Burnet County
Community Toolkit

At each intercept, it is helpful to understand best practices emerging in communities throughout the country. While not every best practice will be relevant to Burnet County, especially when there are serious resource limitations, these practices provide a useful lens for identifying promising pathways forward. The best practices listed below may provide a reference point for Burnet County as it adapts best practices to its own unique challenges.

Use Alternatives to the Criminal Justice System

Communities with the strongest outcomes do not lean on a single program. They build a connected set of crisis response options so that officers, dispatchers, and families always have somewhere to turn besides arrest or the emergency department. The basic shape is simple: someone to call, someone to respond, and a safe place to go.

The research on integrated crisis systems is consistent. When call triage, mobile response, and clinical receiving locations are connected and not three separate programs, arrests, emergency department (ED) visits, and repeat crises all decline. No single piece does the job alone. What makes the difference is the handoff between pieces, and whether law enforcement trusts the system enough to use it by default rather than as an exception.

In Texas, Bexar County's coordinated infrastructure is the most established example, with documented reductions in jail utilization. Oklahoma's statewide investment in crisis-system capacity offers a state-level reference, with reductions in jail bookings and significant cost savings. Both are useful phone calls if your community is building from the ground up.

These factors contribute to a successful strategy:

• Continuous (24/7) operation across every component
• A drop-off door that opens in minutes, not hours
• Written agreements between law enforcement, behavioral health, EMS, and crisis centers
• Officer trust built deliberately, as it takes years to build and is easily lost

Any single unreliable component can reduce the positive impacts of another. If dispatch cannot route the call, if mobile response is slow, or if the drop-off door is not open, officers will default to what they know.

Establish Crisis Receiving and Stabilization Centers

Crisis receiving and stabilization centers are open-door facilities where officers, EMS providers, or walk-ins can bring someone in acute behavioral health crisis for rapid intake and short-term stabilization. Most people are stabilized and discharged within 24-hours with follow-up arrangements in place. The features that make the model successful are simple: individuals can drop someone off in minutes rather than hours, and the facility takes everyone regardless of acuity, insurance, or intoxication.

These centers reliably reduce jail bookings and ED overcrowding, and the clearest effect in the research is on hospital use and length of stay. The direct arrest-reduction case is emerging. The often-cited Miami-Dade figure (about 109 arrests across 50,000 crisis calls over five years) comes from system reporting, not a controlled study. But officers consistently say the fast handoff is what makes the model work in practice, and without it they stop bringing people.

San Antonio's Restoration Center is the most widely known Texas example and the model most other Texas counties reference. Connections Health Solutions operates a scaled "no wrong door" network nationally and is a useful contact for technical assistance.

Factors that distinguish successful centers from centers that do not divert people from justice involvement include:

• 24/7 operation with a no-refusal intake policy
• Drop-off completed in under 10 minutes from the officer's perspective
• Capacity that can comfortably meet typical demand as well as surges in intakes
• Standing relationships with law enforcement, not just written agreements

The instances where these centers fail are predictable. Wait times grow. Exclusion criteria tighten. Capacity falls short of demand. Any of these will cause officers to stop using the center, and once they stop, rebuilding the habit takes longer than building it the first time.

Deploy Mobile Crisis Teams

Mobile crisis teams (MCT) send a behavioral health clinician, often paired with a Certified Peer Specialist, directly to the scene of a behavioral health call. The clinician leads the encounter. Officers may provide safety support but are not the primary responder. It is when these interventions are implemented in this manner that overall arrest reduction is a likely outcome. A 2025 Michigan study, the first real head-to-head comparison of mobile crisis, co-response, and police-only response, found significantly fewer arrests in the 11 months following an MCT dispatch than after a police-only response. Mounting evidence confirms that MCTs resolve a majority of behavioral health calls on the scene without further escalation and produce better follow-up linkage to outpatient care.

Denver's STAR initiative is the most widely studied clinician-led model in the country, with documented reductions in low-level arrests. Houston's Crisis Call Diversion Program is a Texas MCT model. Eugene, Oregon's CAHOOTS is the longest-running clinician-led crisis response team in the U.S. and a potential model for rural and small-metro communities.

Mobile crisis teams work when the surrounding system is built to support them:

• An adequate geographic coverage area
• Clear dispatch protocols that route the right calls their way
• A clinical destination (like a stabilization center) where the team can reliably bring individuals in crisis
• A staffing plan that holds up in rural and small-metro counties

An important caution when implementing a mobile crisis team: when the clinician can respond but there is nowhere to take the person, the intervention quickly loses its effectiveness. Staffing is also a constraint. Finding clinicians willing and available to do the work in rural counties is difficult.

Build Co-Responder Teams

Co-responder programs send an officer and a behavioral health professional together to a crisis call, where the mental health worker leads the behavioral health engagement and the officer handles safety. Co-responder teams reliably reduce involuntary psychiatric detentions, increase awareness of community resources among people in crisis and their families, and reduce future crisis calls. The evidence on arrest and ED-visit reduction demonstrate favorable long-term reductions in arrests when paired with effective follow up and warm handoff to treatment providers. The Dallas Rapid Integrated Group Healthcare Team (RIGHT) Care program is an example of and a possible blueprint for creating successful co-responder initiatives.

