Texans with mental illnesses are dying in Houston-area jails

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After hours of administering state testing for her Houston area middle school students, Rowena Ward glanced at the phone silenced in her desk drawer to find dozens of missed calls from unknown numbers.

Her first thought was one of relief: Maybe her son, Rory, had been released from the Harris County Jail. Maybe he was finally ready to come home after a decade on the streets.

Maybe this time he would take the medications to regulate his bipolar and schizophrenia disorders.

But as the longtime teacher listened to the messages left on that gloomy day in May 2021, each more frantic than the last, panic set in.

“There’s been a fight at the jail…”

“Rory Ward was transported to Ben Taub Hospital earlier today…”

“… found unresponsive …”

“Contact us as soon as possible.”

Rowena struggled to breathe. She felt like she was underwater, the words floating in and out of her grasp.

Rory — her handsome, eldest son who loved Disney World and doodled on every blank surface he could get his hands on — never woke up. He died the next day. Medical examiners eventually ruled it a homicide.

He was 33 years old.

Rory’s death highlights the devastating impact that decades of underfunding has on community mental health programs meant to keep people rooted in their communities while still providing therapeutic services, medication management and crisis mental health care. In the absence of adequate psychiatric services in the community, Texans with mental illnesses like Rory often end up homeless, interacting with law enforcement and languishing in emergency rooms or jails.

Now, the state’s network of county jails is the largest mental health system in Texas, according to the Texas Association of Counties.

“The holes in the community are big and gaping when you look at access to mental health,” said Lt. Scott Soland with the Fort Bend County Sheriff’s Office. “A lot of people typically get mental care when they wind up in the criminal justice system or family members force them.”

The Houston Landing examined thousands of public records to determine how many people who died from homicides, suicides and other unnatural causes in the custody of county and municipal jails across the greater Houston area over the last decade had previously exhibited mental health symptoms that were documented by court, jail or law enforcement personnel.

The Landing created its own database from court documents, custodial death reports and police and jail records. The investigation found that about 46% of the 114 individuals who died of unnatural causes in the custody of these jails had been flagged as potentially mentally ill at least once since the 1980s.

A total of 52 people died. Five others with documented mental health concerns in the eight-county region died of unnatural causes in jail custody during this time frame, but cause of death still was being investigated by the time of publication.

Among those 52 people were:

• Robert Wayne Fore, Jr., or “Bo” as his family lovingly called him, was a 40-year-old father of five who had repeated run-ins with police in 2021 and 2022. The Harris County courts ordered multiple mental health assessments for Bo during that time, and even appointed mental health public defenders to help him navigate the court system. He killed himself in the Harris County Jail in May, three days after being arrested for evading arrest with a motor vehicle and criminal trespassing, leaving behind the love of his life, Jackie.
• Zachary Daniels was 22 when he was charged with aggravated assault in December 2021. Daniels — whose family called him a “loving and kind young man with too many problems” in his obituary — was housed in the Fort Bend County Jail’s mental health cell block when he hung himself on the bars of his cell door in February 2022.
• Chad Silvis was 26 when Kemah Police officers pulled him off a bridge railing in 2014. He was charged with public intoxication and held in the Kemah City Jail for fear that he would hurt himself. Officers gave him a blanket. He hung himself with it 40 minutes later.

This problem isn’t isolated to the Houston area — but the death rate is lower statewide. Across the state, at least 33% — or 178 — of the more than 540 individuals who died of unnatural causes in jail custody over the past decade had been flagged as potentially mentally ill at least once since the 1980s.

The Harris County Jail has become a particularly dangerous place to end up. For years, it has struggled with overcrowding and has run afoul of requirements set by the Texas Commission on Jail Standards, such as failing to ensure that medical professionals review prescription medications for inmates.

In 2022, 27 people died in its custody — one of whom was housed in a Louisiana jail at the time — the jail’s deadliest year on record over the past 17 years. Three more have already died in 2023.

Facing a growing number of inmates with mental illnesses, Harris County has established systems to intercept these individuals and direct them to care instead of incarceration.

Law enforcement officers, on suspicion that someone may be mentally ill, can offer them a spot in the county’s jail diversion center, which aims to help people with mental illnesses get services without entering jail.

