The Herman Center is Filling Critical Gaps in Mental Healthcare

By Gretchen Sanders in 40 Acres on December 21, 2017 at 4:10 pm | No Comments

Travis County has long suffered from a shortage of mental health services, especially for people in crisis. A new center named after UT alumnus Judge Guy Herman, BA ’72, JD ’77, is working to change that.

For years, Austin police officer James Turner would patrol the city’s streets only to drive straight into a dilemma. He would receive a call about someone experiencing a mental health crisis and then scramble to find a safe intervention. Many times, he faced two tough choices: take the person to a hospital emergency room or jail. Neither place really fit the need.

While Austin’s emergency rooms can have long waits, little privacy, and almost no specialized psychiatric care, a national movement among law enforcement agencies has tried to divert mentally ill people who commit minor crimes away from jails and into treatment programs.

Psychiatric hospitals, a third and very expensive option, can fill up fast and occasionally overtreat those with short-term problems. “The majority of people we pick up don’t need a lengthy inpatient stay in a psychiatric hospital,” says Turner, a mental health officer on APD’s Crisis Intervention Team. “Most people just need a place to go for a few hours or days to get stable.”

Until recently, Travis County didn’t have a short-term crisis center, especially for residents who posed a threat to themselves or others and would not voluntarily accept treatment. People who need but refuse mental health care often get temporarily detained for up to 48 hours on a peace officer emergency detention order. From there, they are usually admitted to a hospital.  

In August, the whole game changed. The Judge Guy Herman Center for Mental Health Crisis Care opened in South Austin, becoming Travis County’s first non-hospital facility that accepts people on emergency detention.

Operated by Integral Care, the 16-bed facility provides brief treatment to non-violent adults experiencing a psychiatric emergency. Herman Center psychiatrists, social workers, and other licensed mental health professionals assess, stabilize, and treat clients suffering from severe depression, anxiety, mood disorders, psychosis, and more. They also do therapy and medication management. “Most crises resolve within 48 hours, so we try to work with that timeframe to negate the need for more restrictive intervention,” says Laura Wilson-Slocum, the Center’s practice administrator.   

A more restrictive intervention, likely a stay in one of Austin’s five mental health hospitals, would require health insurance, private pay, or Central Health funding. “Many people who need emergency mental health services are homeless or don’t have much money,” Wilson-Slocum says, “so the Herman Center provides a more cost-effective treatment option and is a good steward of community resources.”

Before the Herman Center, police officers could spend hours calling psychiatric hospitals trying to find beds for citizens in crisis. If they couldn’t find a bed, they might wait with those who needed help in an ER for several more hours. Not anymore. “Our goal is to have law enforcement officers in and out of the Herman Center and back on patrol in less than 15 minutes,” Wilson-Slocum says, pointing to a special door that makes it easy for officers to drop off people who need help.

As Austin grows, the Herman Center can expect a steady caseload. Data from Texas Health and Human Services suggests that one in five adults in the state will experience a serious mental health problem this year. In Austin, the number of people police officers have placed on emergency detention for mental health reasons has doubled since 2011. Last year, APD officers detained 5,600 people for emergency psychiatric care. The Herman Center can’t handle all of the traffic. “We need another facility like this in North Austin,” says longtime Travis County Probate Judge Guy Herman, whose name spreads wide across the façade of the center.

Few elected officials have worked harder to improve indigent mental health care in Travis County than Herman. The memory of a law school classmate serving jail time for “public lunacy” never sat well with him, so upon election to probate court in 1985, Herman moved quickly to change laws to better protect vulnerable populations. “It didn’t take long for me to realize that Travis County, despite its progressive values, had a serious shortfall in the provision of mental health services,” he says.

In 2004, Judge Herman pushed for an election to create a countywide hospital district that would help fund healthcare for uninsured, underinsured, and low-income residents. Voters said yes. “The result was a tremendous amount of money coming into the hospital district due to all county residents paying for indigent medical and psychiatric care, rather than just city taxpayers funding the bulk of these services,” he says. This new hospital district, known now as Central Health, soon had enough money to expand Travis County mental health programs and allow Brackenridge, the public hospital at the time, to have level 1 trauma services.

Funds from a partnership between Central Health and the Seton Healthcare Family will pay for ongoing operations at the Herman Center. The 12,000-square-foot facility, built with money given by the St. David’s Foundation on land gifted from an anonymous donor, boasts natural light, a welcoming lobby, private rooms, and an outdoor patio. The warm environment presents a stark contrast to a sterile emergency room.

Herman Center staff expect to serve 2,500 people in the first two years. The average stay will range from 48 to 72 hours, though some visits may last longer. No walk-ins allowed; all referrals go through Integral Care’s crisis helpline, (512) 472-HELP. Any adult living in Travis County is eligible for treatment, with fees applying on a sliding scale.      

“I wish the Herman Center had existed when I needed it,” says Valerie Milburn, BJ ’83. For years, the retired school teacher battled the high and low mood fluctuations commonly associated with  bipolar disorder. When things got really bad, she would end up severely manic or depressed in a bustling emergency room. “Hospitals can be so scary,” she says, “and they may just send you right back to the situation you came from with no follow-up plan.”

Milburn, who volunteers with the National Alliance of Mental Illness, eagerly attended the Herman Center’s groundbreaking ceremony last year. “They’re going to do incredible discharge planning for these clients,” she says. “Sometimes that’s all one needs.” A discharge plan could include lower levels of service in one of Integral Care’s other programs.

Today, when a mental health call comes over the radio, Officer Turner can point his patrol car toward a scene with more certainty. “If you give us a tool like the Herman Center,” he says, “our officers will utilize it.”