Factors that lead to effective co-responder programs include:

• The mental health worker actually leads the encounter, not advises from the passenger seat
• A warm handoff to follow-up care after the call
• The team has a clinical destination available, not just an ED
• The program is treated as part of the broader continuum, not as the continuum itself

Invest in Peer-Run Crisis Respite

Peer respites are short-term, non-clinical, home-like settings staffed entirely by people with lived experience of mental illness or substance use recovery. Typical stays run 5 to 14 days. The focus is connection, de-escalation, and stabilization, and they often serve as a voluntary alternative to the ED or an inpatient unit for people who might engage with peers but not with clinical settings.

Research shows that peer-run crisis respite guests are about 70% less likely to use inpatient or ED services afterward than similar non-users. The consumer-experience data (people feeling heard, respected, more in control) is consistently stronger than in other clinical settings.

Thresholds' Living Room in Chicago is one of the best-known models, serving as a blueprint for communities wishing to invest in similar programming. Practical design and operating considerations include ensuring that the peer-run crisis respite is:

• Embedded in the broader crisis system with clear referral paths from MCTs and the crisis line
• Visible enough that the people most likely to use it actually know it exists
• Staffed entirely by certified peer specialists, not clinicians
• Trusted enough in the community that families and clinicians refer to it

Aside from the investment in peer-run crisis respite, which is modest in comparison to other clinical interventions, the primary constraint is workforce. Communities must ensure there are peer certification programs available to local residents, as the inability to recruit and train peers is the most common reason these programs underperform their potential.

Expand Access to Housing for People in the Justice System with Behavioral Health Needs

For people with serious mental illness, housing instability is one of the strongest predictors of repeat contact with police, EDs, and jails. In Texas, Local Mental Health Authorities and community partners coordinate housing through Medicaid, state programs, and federal supports. The Corporation for Supportive Housing is the national reference for program design and a useful first call. Texas HHS maintains state-level coordination. Counties will not solve the housing shortage on their own, but targeted strategies can make sure people leaving custody or crisis settings have at least one placement option that actually works. Some strategies counties have used successfully include:

• Landlord engagement programs that build a willing landlord pool
• Bridge housing to cover the gap between release and longer-term placement
• Recovery housing for people with co-occurring substance use disorders
• Pre-release housing planning that confirms a placement before the door opens

Importantly, the research is unambiguous on housing stability. Housing First reliably increases retention (typically 70 to 90% at 2 to 3 years versus 30 to 50% in treatment-first models) and reduces ED visits and hospitalizations. Its effects on substance use and psychiatric symptoms are smaller and more mixed than many SIM documents imply. Its effects on arrest are real but modest on its own. They get larger when housing is bundled with assertive community treatment, peer support, or medications for opioid use disorder. Economic review s put the return at roughly $1.44 for every $1 invested.

The Council of State Governments Justice Center recommends a four-step action plan for communities experiencing a lack of housing options for people with criminal records who also have mental health and substance use challenges:

Step One: Collaborate

Like SIM Mapping, addressing housing needs for justice-involved people with mental health and substance use challenges requires cross-system collaboration. By sharing data, identifying gaps, and coordinating strategies, communities can create leadership teams to guide efforts, strengthen existing services, and build partnerships with housing providers and landlords.

Step Two: Assess

Communities should analyze available housing resources, identify gaps, and use data from agencies such as mental health authorities and probation to understand housing needs. Shared data helps determine the types of housing needs - supportive, transitional, or sober living - and allows communities to anticipate demand, measure outcomes, and adjust strategies over time.

Step Three: Connect

Housing stability is critical to reducing recidivism and supporting recovery after arrest, detention, or incarceration. When agencies such as probation, parole, housing authorities, and crisis response teams coordinate efforts, they can quickly identify needs, prevent crises, and connect individuals to housing and support services.

Step Four: Expand

Although housing shortages affect most communities, coordinated planning allows partners to make more strategic investments. By using shared data instead of relying solely on subjective priorities, communities can help funders direct resources toward housing solutions that will have the greatest impact.

Develop Community Paramedic Capacity

Community paramedicine extends the role of EMS. Paramedics receive additional training so they can respond to lower-acuity calls, do home visits with frequent EMS users, and connect people to services without automatically transporting to an ED. The model is particularly attractive in rural counties that cannot sustain a clinician-led mobile crisis team.

Recent studies show the model improves health engagement and reduces EMS call volume among frequent users. Pilot data from rural jurisdictions suggest real reductions in avoidable ED visits, in the range of 14 to 40%.

The factors that contribute to the success of a community paramedic program include:

• Clear medical and operational protocols that paramedics can act on
• Real authority to divert from traditional ED pathways
• A working list of community providers willing to accept the referral
• Telehealth back-up for clinical assessment when needed

The evidence also points to some cautions when implementing a program. Paramedics without referral options become another ride. Isolation from the local behavioral health system turns the program into transport with extra training. The model needs the same level of support and behind the scenes resource and training infrastructure that mobile crisis teams need.

Strengthen Front-End Access to Behavioral Health Care

Limited access to routine behavioral health care is one of the biggest drivers of crisis-system involvement. When people cannot get in early, symptoms build until police or the ED become the default front door. The core practices for fixing this are the same in most places: same-day or walk-in intake, extended hours, telehealth, and warm handoffs (directly connecting with another provider while patient is still present) at the point a person first asks for help.

