Dr. Marcus Guice, MD, Interim Executive Director of Health Services
It is the policy of the Harris County Sheriff’s Office to provide all inmates with professional health care. Inmates will be afforded the opportunity to have access to care to meet their serious medical, dental and mental health needs. Care is delivered to all inmates regardless of housing status, sex, race, religion, creed, national origin or ability to pay.
The Health Services Division provides services in dental, dietary, chronic care, OBGYN, orthopedics, infectious disease, TB, dialysis, optometry, MHIDD, radiology and laboratory. The Division has a 24/7 full service pharmacy. The Division operates a 100-bed in-patient medical infirmary, staffed 24/7 by a dedicated staff that includes a full-time physician, psychiatrist, nurse practitioner, nurses and other medical professionals. The 1200 Baker Street Jail hosts the Main Clinic that provides the same medical care found in most urgent care centers or emergency rooms. It is staffed 24/7 with physicians, physician’s assistants, nurse practitioners, nurses and other medical professionals. Both the 701 and 1307 Jails have clinics for minor emergencies.
Mental health services in the Harris County Jail can often begin long before a person arrives to the jail. Arresting officers obtain pertinent information that is shared with Harris County Sheriff’s Office (HCSO) Jail staff at the time of booking. HCSO security staff will ask additional questions regarding mental health history as well as thoughts of self-harm. The booking process culminates with a nursing assessment to determine any medical and/or mental health needs that warrant contact with a provider prior to a person receiving their housing assignment. Individuals needing mental health services will be seen by a Mental Health and Intellectual Developmental Disabilities (MHIDD) psychiatrist in the Front Door Clinic located in the 1200 Baker Street Jail.
The Front Door Clinic is the first contact a mental health patient will have with a MHIDD psychiatrist. The psychiatrist will complete an evaluation looking at mental health needs and will make housing recommendations. Some will go to general population and others may go to one of the Forensic Inpatient Services mental health units.
Forensic Inpatient Services consist of 2 infirmary cell blocks and 3 step-down units. These cell blocks are a joint effort between MHIDD and HCSO. Staff for the infirmary units consist of HCSO nursing, psychiatric technicians and specially trained deputies. In addition, MHIDD provides psychiatrists, physician assistants (PA), advance practice nurses (APN), clinical case managers, and other licensed clinicians. Licensed clinicians such as Licensed Chemical Dependency Counselors (LCDC), Licensed Professional Counselors (LPC), Licensed Clinical Social Worker (LCSW) and etc., provide group counseling to address mental health and substance abuse needs.
Services for individuals housed in general population are provided by the Forensic
“Outpatient Services” and Chronic Care Units. “Outpatient Services” consist of licensed clinical staff and psychiatric staff who respond to requests for MHIDD services from patients, HCSO staff, family members, courts and many others. These clinicians complete assessments and determine the most appropriate level of care needed at that time. Chronic Care consists of registered nurses and psychiatrists who are responsible for monitoring and addressing ongoing medication concerns expressed by patients or any other referral source. Patients who are stable and require no medication changes or concerns, are seen face-to-face by a registered nurse, at least once every 90 days, and then discussed with an MHIDD psychiatrist. Continuity of Care services, for individuals active with MHIDD community clinics at the time of arrest, are provided by case management staff.
Psychologists are available to conduct evaluations for those individuals whose competency or sanity come into question. The Competency and Sanity Unit completes evaluations in the jail and at MHIDD Bristow Clinic for individuals out on bond.
The Harris County Jail has been referred to as the largest psychiatric facility in the State of Texas. More than 2,000 inmates incarcerated are on psychotropic medications on a daily basis. Harris County leads the nation in correctional mental health treatment.