In the wake of the hanging death of Sandra Bland and other recent suicides, the state agency that oversees jails is issuing a new inmate intake form so jailers will ask more specific, direct questions when booking people.
Bland was found dead on July 13, and an autopsy concluded she committed suicide. On one of two intake forms at the Waller County Jail, Bland indicated that she had suicidal thoughts. The screening form gauges the risk of inmate suicide and helps identify medical and mental impairments.
The jail's failure to monitor her as a suicide risk drew ire from activists and prompted lawmakers to seek improvements in jail screening.
Changing the standard jail intake form — which is supposed to be filled out immediately after an inmate is admitted — was the low-hanging fruit for lawmakers who have summoned experts, academics and state officials over the last three months to demand answers.
The Texas Commission on Jail Standards is changing the intake form and expects the new ones to be in use by December.
The previous form asked inmates to self-report medical problems, mental health histories or intellectual disabilities and indicate if they felt depressed or suicidal, among other inquiries.
The new form uses multiple questions to try to elicit the same information, and gives jailers lengthier instructions responding to inmate answers.
For instance, to indicate if military veterans in custody might have mental health issues, the form replaces the question "Do you have any previous military service?" with "Do you have nightmares, flashbacks or repeated thoughts or feelings related to PTSD or something terrible from your past?"
If an inmate answers yes to any of the questions, the employee filling out the form is instructed to notify their supervisor, a magistrate and a mental health official immediately — directions that have been unclear to county jails.
"It's clear guidance for front-line staffers," said state Rep. Garnet Coleman, a Houston Democrat and chairman of the House Committee on County Affairs. "There's no ambiguity in these questions."
Coleman said the revised form "routes" inmates with mental health issues to help. Brandon Wood, executive director of the Texas Commission on Jail Standards, agreed.
"The entire reasoning behind that," he said, "is to hopefully divert individuals from the criminal justice system into treatment or a more appropriate setting where they might actually receive treatment in lieu of just sitting in the county jail as punishment for a crime."
How efficient the revised form will be remains an open question.
The revisions are a step in the right direction, but "one of the things that needs to happen, though, to really make it effective is better coordination between the jails and the local mental health authorities or some mental health provider," said Kate E. Murphy, mental health policy fellow with the Center for Health Care Policy at the Texas Public Policy Foundation.
"Even in the jails that are using these screening and assessment tools, they're not necessarily able to get the assessments very timely, and the magistrates aren't getting the information very timely, and the magistrates also don't always know what to do with the information when they've received it," Murphy said. "So there needs to be better education and a little bit more coordination to make sure that what happens with the screening actually makes a difference down the line."
And when an inmate is placed after admission, jail officials ought to be aware of their surrounding and the resources inmates can use to harm themselves, said Coleman, who added that the form alone does not solve all problems related to suicides in jail.
The commission worked with the Texas Correctional Office on Offenders with Medical or Mental Impairments and The Meadows Mental Health Policy Institute for Texas on the revised form. In a memo to all sheriffs and jail administrators, Wood says the commission tested the revised form in four counties and made adjustments based on recommendations.
Addressing the communication concern between entities, Wood recommends in the memo that when jails refer inmates to a magistrate or mental health professional a copy of the intake form is sent with them. Wood also told The Texas Tribune that his agency reviews incidents of in-custody suicides and is exploring training programs to identify and prevent those occurrences as part of its comprehensive response to mental health concerns in the Texas criminal justice system.
"The form itself is just one thing."
Disclosure: The Texas Public Policy Foundation and Meadows Mental Health Policy Institute of Texas are corporate sponsors of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here.