The evidence on engagement is clear. A 2023 study found that warm handoffs more than tripled the odds of mental health service engagement. Open-access scheduling consistently reduces no-show rates. Telehealth warm handoffs produce similar engagement GAINS and reach rural areas in-person models cannot.

In Texas, Tropical Texas Behavioral Health and Tri County Behavioral Healthcare are among the LMHAs that have moved toward same-day and walk-in access. Both are useful calls for counties redesigning intake. Nationally, the Certified Community Behavioral Health Clinic (CCBHC) model, covered separately later in this section, provides the clearest funded vehicle for this practice. Additional factors associated with successful front-end access strategies include:

• Treatment capacity that can absorb the newly engaged patients
• Care coordination that keeps people connected after the first appointment
• Follow-up protocols (warm handoffs, scheduled outreach) for the first 72 hours
• Telehealth integration that extends reach to rural and small-metro areas

Address Transportation as a Core Issue

Transportation shows up in just about every SIM conversation as a top barrier to behavioral health care, especially in rural Texas. When people cannot reliably get to an appointment, their conditions can deteriorate until they re-enter the system through the Emergency Department or an officer's car. The barrier itself is well documented. Urban Institute surveys find that more than one in five adults with limited transit access forgo care because they cannot get to it. The relationship runs in both directions. Anxiety and depression themselves make it harder to arrange a ride.

In Texas, LMHAs coordinate transportation directly, partner with EMS, or contract with providers. Voucher programs, ride-share partnerships, and regional coordination agreements are all in various stages of pilot. The Rural Health Information Hub is a useful cross-state reference for program design. One promising-practice example is the South Texas Transportation Rx program, run in partnership with the nonprofit Feonix Mobility Rising, which coordinates volunteer drivers, taxis, public transit, and rideshare through a single platform to fill rural transportation gaps.

What separates transportation programs that work from ones that do not:

• Predictability. People can count on the ride showing up
• Tied to the care coordination plan, not handled as an informal favor
• Integrated with the behavioral health system rather than parallel to it
• A clear point of accountability for who owns the ride

Designate Specialized Mental Health Officers or Units

Many law enforcement agencies have improved outcomes by designating officers or units with advanced training and experience in behavioral health response. These officers serve as internal subject matter experts, back up patrol officers in real time, and often take the lead on complex or repeat cases.

Research on police-mental health collaboration models indicates that specialized units improve coordination with behavioral health providers and increase the likelihood of diversion to services. Agencies with dedicated mental health officers use de-escalation more consistently and connect people to care more often.

In Texas, the Dallas and San Antonio police department s operate dedicated mental health units that work closely with Local Mental Health Authorities and crisis providers. In smaller and rural communities, the model is adapted by designating a subset of officers with enhanced training and strong relationships with behavioral health partners. In regions served by Tropical Texas Behavioral Health, designated officers function as key connectors between patrol and crisis response.

What makes a specialized unit effective in the field:

• Integration with daily patrol operations, not separation from them
• Clear roles that distinguish specialist from patrol response
• Active partnerships with LMHAs and community providers
• Dispatch protocols that actually route appropriate calls to the unit

Ensure Officers Understand Their Authority and Discretion to Divert

Texas law gives officers two distinct authorities for diverting people in behavioral health crisis away from arrest, but legal authority alone has not produced consistent practice anywhere in the state. The gap between statute and field practice is the variable that most often determines whether someone ends up in jail or in care. Closing that gap requires department-level policy, training, and operational support.

Article 16.23: Legal Authority to Divert from Arrest

Code of Criminal Procedure Article 16.23 directs law enforcement agencies to make a good-faith effort to divert individuals experiencing mental health or substance use issues to treatment when:

• there is an available and appropriate treatment center in the agency's jurisdiction to which the agency may divert the person;
• it is reasonable to divert the person;
• the alleged offense is a misdemeanor, other than one involving violence; and
• the mental health crisis or substance use issue is suspected to be the reason the person committed the alleged offense.

The Texas Judicial Commission on Mental Health has documented that implementation of Article 16.23 is uneven across the state, with many agencies operating without written policy or local guidance specifying what "available and appropriate" means in their jurisdiction. Research on police discretion in behavioral health encounters consistently finds that officer behavior tracks closely with department expectations: where supervisors visibly back the use of alternatives to arrest, officers use them; where expectations are ambiguous, outcomes vary widely between shifts, between officers, and between calls that look operationally similar.

Chapter 573: Emergency Detention Without Warrant

The Texas Health and Safety Code Chapter 573 gives officers the authority to take a person into custody without a warrant when they have reason to believe the person has a mental illness, there is a substantial risk of serious harm to self or others, the risk is so imminent that intervention cannot wait, and the belief is grounded in the officer's own observation or a credible representation. Exercised with authority, training, and guidance, this pathway routes people into clinical assessment rather than booking.

However, in the absence of emergency department receiving capacity or clear procedures, the use of an Emergency Detention Without Warrant produces friction without benefit. Officers spend hours on transport and paperwork, the hospital screens and releases within a short window, and the same person is back in front of the same officers a few days later. That pattern is one of the most consistent sources of frustration for patrol officers in smaller jurisdictions.