Jail staff can flag mental health indicators at intake during its robust screening process, which not only identifies people who have received state-funded mental health services but also asks questions about mental status, suicidal thoughts and psychotropic medications.

The public defender’s office can be notified when someone might be mentally ill and connect them with an attorney who specializes in helping mentally ill defendants.

Despite Harris County’s resources, nearly 60% of the 61 people who died of unnatural causes in the custody of the county jail over the past decade had documented mental health concerns.

“We are not surprised by your finding,” said Jason Spencer, chief of staff for the Harris County Sheriff’s Office. “We believe more resources should be directed toward addressing the mental health crisis outside of a jail setting. Unfortunately, we find that too many people coming into the jail have serious mental health needs that are not being addressed outside the jail.”

The passage of Senate Bill 6 in 2021 only made matters worse, experts say. Under the measure, individuals arrested for violent crimes cannot be released on personal bonds, which requires no cash as long as the defendant gives their word that they’ll show up at the next court date.

This is a dangerous problem for mentally ill defendants, experts say, because it’s not unusual for a person in crisis to be scared of police and become violent.

Krish Gundu, executive director of the Texas Jail Project — a nonprofit that advocates for people in county jails — was shocked by the Landing's findings.

She said more data needs to be collected about who is cycling through the criminal justice and mental health systems so that funding can be directed appropriately.

“Without that data we will keep funding the wrong end of the system, the back end in jails,” Gundu said. “Instead of robustly investing in front end, preventive solutions. … If people get the right care at the right time at the right place, our jails would not be the de facto mental health warehouses that they've become.”

Experts say more money needs to be directed toward community mental health programs so that individuals can be helped before they reach crisis — and before they ever get in a situation where they interact with police.

The Legislature needs to direct more money to state-run psychiatric hospitals, they say, which as of December had a waitlist of more than 2,500 people.

More also needs to be done to ensure Texans across the state have access to mental health public defenders and diversion programs, they added.

Harris, Fort Bend and Galveston counties are among fewer than 30 of Texas’ 254 counties that have access to mental health public defenders, according to the Texas Indigent Defense Commission.

None of these changes will help Rory, who died four days after being assaulted by a fellow inmate.

It won’t help his mom, who decorates her son's grave for every holiday, big or small — or his dad, Gene, who fondly remembers their Cub Scouts days and camping trips — who will forever question why their son was allowed to die over $3.16.

On the chopping block

Rory was 16 when he walked into his mother’s bedroom and told her God was speaking to him.

He could see into the heavens, he said. He was going to be a preacher.

Rowena didn’t understand.

“But Rory,” she said as she got ready for bed in her home near Cypress. “I thought you wanted to be an artist?”

Rory walked out of the room with no explanation. Rowena brushed it off — her son had always been religious.

But the next day, Rory was staying with his dad and had a psychotic break in the street.

Police were called. They took Rory to a hospital and later committed him to a private psychiatric hospital near Sharpstown.

He was diagnosed with bipolar and schizophrenia disorders soon after, launching a yearslong battle for his parents to find the right meds, the right care, the right solution.

About 150 miles away in Austin, Texas lawmakers had made a decision the year prior that would greatly impact Rory’s future.

It was 2003. Lawmakers were facing a $10 billion budget shortfall, and crucial state programs were on the chopping block

One of the many cuts they made was in community mental health programs — a $101 million wound that decimated the services meant to keep people in their communities and out of institutions while receiving psychiatric care.

That same year, lawmakers shrank the pool of people who could receive care through local mental health authorities, but made it easier for a defendant’s competency to be evaluated.

Before long, Texans began struggling to get mental health care in their communities. They wound up in crisis, filling state-funded psychiatric hospitals to capacity.

There was nowhere for people to go.

Mentally ill Texans landed in emergency rooms or jails.

And both systems soon became overwhelmed.

Rowena and Gene did their best to get Rory the care he needed. He was in weekly therapy sessions and seemingly constant appointments with psychiatrists to regulate his medications.

But the old Rory was gone.

Before his psychotic break, Rory was talkative and social. He loved family vacations to Disney, the Bahamas and Myrtle Beach. He was always drawing or painting, boastfully showing off his creations to anyone who gave a second of their time.

