Sheriff Troy Nehls defended his staff and called instead for state legislators to “pony up” to help meet inmate needs. He said lawmakers have designated county jails as “de facto mental health facilities” and passed down “unfunded mandates” for local authorities like his to fulfill.

“The state has failed in their response to mental illness,” Nehls said in an interview this month. He pulled out an annotated newspaper clipping from the Chronicle to prove his point: Texas had been cited as 49th in per capita mental health care spending, based on its 2010 funding.

However, experts say local attitudes toward mental health care in jails need to shift as well.

“They have to step up and be better at handling all of this,” said Diana Claitor, co-founder of the Texas Jail Project.

Agency officials say changes are underway to improve conditions at the county jail. They include a tweaking of the set-up of some cells; implementation of an electronic system for guards to use on rounds to replace paper sign-off sheets; and plans to request $600,000 from the county before the end of the year to hire more inmate processing personnel.

Still, Worthington noted, “Nobody has enough funding.”

For anyone to say nothing more could be done because of it is a “huge cop out,” Worthington said, adding: “To not protect a human life, in whatever capacity they can, is totally unacceptable.”

The county jail in fast-growing Fort Bend currently holds 850 to 1,000 inmates on a given day, officials said.

Of those incarcerated in county jails statewide, more than 60 percent have not been convicted yet, Claitor said. But, if they cannot post bail, they must remain in an atmosphere that can be hostile, depressing and even threatening.

“A lot of time people are treated kind of in a generalized way,” she said. “They’re all the enemy.”

Six Fort Bend inmates have committed suicide since 2003, Nehls said.

Jailers say they take seriously their task of keeping inmates safe, beginning when each arrives for booking. A nurse goes through 16 numbered questions, and the answers to some questions can result in inmates being automatically placed on suicide watch. They include:

“Are you thinking of killing or injuring yourself today? If so, how?”

“Have you ever attempted suicide? If so, when and how?”

“Does inmate show signs of depression (sadness, irritability, emotional flatness)?”

Inmates who are unable to answer a question or whose answers elicit concern – on average, eight people a day – are dressed in hefty dark-green smocks, like stiff quilts shaped to be fitted onto paper dolls. Then they are shuttled to a cell for mental health evaluation, assuming one is available.

There, with only a drain in the floor, a light on the ceiling and a ledge to sleep on, they are to be checked on every 15 minutes by a jailer and evaluated within 24 hours by a mental health professional, staff said.

The cell’s pinkish beige walls look like normal walls, but they give when pressure is applied. In one, scratch marks were carved into the foam-like material. The word “fame” was scratched inside the door.

Potential hurdles

Despite the precautions, Nehls said that when it comes to catching potential suicide victims, the possible “roadblocks” are numerous. Of those who died from suicides most recently, on Sept. 30 and Nov. 3, neither was said to be on a mental health “hold.”

Inmates with past experiences in the criminal justice system may realize that certain responses to the questionnaire could land them in the “rubber room,” Nehls offered. Or an inmate could lie, covering up underlying problems

“We won’t know, right?” Nehls said. “We just won’t know.”

Once inside, if an inmate tells a loved one about suicidal feelings, these comments will be handled by officers if reported, said Sgt. Diego Garza, who oversees the jail’s medical department.

But sheriff’s Lt. Christopher Pressler added that if someone really wants to commit suicide, “Are you going to tell somebody that’s going to help you?” Pressler oversees inmate processing.

The so-called “general population” inmates are to be checked on by guards hourly, a requirement that the state commission found jailers had recently been failing to meet. (The jail remained in noncompliance as of Wednesday, according to the commission’s website.)

Even so, Nehls said, “Hour’s a long time.”

No new training

His colleague, Capt. Jule Brownfield, director of detention operations, agreed. It takes less than 10 minutes to kill oneself, he said, be it by tying a uniform on a plumbing apparatus, as one inmate did, or hanging oneself with a sheet on a shelf on the cell wall, as they believe another did.

The minimum standards for checks ensure inmates – as well as the security and safety of the facility – are visually seen, said Brandon Wood, executive director of the Texas Commission on Jail Standards. But the missed checks were not symptomatic of a larger problem so much as a result of, perhaps, mitigating circumstances like a fight breaking out, Brownfield said.

“Everyone back there is competent,” Nehls said of his staff. From his point of view, there would be no need for new training of jailers. He planned instead to re-emphasize the importance of walking routes.

Volunteer pride

The criticism of the sheriff’s office comes even as Nehls has implemented what academics, jailers and advocates consider progressive change. Nehls, a former constable and police officer elected sheriff in 2012, believes his initiatives have improved the outlook of inmates.

They include vocational training classes, programmed “self-help tablets” for rent, and kiosks for requesting hair cuts, chaplain services and medical appointments.

Nehls takes particular pride in people like volunteer Robert “Bob” Kidd, 77, who preaches on two days of the week to whomever wants to listen. Kidd believes all humans are spiritual beings, and all problems have a spiritual beginning, but he said that inmates must recognize they need help.

“Most guys that are going to commit suicide don’t tell you,” he said, his eyes beginning to tear up. “I wish I could; I wish I had an answer.

“I don’t know how to help people unless they reach out,” he said.

Still, Kidd keeps coming, every Monday and every Friday. On a recent morning, a chaplain had provided him with signs to pass out:

“Depressed? Need to talk to someone?” the signs begin.

“We will sit down with you, pray with you. Don’t face this all on your own, we are here to help.”