Factors that lead to successful officer-level diversion include:

• Written department policy that names diversion as the preferred response for non-violent misdemeanors involving behavioral health, and emergency detention as the preferred response for qualifying crisis situations
• Field reference materials - printed, laminated, or in the electronic system - listing current diversion options, LMHA crisis line numbers, and the threshold criteria for warrantless emergency detention
• Initial and refresher training that covers legal thresholds, documentation requirements, and how to articulate observations in a way that is consistently appropriate for clinical and judicial review
• Supervisor reinforcement so officers feel backed when they use discretion, plus after-action review of diversion decisions (both successful and unsuccessful) to build institutional learning
• Active department-level participation in coordination with the LMHA, area hospitals, and JP/magistrate offices, surfacing system gaps rather than absorbing them quietly

Use Civil Interventions When Appropriate

Civil interventions refer to legal processes by which people other than the person with mental illness can initiate treatment and includes initiation of civil commitment proceedings and court-ordered treatment, including assisted outpatient treatment (AOT). Civil commitment processes and AOT do not require the involvement of the police or the criminal justice system. Recently, states have begun to provide for civil interventions for behavioral health conditions other than mental illness, including substance use disorders.

Court-ordered treatment can be provided in the community or in an inpatient setting as determined by a clinical evaluation. Inpatient and outpatient treatment can be delivered sequentially or, alternatively, beginning with outpatient options and utilizing inpatient settings as needed. It is important to recognize that more coercive approaches are appropriate only after services have been offered to individuals and they have rejected them on a voluntary basis.

The research base on AOT is mixed: some multisite studies report GAINS in treatment adherence and reduced hospitalization, while broader federal reviews have been less conclusive. Outcomes tend to be strongest where court orders are paired with intensive voluntary services rather than relying on the order alone.

Most civil commitments in Texas start with an Emergency Detention. Emergency Detentions require a mental health crisis: that the individual displays a mental illness; that the individual displays a substantial risk of serious harm to themselves or others; that the risk of harm is imminent unless the individual is immediately restrained; and a statement of supporting facts describing specific recent behavior for the belief, including overt acts, attempts, or threats that were observed. The Emergency Detention may happen through either of two legal pathways:

• A law enforcement officer may take an individual to an inpatient facility through an Apprehension by Peace Officer Without a Warrant (APOWW, also known as an Apprehend and Detain or A&D) under Texas Health & Safety Code § 573.001; or
• A judge may issue a warrant under Texas Health & Safety Code
  § 573.011 authorizing a peace officer to transport the individual to an inpatient facility.

Psychiatric Advanced Directives, also known as Declarations for Mental Health Treatment, allow a person to control their mental health treatment in the event that they become unable to make treatment decisions at a later date. It may be possible for a person to carry these documents or pre-submit them to hospitals, jails, and other facilities.

Supported decision making allows individuals to make their own decisions and manage their affairs while receiving the assistance needed to do so. Resources about supported decision making include a handout, a toolkit, an explainer video, and sample agreement forms.

Guardianships can be used to support individuals who, due to age, disease, or injury, need help managing some or all their daily affairs. It should be noted that guardianship removes some of the individual’s rights and privileges. More information on guardianships is offered by the Texas Guide to Adult Guardianship, and the Texas Guardianship Association.

Assisted Outpatient Treatment (AOT) Court Programs are programs in civil courts, typically probate courts, that use court-ordered community-based treatment to improve treatment outcomes and reduce involvement in the judicial system. Implementing an AOT Court explains how to set up an AOT court in Texas. The Texas AOT Practitioner’s Guide explains how to operate an AOT Court in accordance with Texas laws and procedures.

Explore Pre-Arrest Diversion

Counties across the country have implemented pre-arrest diversion programs, wherein police work with local human service and harm reduction providers to connect individuals with substance use and mental health challenges to appropriate resources in lieu of arrest. For instance, the Law Enforcement Diversion Program (LEAD), which originated in King County, Washington, gives greater authority to police to divert someone from arrest for a set of non-violent, substance-use related offenses and instead require the individual to engage with services in the community. Police remain involved with the service provider to ensure the individual is engaging in services. A similar program is the Yellow Line Project, which provides assessment and service connection to individuals in lieu of arrest. Police can bring someone in for assessment and delay arrest conditional upon the individual engaging in services.

These programs and others like them can have profound impact on the lives of people with substance use and mental health challenges. According to an evaluation of the LEAD Program, people engaged in pre-arrest diversion programs were less likely to be arrested, more likely to engage in services, and more likely to take psychiatric medications. They were also less likely to experience overdose because the program helped to connect them with medication assisted treatment. These individuals were less likely to experience mental health crisis compared to those who were not referred to the program. All system partners saw the impact of the program, with fewer arrests, lower recidivism, and decreased pressure on a strained system.

Provide Crisis Intervention Training for Law Enforcement

Specialized training, particularly Crisis Intervention Team (CIT) training, helps officers recognize behavioral health conditions, apply de-escalation, and connect people to services. The training is the foundation that other Intercept 1 practices build on.

