishioners recall seeing her filling buckets of water from the spigot outside of the church to bathe her boys.

Family members said she rejected offers of help from those who hoped to provide a more stable environment for her sons. But even if she hadn’t, it’s unclear what, if any, mental health care resources might have been available to an indigent single mother in rural Texas.

From Asylum to Community

Texas opened its first mental institution in 1861. The State Lunatic Asylum in Austin was started with $50,000 from the Legislature and admitted 12 patients. By 1961, the system grew to include nine hospitals across the state, and the words “lunatic” and “insane” were removed from the facilities’ names.

Population at the facilities declined in the 1950s and 1960s as societal thought about the role of institutions in psychiatric care changed and the public became outraged at the poor, overcrowded conditions inside them. One study of the institutions in Texas found that male attendants worked 72 hours per week and were paid $90 per month. And elderly patients at the facilities received solely custodial care.

Even after legislators in 1949 adopted reforms to the system, the U.S. Public Health Service reported that no other state fell as far below national psychiatric care standards as Texas did.

In 1955, psychoactive drugs were introduced in the United States, which, along with a national reform movement, drove down the use of mental hospitals. With the help of federal grants, Texas began creating community mental health/mental retardation boards in the 1970s to implement comprehensive community mental health care plans. The state hospital population dropped precipitously, from nearly 15,000 in 1964 to 8,000 in 1975. 

By 2003 there were 41 state-funded local mental health authorities working to plan, develop and coordinate community mental health policies and resources. That year, though, mental health providers in Texas suffered some of the most severe cuts to their resources they had ever endured.

Texas faced a $10 billion budget shortfall in 2003, and Republican state leaders vowed to fix it with cuts. Legislators slashed $400 million from the mental health care budget, The Dallas Morning News reported. The budget for state mental hospitals lost $10 million. Counseling services were eliminated for 50,000 low-income youths in the state’s Children’s Health Insurance Program and 128,000 adults on Medicaid, the joint state-federal health program for the disabled and very poor.

As critics of the cuts predicted, emergency rooms and jails across the state became warehouses for the mentally ill.

In Harris County, the jail population bulged with mentally ill inmates, becoming the largest de facto mental hospital in the state. In February 2011, jail officials reported that 2,400 inmates were taking psychotropic medication. The jail, which had three psychiatrists in 2003, had hired 15 jail psychiatrists and created a special unit with 108 beds for the severely mentally ill by 2011.

Since the cuts of 2003, lawmakers have returned some money to the mental health system, but Texas still ranks 49th nationally in per-capita mental health care expenditures, according to the National Alliance on Mental Illness.

The shortage of mental health care is most pronounced in rural counties, which have a severe lack of mental health professionals. Grayson County, where Thomas lived, had 24 psychology professionals in 2010 to serve more than 120,000 residents. In 2009, 68 percent of Texas counties, including Grayson, were designated by federal officials as having a shortage of mental health professionals.

“There are whole big sections of the state that don’t have a psychiatrist or don’t have a psychologist,” said Lynda Frost, director of planning and programs at the University of Texas at Austin’s Hogg Foundation for Mental Health.

In many communities, the wait to get services from the local mental health authority can be weeks, if not months, said Frost.

State Rep. Cindy Burkett, R-Sunnyvale, has filed House Bill 1023, which would require the creation of a task force to study why there is a shortage of mental health workers and then make recommendations to the Legislature to address the problem.

Coleman, the state representative from Houston, knows firsthand the difficulties Texans encounter when seeking mental health care. When his father died in 1994, he struggled with depression. Twice that summer, the 32-year-old legislator got in his car and drove off, leaving his family without word of his whereabouts for weeks at a time.

“I knew that the next time I’d be dead,” he said.

Coleman had health insurance and found help through an in-patient program in Kansas, where he was diagnosed with bipolar disorder. Now, he is on medication and receives treatment.

That, he said, is what many lawmakers fail to realize: The disease does not go away, and without treatment, it gets more dangerous and more expensive to treat. When lawmakers gutted mental health funding in 2003, Coleman’s voice was among those warning that the result would be emergency rooms and jail cells inundated with mentally ill Texans.

Despite the warnings, Coleman said funding levels today remain below the per-capita spending levels of 2001.

Coleman said the best way to address the state’s mental health care woes is to expand Medicaid under the federal Affordable Care Act. It would make 2 million low-income Texans eligible for mental health care over the next decade. But Gov. Rick Perry, an ardent opponent of “Obamacare,” has vowed Texas will not expand Medicaid to cover poor adults.  

Even if there is not the political will to expand Medicaid, Coleman said he is hopeful that lawmakers would devote dollars to mental health care. Tragedies like the December shooting at a Newtown, Conn., elementary school that left 20 first-graders and six staffers dead, he said, have renewed lawmakers’ focus on mental health care.

When Andre Thomas was growing up, mental health resources were scare. He grew up believing that he heard messages from evil spirits and telling friends that he had to beat the demons in his head that told him to do bad things.

The troubled boy’s run-ins with the law began at age 11. His second suicide attempt came when he was 13, after one of countless times his mother told Thomas she should have aborted him. His father remembered watching his son as he sobbed and sawed with a butcher knife, holding his skinny wrist over his father’s kitchen sink.

“Look, you need to make long cuts down your arm so it will split open if you really want to kill yourself,” Danny Thomas recalled instructing his son, testing the boy’s seriousness. If he really wanted to die, he told the boy in jest, he should throw himself in front of an 18-wheeler on the highway nearby.

Suddenly, Andre dropped the knife, walked out of the house and into a field across the road. He walked like an old man, Danny Thomas recalled.

“It touched me so bad,” he said.

This story is part of a collaboration with Texas Monthly magazine. Read the long-form narrative tale of the Andre Thomas case here.

Coming tomorrow:  In Texas, there are few mechanisms in place to identify and treat youths who suffer from mental illness, particularly in rural communities like the one where Thomas grew up with few resources and little parental guidance. 

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