Now, he was withdrawn and isolated. He became paranoid. His pencils, charcoal and paint sat untouched on his bedroom desk.

After high school, Rory moved in with his dad. He worked at a movie theater and even enrolled in Job Corps.

But at 21, Rory just left.

He felt a sense of freedom living on the streets, he told Rowena.

Closing hospitals

Community mental health programs were a product of President John F. Kennedy’s administration — an attempt to provide mental health care in communities as psychiatric hospitals were shuttered across the country.

The programs, however, were never funded adequately. And with so many fewer psychiatric beds, people struggled to find care.

Across Texas, communities have come up with ways to address the growing population of mentally ill residents unable to get the treatment they need.

Law enforcement agencies have established crisis intervention teams, which focus on training police in how to identify and handle people with mental illnesses to reduce arrests and connect them with services.

Public defender offices began creating mental health divisions to ensure mentally ill defendants were adequately represented.

Local mental health authorities and law enforcement began working together to divert mentally ill Texans away from jail and into the appropriate care.

Faced with a growing waitlist for public psychiatric beds, some counties — with the help of legislative funding — established pilot programs to provide competency restoration that didn't require an inpatient hospital commitment.

It still wasn’t enough.

“The waiting period (for state hospital beds) is over a year now, so in the meantime we try to keep them safe as best as we can,” said Ann Marie Mitchell, Liberty County Jail administrator. “But the inmates here that need treatment, they just further deteriorate the longer they’re here.”

The lost son

In the years following Rory’s departure, Rowena made frequent drives downtown, searching for Rory in what became his usual haunts: The park close to Interstate 10; the sidewalks near the Harris County jail.

If she didn’t find him, she started calling the morgues.

But sometimes, she was able to spot him on the street. On those days, she would beg him to come home. As long as he took his meds, she would loosen the reins. She would relax the rules.

“Rory,” she would say. “You’ve got some options. We can do some other things.”

If he was acting erratic, she went through the steps of getting him committed. But occasionally, she could convince him to come home for a hot meal and clean clothes. He never stayed more than two nights.

He liked living on the streets, he told her. He was happy.

But sometimes she would get late night calls from Rory.

Police had brought him to a mental hospital, he would say. He was about to get out and wanted to come home. He wanted to get his driver’s license.

Rowena quickly learned to tamper her excitement when these calls came. His change of heart was a symptom of taking his meds. As soon as he got out of the hospital, he would stop taking them. He would no longer want to be home.

Still, Rowena slept easier knowing that Rory, at least, was staying out of trouble. He seemed to be finding his way.

That changed in 2010, when he and eight others were arrested for trespassing near the East End. By this time, Houston Police already had a well-established crisis intervention team program and the Harris Center, the county’s local mental health authority, was in year seven of its Mobile Crisis Outreach Team, or MCOT, where mental health professionals, instead of law enforcement, could be dispatched to a person’s location to assess their psychiatric needs.

But police and court documents do not indicate that Rory was identified as mentally ill at the time of his arrest.

He was sentenced to six days in jail.

Rory was arrested three more times over the next five years. A court questioned his state of mind after the third arrest.

“I’m in jail”

Rowena took a deep breath as she accepted the collect call from the Harris County Jail in March 2015 — she knew in her gut the day had come.

“Mom,” Rory said. “I’m in jail.”

Though Rory previously had been incarcerated for misdemeanors such as trespassing and marijuana possession, Rowena felt it was only a matter of time before he was picked up on something more serious.

It had finally happened.

Rory explained that he had been arrested for trying to use a fake $100 bill. Someone had given it to him on the street, he told her, and, not believing his luck, he tried to use it.

“Rory, what were you thinking?”

Rory didn’t have an answer.

But Rowena knew. She knew it was his mental illness. She knew he wasn’t taking his meds.

He sat in jail for almost two months before a competency evaluation — to assess Rory’s ability to understand and participate in his legal case — was ordered.

Court records show the evaluation was submitted, but Rory still was sentenced to six months in jail in June 2015.

A month later, as Rory served out his term in the Harris County jail, a 28-year-old woman named Sandra Bland hung herself in a Waller County jail cell 50 miles away after being arrested three days prior for not signaling when changing lanes.