Studies consistently show CIT improves officer knowledge, attitudes toward mental illness, and confidence in de-escalation. It is also associated with increased use of de-escalation in the field and improved direction into mental health treatment. The Texas CIT Association, including Shawn Edwards (Lavaca County Sherrif’s Office CIT Captain and current president), has advanced scenario-based training that emphasizes real-world decision-making and connection to local care. The Association is the most useful Texas starting point for counties building or refreshing training programs.

Factors that lead to successful outcomes include:

• Scenario-based exercises tied to the actual local resources officers can use
• Refreshers and ongoing training, not just initial certification
• Supervisory reinforcement so officers feel supported when they choose diversion
• Clear communication about what receiving facilities and clinical partners are available

While CIT delivered in isolation does not move outcomes, it is foundational infrastructure that pays off when combined with cross-sector strategies to facilitate diversion from the ED and jail. The most common mistake is counting the training as the intervention itself.

Create Diversion Centers and Other Clinical Alternatives to Arrest

A clinical alternative to jail is a destination where an officer can hand off a person in behavioral health crisis or facing low-level non-violent charges, complete paperwork in minutes, and return to service. The model works when three conditions hold: the destination accepts everyone regardless of acuity, insurance, or intoxication; the handoff is fast and predictable from the officer’s perspective; and downstream capacity exists for what happens after the officer leaves.

Three operational variants are most relevant for a small or mid-sized Texas county. They overlap in clinical content but differ in who they serve and how access happens.

Crisis Receiving and Stabilization

The defining condition is acute behavioral health crisis. Any door: officers, EMS, family, or the person themselves can initiate contact. No offense is required. Clinical work focuses on stabilization and disposition planning within twenty-four hours. The Bexar County Restoration Center in San Antonio is the most widely cited Texas example.

Pre-Booking Diversion

The defining condition is a low-level non-violent offense by someone with a history of mental illness. Active crisis is not required. The mechanism is officer-initiated routing of someone who would otherwise be booked, typically for a misdemeanor such as criminal trespass, to clinical engagement instead of jail. The Judge Ed Emmett Mental Health Diversion Center in Harris County, provides a strong Texas blueprint. Over its first five years, the Emmett Center reported approximately 8,800 diversions and a fifty percent reduction in subsequent bookings for participants.

Sobering Centers

The defining condition is acute intoxication that would otherwise produce a public-intoxication arrest or emergency department visit. The Austin/Travis County Sobering Center provides another Texas blueprint. The Center advanced the sobering center model by creating dedicated stimulant sobering capacity, an innovation other centers can apply with training and dedicated space.

Clinical Service Categories

The clinical work in any of these facilities operates under one or more state crisis service categories defined by the Texas Health and Human Services Commission: Crisis Respite Unit (low-acuity, voluntary), Crisis Residential Unit (higher-acuity, structured), Extended Observation Unit (up to forty-eight hours), and Crisis Stabilization Unit (licensed inpatient-equivalent, up to fourteen days). A single facility often integrates more than one type on a single campus. The Bluebonnet Trails Diversion Center in Georgetown layers Extended Observation Unit and Crisis Respite Unit capacity under a broader Diversion Center function. The Lubbock County Hope Center for Health and Wellbeing, operated by StarCare, is another Texas facility modeled on existing Texas diversion centers.

Factors leading to successful implementation include:

• Twenty-four-hour operation with a no-refusal intake policy
• Officer drop-off completed in roughly ten minutes
• Capacity sized to typical demand with reasonable surge tolerance
• Standing relationships between facility staff and law enforcement
• Clear transport protocols, including who covers transport when distance is significant
• For pre-booking diversion: a designated point of contact in the District Attorney’s office
• For sobering centers: protocols accounting for substances beyond alcohol, with pathways into ongoing care

Identify Early and Divert When Appropriate

Every person that is arrested and brought to jail should be screened for mental health and substance use disorders and diverted when appropriate. Texas law provides some guidance for this process:

• Continuity of Care Query (CCQ): With limited exceptions, the Texas Administrative Code requires every jail to conduct a CCQ check on each individual upon intake into the jail. The CCQ is originated through the Department of Public Safety’s Texas Law Enforcement Telecommunications System (TLETS), which initiates a data exchange with HHSC’s Clinical Management for Behavioral Health Services system to determine if the individual has previously received state mental healthcare. The CCQ identifies whether an individual has sought services at a Texas local mental health authority (LMHA) in the previous three years. This information is often limited in nature and not as helpful as magistrates, judges, and lawyers would like it to be; the utility of this system depends on the accuracy of TLETS data.
• Code of Criminal Procedure art. 16.22: CCP 16.22 details a procedure for identifying a person’s possible mental illness or intellectual disability at the earliest stages of, and throughout, a criminal proceeding. Under article 16.22, a magistrate must, under certain circumstances, order an expert to interview the defendant and otherwise collect information regarding whether the defendant has a mental illness or intellectual disability in order to alert the necessary stakeholders if the resulting report indicates possible mental illness or intellectual disability. Once the report is reviewed, diversion options like outpatient treatment, voluntary inpatient treatment, or involuntary civil commitment may be pursued.
• Code of Criminal Procedure art. 17.032: Pursuant to CCP 17.032, unless good cause is shown, the magistrate must release the person on personal bond if they are not charged with or previously convicted of a statutorily defined violent offense, the procedures in the statute were followed, and the conditions were met. The magistrate may include bond conditions that address behavioral health needs. Typical conditions of “mental health” bonds include requirements to: check in with the LMHA; abide by the LMHA’s recommendations; possess no firearms; possess no marijuana, controlled substances, or cannabidiol (CBD); and attend all appointments for assessments and services. A “warm handoff” to the LMHA can help promote compliance with the conditions.

