Spotlight on San Antonio

The Boston Globe “Spotlight” team reports on the mental health care system in San Antonio, where the behavioral health care system has come to be considered a national model. In addition to improving coordination between law enforcement, the courts, and treatment providers, and improving law enforcement training, they have pursued the controversial strategy of taking decisions on treatment and medication out of the hands of the most severely ill.

San Antonio and the surrounding Bear County built a crisis center for psychiatric and substance abuse emergencies and a 22-acre campus for the homeless that resembles a community college. Thousands of emergency responders in San Antonio and Bexar County have been trained to manage mental health crises. Local judges devised an involuntary outpatient treatment program for people resistant to help and special juvenile court sessions for teens struggling with mental illness. An alliance of mental health specialists set up a transitional clinic to make sure people released from hospitals have immediate access to therapy and medication. And in May, the county opened a $2 million reentry center designed in part to help mentally ill inmates transition to society.

To date, more than 100,000 people have been diverted from jail and emergency rooms to treatment, local officials say, resulting in a savings of nearly $100 million over an eight-year period.

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