Family members said Bland was in good spirits when she was arrested. But after her death, the Waller County Sheriff’s Office released her suicide screening form. In it, she wrote about previously attempting suicide and being depressed.

By this time, the Landing’s analysis shows that Bland was the ninth person previously identified by officials as mentally ill in the greater Houston area’s eight counties to die of unnatural causes in jail custody since 2012.

Bland’s death sparked outrage across the globe — both because of how she was treated by a white officer and because the jail had not been following state standards for observing inmates.

Advocates demanded change. It came two years later.

Texas lawmakers in 2017 passed the Sandra Bland Act, which revised the jail intake screening process to better identify mental illness. It mandated diversion of people with mental health issues to treatment and made it easier for mentally ill or intellectual or developmentally disabled defendants to be released on a personal bond.

That same year, four of the 10 people who died of unnatural causes in the custody of Houston-area jails had previously been identified as mentally ill, records show.

A lack of diversion centers

In 2018, the Judge Ed Emmett Mental Health Diversion Center officially opened in Harris County — a place where individuals picked up on misdemeanors could be sent instead of jail.

The center is voluntary, but it gets people stabilized, on their medications and linked with a psychiatrist. It even provides housing and employment assistance if needed.

While most local mental health authorities have jail diversion plans for the counties they serve, not every area has an actual center to send people. In the Houston region, Harris, Fort Bend and Waller counties do. But there’s limited space and funding for defendants with mental illnesses.

The Texana Crisis Center in Rosenberg — which opened its doors in 2014 — has both an extended observation unit that provides 48 hours of emergency services and a crisis residential unit that provides therapy as well as case and medication management.

Last year, the crisis center admitted nearly 650 individuals, who stayed an average of six days. The majority of these admissions were brought in by law enforcement.

The Texana Crisis Center is at risk of closing, however, because of lack of funding.

“Law enforcement frequently brings folks to the crisis center,” said Shena Ureste, director of behavioral health care services for the Texana Center. “If the center is not funded, we’ll go back to mentally ill residents ending up in jail or clogging up emergency rooms.”

In the past decade, two of the six people who died unnatural deaths in the the custody of the Fort Bend County jail had documented mental health concerns. Both of those individuals hung themselves.

In a statement, Lt. Scott Soland with the Fort Bend County Sheriff’s Office said that inmates are screened for suicide risks and are informed of how to access mental health treatment in jail. Employees receive suicide prevention training, the statement continued, and the office has a crisis intervention team that responds to mental health related calls.

The sheriff’s office also just received a grant to implement crisis counselors in the 911 dispatch center.

“After reviewing the records, the individuals who desired to end their life was greater than our ability to prevent it,” Soland’s statement read. “We agree that suicide is not acceptable, and we strive to protect the lives and safety of the persons detained in our facility.”

A grueling time

Rory was leaving the Fiesta Mart near Independence Heights in May 2020 when he was approached by a man who identified himself as a Harris County sheriff’s deputy.

The deputy wasn’t wearing a uniform — he was working an approved off-duty job at the store and had seen Rory conceal a beverage can in the front of his pants, the police report states.

Before the deputy could tell Rory why he was being stopped, the police report says, Rory began punching him and attempting to flee.

A second deputy who was on scene “bear hugged” Rory and they both fell to the ground.

According to the report, Rory started throwing punches, scratching and attempting to bite the deputies.

Eventually the officers were able to subdue him. They retrieved the stolen items: a Monster Energy drink and a container of baby wipes.

The total cost was $3.16.

Rory was charged with assault on a police officer.

By this time, Rory’s mental illness had been well documented by the Harris County court system. Charges were filed against Rory on nine separate occasions in the past 10 years, mostly for misdemeanor crimes. He had been flagged as potentially mentally ill three times.

Police reports do not indicate that the deputies ever questioned Rory’s mental health. But even if they had, he was being charged with a felony. He wasn’t eligible for the jail diversion center.

But the magistrate did order a mental health assessment two days after his arrest.

For the court to order this assessment, a sheriff or jailer receives information that the defendant might be mentally ill and informs the magistrate within 12 hours of the arrest. If the defendant hasn’t been assessed in the past year, the magistrate orders the Local Mental Health Authority to conduct one.