As discussed above, diversions for defendants with mental health disorders can provide a benefit to the defendant, the judicial system, and the community as a whole. Jail diversion occurs after an arrest has been made, but before an official charge from the state. This type of diversion can also be called a pre-charge diversion or a prosecutor-led diversion.

Create Cross-System Review Teams

Cross-system collaboration reaches across fragmented services and systems to build constructive working relationships to accomplish goals. Teams composed of individuals across systems can work together to overcome challenges, such as funding silos, limited resources, and differences in system “cultures” or values.

Court liaisons provide a vital link to mental and behavioral health service providers during the life of court cases. Liaisons are typically clinically trained and connected either with a behavioral health provider or with the court. They are adept at providing program and treatment coordination and communicating with service providers and agencies outside of the court.

Community Diversion Coordinators play a critical role. Typical duties and responsibilities include:

• Engage stakeholders in education on the many diversion opportunities across the SIM.
• Assist the court and attorneys in evaluating cases and defendants to determine if a pathway other than jail would better serve the defendant and the community.
• Develop and foster collaborative relationships between the LMHA, local hospitals, the jail, and the courts.
• Coordinate the creation of treatment plans to ensure appropriate community support for individuals being released into the community.

Solid data and information sharing policies support strong cross-system collaboration. Data-driven indicators measure the effectiveness of behavioral health interventions and allow adjustments to be made to increase the effectiveness of those interventions. Data can also measure the cost effectiveness of behavioral health programs and allow policy makers to allocate resources more effectively. Coordinating data offers an opportunity to identify high cross-system utilizers. Data should be collected about individuals' progress and needs, responses to those needs, and efforts to improve mental health responses. Information sharing is required under Health and Safety Code Sec. 614.017 for continuity of care and continuity of services purposes for certain individuals with special needs.

Appoint Counsel with Mental Health Training

There are several ways to increase the Burnet County defense bar’s knowledge of mental health laws. One quick-fix recommendation is a focused education and training campaign. Burnet County could identify a larger group of local defense attorneys who can be champions for initiating an education and training campaign among the local defense bar association. These champions can utilize the assistance of TIDC, JCMH, TCDLA, or other entities to develop curriculum for local defense attorneys and to identify the best methods for implementing education and training among the local defense bar. Training should cover several topics regarding mental health laws, including early identification (16.22), transfer and dismissal (16.22(c)(5)), mental health bond conditions (17.032), competency restoration (46B), information sharing (HIPAA & HSC Chapter 611), and resources available from the local mental health authority, Bluebonnet Trails.

In addition to training on mental health laws, the local defense bar can learn how to fully and skillfully incorporate the principles of Holistic Defense and how to effectively use social workers in criminal defense. The Bronx Defenders is a public defender nonprofit that pioneered a ground-breaking, nationally recognized model of defense that achieves better outcomes for defendants. The Bronx Defenders’ Center for Holistic Defense provides technical assistance and training to public defender organizations and individual practitioners and currently provides assistance in 38 states, including Texas.

The local defense bar can play an integral role in enhancing Burnet County’s justice system by addressing the circumstances driving people into the criminal justice system and the consequences of that involvement. A Harvard Law Review article evaluated the holistic defense model and determined the impact of the program included a reduction in the likelihood of custodial sentences by 16% and expected sentence length by 24%.

There are four pillars at the core of holistic defense:

• Seamless access to services that meet legal and social support needs.
• Dynamic, interdisciplinary communication.
• Advocates with an interdisciplinary skillset.
• A robust understanding of, and connection to, the community served.

Several counties across Texas have begun to incorporate these principles into their local defense organizations, including:

• Harris County
• Bexar County
• Travis County

Many counties offer incentives for defense attorneys to seek training and specialization in mental health laws by offering additional compensation for court appointment cases to attorneys with specialized training or creating a special “wheel” full of attorneys specializing in mental health laws who can be appointed to cases with a defendant identified as having a mental illness. Williamson County is an example of a county with an indigent defense plan that incorporates special qualifications for a mental health wheel.

It is best practice to appoint counsel as soon as practicable upon arrest of an individual. Appointing counsel at an earlier point in the case, such as before indictment, will reduce the length of time people are housed in jail waiting for evaluations or waiting for transportation to facilities for evaluation or restoration. Instead, defense counsel can meet the client and begin assessing the client’s needs. Opportunities to better utilize early appointment of counsel include:

• Creating and implementing a process for appointed defense counsel to access certain evidence in the case file, such as the offense report and arrest warrant affidavit, prior to indictment, so they can begin working on the case.
• Creating and implementing a process for defense counsel to request competency evaluations prior to indictment.
• Discussing possibilities of diversion in lieu of competency restoration in certain cases.

