To the better-known name of Sandra Bland — whose death by apparent suicide in the Waller County Jail this summer sparked national outrage — state Sen. John Whitmire on Tuesday linked three others:

Jesse Jacobs: Galveston County Jail, March 14, 2015;

Hung Do: Houston Police Department Jail, July 23, 2015;

Francisco Vasquez: Williamson County Jail, Aug. 8, 2015.

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All died in custody, and each had a mental health or emotional problem. A collapse in protocols or lack of training played a role in each tragedy, Whitmire noted as he opened a Senate Committee on Criminal Justice hearing on jail standards and mental health.

The committee heard four hours of testimony from policy analysts, law enforcement leaders and state corrections officials about making jails safer, diverting people with mental health problems from the criminal justice system, training staff and helping different branches of government collaborate to make reforms work.

The discussion can’t be put off, said Whitmire, a Houston Democrat who chairs the committee. “You pay now, or you pay later,” he said, adding that “later” could mean with one’s life.

Proposals included revamping jail intake forms so jailers can better assess the mental state of people arrested and booked. Current intake questions are in the yes-or-no format and ask about medical problems, suicidal ideation, military background and more.

In many cases, when the system breaks down, it's in the way jail staff handles how an inmate responds to a question, experts noted. In Bland’s case, one intake form said she reported being suicidal at one point in her life, but another form did not.

Bland was not monitored properly, officials later determined, and was found hanged in her jail cell from an apparent suicide. Now, the Texas Commission on Jail Standards wants to make new intake forms so simple for jail staff that it would be a troubling if they need further training on how to use it, said Brandon Wood, the commission's executive director.

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The new form, which is under review, would keep questions such as “Are you thinking about killing yourself today?” but add specific directions for what a staff member should do depending on how an inmate responds.

“It’s an improvement,” Whitmire said, but “it’s only as good as the person asking the questions. You have to take your time, have people skills.”

That’s where training comes in, which is minimal at best in most jurisdictions – especially in rural Texas, officials said. Wood testified that jailers essentially need a high school diploma or its equivalent and a psychiatric evaluation before starting work. They have up to a year after being hired to receive basic training.

“I can see where that can create some issues,” Whitmire said to Wood.

Diversion, the overwhelmingly preferred treatment for low-level offenders with mental health problems would work best with coordination among mental health authorities, law enforcement, jails and courts, lawmakers said.

If an inmate has a mental health problem, all those entities should work together to move them into treatment as soon as possible, Whitmire said, adding that it shouldn’t be an issue in rural areas where officials likely know each other well and can use that as a benefit to help with seeking treatment.

An all-encompassing plan for treatment also needs to be addressed, lawmakers added. For many people with mental illnesses, homelessness is a hindrance to treatment, senators said.

“How can they take their meds when they have no place to live?” said Sen. Joan Huffman, R–Houston, vice chairwoman of the committee.

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Ultimately, Whitmire said, the state has a responsibility to address this issue because if it denies someone their freedom, there are constitutional responsibilities involved in caring for people in custody.

“A lot of it gets down to attitude and cultural awareness,” Whitmire said. “You have to recognize mental health and emotional problems.”

Sen. Charles Perry, R–Lubbock, injected caution throughout the hearing, warning that the state risks having a knee-jerk reaction to high-profile cases such as Bland's and not seeing that protocol is not the enemy. He asked Wood what ultimately led to Bland's death.

"People not following through, first and foremost," Wood said.

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