The results of that assessment can be used to direct the defendant to a specialty court. They can also be taken into consideration when determining punishment or used to move forward with a competency evaluation.

Jason Spencer, with the Harris County Sheriff’s Office, said that Rory was offered psychiatric services during the intake process, but that he refused them. Without a court order, the sheriff’s office couldn’t force him to accept psychiatric help, and Spencer said Rory was not housed in the jail’s mental health unit.

Two weeks later, Rory was being treated in the jail clinic downtown for wounds on his wrist, a police report stated, when he refused to get on an elevator to return to the jail.

He needed to go to a hospital, he said. He was told that’s where he was headed.

The officer said no, the police report stated, and Rory began to resist. He attempted to run away from the officer.

Rory eventually was handcuffed, the report said, but not before biting two deputies and a detention officer.

He was charged with assaulting a public servant.

Rory spent another four months in jail before a psychiatric evaluation was ordered.

At this point, a finding of incompetence could have put Rory in a competency restoration program, either in jail or in a mental hospital. It could have resulted in him getting help.

But court documents do not show that an evaluation was filed. And Rory’s hearings kept getting rescheduled.

Mario Madrid, Rory’s court-appointed attorney, did not return messages from the Landing.

It was a grueling time for Rowena and Gene. Rowena wasn’t allowed to visit her son because of COVID-19 restrictions. Gene, who had by then moved to Georgia, sent care packages full of snacks and personal hygiene items as often as he could.

But for some reason, Rory never called.

“It was draining,” Rowena said, rubbing exhaustion out of her eyes at the mere thought of it. “It was so, so draining.”

By May of 2021, a competency evaluation still had not been filed with the court.

And then, Rory was assaulted.

And then, Rowena and Gene’s world came crumbling down.

Assaulted in a jail cell

Sitting at Rory’s bedside at Ben Taub Hospital, Rowena struggled to comprehend the words the doctor was saying.

“I’m sorry, ma’am, there’s no brain activity.”

All she could do was stare at her son’s face, whose once beautiful features were now marred with black and blue bruises; with cuts and scrapes and bumps.

No brain activity? How could there be no brain activity?

She brushed off the doctor.

God has the final say, she thought. He will perform a miracle.

Still, she called Gene, frantic.

“Rory’s in the hospital. It’s bad.”

Gene hopped on the next flight to Houston.

As she waited and prayed, bits and pieces of what happened to Rory started to come through.

According to the custodial death report, Rory was punched in the head six times by a fellow inmate in a cell on May 8, 2021. That day, he was assessed by a medical provider and cleared to be released to a single cell in the jail.

Three days later, on May 11, Rory was found slumped over in his cell.

He was taken to Ben Taub with a pulse. Rowena was called.

The next day, Rory died, becoming the 40th person with documented mental health concerns to die in jail custody in Houston’s eight-county region since 2012. His death was ruled a homicide due to complications of blunt head trauma.

Gene made it to Houston in time to say goodbye.

The family donated his heart and lungs, being mindful not to donate anything that could impact the autopsy report.

Two lives were saved. But Rowena and Gene still don’t have answers about what happened to their child.

They’ve retained a lawyer, but are struggling to get answers from the county. The Texas Rangers are investigating and have submitted their findings to the Harris County District Attorney’s Office.

The district attorney would not release information about Rory’s death because the investigation is pending. The man who assaulted him has not been charged.

So Rowena and Gene wait in anguish.

Rowena visits Rory’s grave less than four miles from her house twice a month.

She decorates it for his birthday, Christmas, Easter and Valentine’s Day.

She keeps his memory alive in her home through the photos on the mantle. The framed artwork on the wall.

Gene can’t visit Rory’s grave or Memorial Park, where he and son used to ride BMX bikes. But he has a room in his Georgia home filled with photos of Rory — of him camping and playing football as a kid. Memories he wants to last forever.

And everyday they wonder:

What if we had him committed one more time?

What if he was able to get the mental health care he needed?

This story was produced by the Houston Landing, a nonprofit news organization that covers the Houston region. Learn more and subscribe to the Houston Landing’s newsletter at https://houstonlanding.org.

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