Transfer to Civil Court Via Ccp 16.22(c)(5)

Pursuant to Code of Criminal Procedure art. 16.22(c)(5), after an interview of the defendant provides clinical evidence to support a belief the defendant is a person who has a mental illness or intellectual disability, the court may release the defendant on bail while charges remain pending and enter an order transferring the defendant to the appropriate (civil) court for court-ordered outpatient mental health services under Chapter 574 of the Health and Safety Code. Case transfer under this statute is only for cases where the offense charged does not involve an act, attempt, or threat of serious bodily injury to another person.

Right-Size Competency Restoration Services

The competency to stand trial process is designed to protect the rights of people who do not understand the charges against them and are unable to assist in their own defense. Long-established constitutional law mandates that a criminal prosecution may not proceed unless the defendant has sufficient present ability to consult with their lawyer with a reasonable degree of rational understanding and a rational as well as factual understanding of the proceedings against them. This standard is echoed in Texas statute.

Under Texas Code of Criminal Procedure article 46B.004, if the mere suggestion of incompetency is raised in a case, the court must conduct an informal inquiry to assess whether there is “some evidence from any source” that would support a finding of incompetency. If so, then the court is required to stay (or stop) all proceedings and order a competency exam. If an individual is found competent, the case will proceed to determine adjudication. If the individual is found incompetent, judges can order services, including mental health treatment and medications designed to restore the defendant to legal competence.

For more than a decade, Texas and other states have seen an increasing number of individuals in county jails who have been found to be incompetent to stand trial but who do not have access to a state hospital bed to begin an inpatient competency restoration process. In Texas, several thousand people fail to receive competency restoration services for months or even years, presenting severe challenges to county jails and great personal cost to the individuals. Actively monitoring the local waitlist can help find ways to divert individuals. One method is to have an individual re-evaluated if there is reason to believe the person is stabilized while receiving jail-based mental health services.

JCMH and HHSC partnered to create a statewide initiative to Eliminate the Wait and right-size competency restoration services through education, training, and technical assistance. Every effort should be made to streamline determinations of competency and related proceedings. There is also a growing consensus that because of the likelihood of an increased length of incarceration and confinement, the competency process should be reserved for defendants who are charged with serious crimes, and others should be diverted to treatment.

Outpatient competency restoration and jail-based competency restoration programs are alternative competency restoration options provided by community-based services and in-jail services, respectively. For individuals who meet the criteria, these local programs are effective alternatives to using state hospital beds.

Involuntary medication frequently restores competency for individuals and allows for a more rapid return to the community than involuntary hospitalizations. (Read more at: https://mentalillnesspolicy.org/medical/involuntary-medication.htm l). Rather than requiring cumbersome guardianship proceedings, the Mental Health Code permits treating physicians to seek court orders to allow the administration of psychoactive medications to persons who lack capacity to consent to such medication. The court-ordered medication process cannot be used for Class B offenses; these cases may be good candidates for transfer to civil court under CCP 16.22(c)(5).

Use Alternative Sentencing When Possible

Post-trial diversion and alternative sentencing options provide opportunities to direct individuals to rehabilitation-focused interventions that balance the interests of justice with treatment. Most importantly, they avoid incarceration for individuals who meet certain sentencing conditions. Often involving suspended sentences and/or probation, alternative sentencing can be as creative and flexible as a judge and community resources will allow. Examples of alternative sentencing include community service, assisted outpatient treatment, and other required participation in appropriate treatment, including problem solving courts. Pursuant to Code of Criminal Procedure art. 46B.004(e), the prosecutor may dismiss all charges pending against a defendant after the issue of the defendant’s incompetency to stand trial is raised.

Seek to Establish Mental Health Specialty Courts or Dockets

A “mental health court program” under Texas Government Code § 125.001 has the following essential characteristics:

• integrates and provides access to MI and ID treatment services in processing cases in the court system;
• uses a non-adversarial approach involving prosecutors and defense attorneys to (1) promote public safety and (2) protect the due process rights of program participants;
• promotes early identification and prompt placement of eligible participants in the program;
• requires ongoing judicial interaction with program participants;
• diverts people with mental illness or intellectual disability to needed services in lieu of prosecution;
• monitors and evaluates program goals and effectiveness;
• facilitates continuing interdisciplinary education on effective program planning, implementation, and operations; and
• develops partnerships with public agencies and community organizations, including LMHAs/LBHAs.

Appendix 2 at the end of this report provides additional resource recommendations on mental health and other specialty court programs that Burnet County may find useful. The Texas Judicial Commission on Mental Health has a wealth of relevant resources and technical assistance.

Increase Use of Peers for Justice-Involved Individuals

Certified peers such as Mental Health Peer Specialists, Recovery Support Peer Specialists, and Reentry Peers can make a significant difference for justice involved individuals. The National Judicial Task Force describes examples of how certified peers can add value in court settings.

In reality, certified peers can be utilized effectively at every intercept. Pairing a certified peer with someone with mental health and substance use challenges can foster success for those released on bond conditions or placed on probation.

In studies on the use of peers for justice-involved individuals, researchers found statistically significant improvement in mental health outcomes. They found reduced anxiety and depression, and justice-involved individuals felt more confident that they could abstain from substance use. People paired with peers were less likely to have their bond, probation, or parole revoked. The chance of re-arrest was reduced from 43% to 22%.

More information about certification of peers is available earlier in this report.

Provide Reentry Planning

Transition plans offer guidance for community reentry. A comprehensive plan identifies expectations, resources, and services to guide individuals towards independence. Individuals should play an active role in creating their transition plan.

The most effective reentry planning occurs when the planning begins at intake and continues throughout the individual’s time in jail. Community-based providers should be engaged in this planning process. Coordination between community providers and the jail - sometimes called jail in-reach - can increase the likelihood of a smooth transition, including medication access upon release, warm hand-offs to service providers, and immediate access to benefits and health care coverage.

In jail, time is of the essence. The time someone remains detained in jail can vary from hours to months. There is rarely a set day or time someone will be released. Even when the individual has been convicted and is serving a sentence in county jail, they will likely not have a determinate day of release, as county sheriffs have authority to give time credits based on number of days served.

Therefore, it is imperative to seize each day as an opportunity to help people prepare for success following release. At a minimum, this might mean providing them with a list of relevant resources. Staff could also help to facilitate connection with services by setting an appointment for them. To the extent authorized by law, jails should assist people in obtaining benefits prior to release by pre-screening for eligibility and starting the application paperwork.

If someone needs substance use treatment, the jail staff could coordinate with the local mental health authority to facilitate the Outreach, Screening, Assessment, Referral (OSAR) process. Similarly, if someone is in need of vocational training, jails can partner with Goodwill or the workforce development board to connect them with those training opportunities. They might consider inviting these providers into the jail to orient people to available services and to do intake. Jails might also go so far as to initiate short-term vocational training and on-the-job training programs for people inside.

Provide Reentry Peer Support

Reentry peer support, described in “The Power of Lived Experience” in the Background section of this report, can be a helpful resource in developing and implementing individualized transition plans. Peer support is one of the most effective engagement strategies for justice-involved individuals, particularly during reentry. Individuals with lived experience are uniquely positioned to build trust, support recovery, and help navigate complex systems.

Research shows that peer support improves engagement in treatment, reduces substance use, and increases retention in services. For justice-involved populations, peers are especially valuable during transitions, helping individuals navigate housing, benefits, treatment systems, and supervision requirements.

In Texas, Certified Reentry Peer Support Specialists are increasingly integrated into jail and community-based programs, providing support both prior to release and during reentry. In practice, peers may meet individuals in jail, develop reentry plans, and continue work ing with them in the community to maintain engagement. The Texas HHS peer services portal and SAMHSA peer support toolkit are useful starting points for counties building this capacity.

Peer support tends to add the most value during reentry at these transition points:

• Pre-release engagement that builds trust before the door opens
• Post-release navigation of housing, benefits, and treatment systems
• Re-engagement after a missed appointment or a setback
• Coordination with treatment providers and case managers as part of a care team

Expand Access to Recovery Housing

Recovery housing programs provide a safe, supportive, and drug free environment for people with substance use challenges, especially those transitioning out of jail or inpatient treatment. These programs, such as Oxford Houses, foster mutual accountability and provide a sense of community. Recovery housing has been shown to decrease relapse rates and criminal involvement.

Typically, these are ordinary residential homes with one or two people per bedroom. Residents are often required to engage in recovery programming outside of the home. Often, the residents themselves create and enforce the rules for entry and continued residency, and mutually decide when and if someone can remain in the program if they do not abide by standards.

Communities interested in expanding the number of recovery housing options can contact Recovery People for information.

Create Specialized Behavioral Health Supervision That Matches Individual Need and Stability

Traditional probation and parole models are often not designed for people living with serious mental illness, substance use disorders or co-occurring behavioral health conditions. Supervision conditions such as frequent office visits, community service obligations, multiple treatment appointments, and strict compliance expectations can quickly become overwhelming for individuals already struggling to maintain housing, medication access, employment, or basic daily functioning.

As a result, what appears to be “noncompliance” is frequently the result of untreated symptoms, transportation barriers, housing instability, cognitive limitations, or competing survival needs rather than intentional refusal to comply. When supervision conditions are not aligned with a person’s behavioral health needs and level of stability, community supervision can unintentionally become a pathway back to jail.

A growing body of research and practice shows that supervision is most effective when it is individualized, treatment-oriented, and proportionate to both risk and clinical need. Specialized behavioral health caseloads allow probation and parole officers to work more effectively with individuals experiencing mental illness or co-occurring disorders by reducing caseload size, increasing coordination with treatment providers, and focusing supervision on stabilization, recovery, and long-term engagement rather than surveillance alone.

In Texas, several jurisdictions have implemented specialized mental health supervision models that reflect these principles. Harris County Community Supervision and Corrections Department (CSCD), for example, operates specialized mental health caseloads that pair trained supervision officers with behavioral health providers and wraparound services for individuals with significant mental health needs.

Key elements of effective behavioral health supervision include:

• Specialized caseloads staffed by officers trained in behavioral health, trauma, and crisis response
• Smaller caseload sizes that allow for individualized supervision and relationship-building
• Supervision conditions focused on treatment engagement, safety, and stabilization rather than excessive compliance requirements
• Flexible reporting structures, including phone or community-based check-ins when appropriate
• Strong coordination between supervision officers, behavioral health providers, courts, and community supports
• Attention to transportation, medication access, housing, and other practical barriers that directly impact compliance and recovery