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Jonathan Taylor Ngumbi was experiencing a mental health crisis. His brother called 911, expecting Ngumbi to be taken to the hospital. Instead, Ngumbi was arrested and died in jail six days later on Nov. 2, 2023.
“My mentally ill son [received] a death sentence while in crisis,” Deborah Winters, Ngumbi’s mother, shared in her written testimony submitted to an advisory commission overseeing this year’s Texas Sunset Review. The Sunset Review is a periodic evaluation of state agencies that includes public input, meetings, and a self-evaluation report.
For advocates, the Sunset Review presents an opportunity to address gaps in services affecting people such as Ngumbi who have serious mental illness, or others with intellectual and developmental disabilities (IDD), who are caught in the pretrial detention system. The review is set to end for the Health and Human Services Commission (HHSC) in December, ahead of the 90th Texas Legislative Session.
Winters spoke with Prism about the 13 years between her son’s Bipolar 1 diagnosis, his freshman year of college, and his death at Kaufman County Jail. Ngumbi was arrested numerous times, according to Winters and over a dozen arrest and conviction records that Prism reviewed. All but one of these arrests occurred during mental health crises, Winters said. She said her son was pinballed between agencies, hospitals, and jails instead of receiving the care he needed.
“The line blurs between who’s insane, the person or the system,” Winters wrote in her testimony.
Incarceration in lieu of treatment
According to Prison Policy Initiative, 40% of individuals in state prisons have a disability, and over half report mental health problems. This disproportionate representation speaks to the landscape of mental healthcare in the over half a century since President John F. Kennedy signed the Community Mental Health Centers Act of 1963 into law, distributing grants to states to help build treatment centers across the country. Mental health advocate Sonja Burns, who focuses on individuals who live with the most complex needs, told Prism, “We were supposed to build all these small things, which we didn’t do.”
Federal limitations, such as Medicaid’s Institution for Mental Diseases (IMD) Exclusion and Medicare’s 190-day lifetime limit of inpatient psychiatric care, can lead to individuals being excluded from care they need in order to stabilize from a mental health crisis. Outcomes from the Early Onset Treatment Program at the University of Texas Health Science Center at Houston–Harris County Psychiatric Center showcase the efficacy of early interventions for psychosis, but the program requires outside funding sources to provide treatment for an appropriate length of stay that may go beyond the IMD Exclusion limitations.
Texas state hospitals have been shifting to acute care over the past two decades, according to Burns. The proportion of the state hospital census made up of “forensic” commitments, or those relating to the criminal legal system, has shifted from 28% in 2006 to 72% of state hospital commitments in 2025, according to HHSC. While the forensic waitlist has actually increased as the civil, or non-carceral, waitlist decreased, advocates say this does not mean the need for mental healthcare in the general public has gone down. Rather, they say, the shift captures how unmet needs funnel people into the carceral system.
Krishnaveni Gundu, co-founder and executive director of the Texas Jail Project (TJP), shared HHSC data showing that county jails are a major source of transfers of people with IDD to State Supported Living Centers. “What this tells us is they are forced to go through jails for something that is already an entitlement for them,” Gundu said. “People are being institutionalized in our jails.”
Road to nowhere
Advocates, family members, and representatives from the judicial system spoke to gaps in services leading to incarceration instead of treatment, including an absence of a “step-down” residential option to provide adequate intermediate levels of care for individuals needing longer-term care with stronger guardrails than group homes and other outpatient services can provide.
The 988 Suicide and Crisis Hotline, aimed at mental health crisis support, cannot function effectively if appropriate mental health services do not exist. Winters spoke to the importance of having an option where people can live with dignity and be successful, with support available to return to care as needed.
Advocates encourage innovating within the programs the state is already funding to create this space between hospital-level care and community placement, providing workforce training and community where people can thrive.
Adequate data collection organized in a dashboard is another central ask. Dashboards would provide access to information often held behind an open records request, advocates say. Without adequate tracking, individuals who have already reached their lifetime 190-day Medicare inpatient care limit are unable to access care even when well-intentioned programs try to direct them to it. Despite the state investing $2.6 billion in the hospital system, the need is greater. “You want to collect that data so you can build out the system you need,” Burns explained.
Simple solutions
Many of TJP’s clients are unenrolled from the local mental health authority after being jailed for more than 30 days, Gundu said. Having individuals remain enrolled in services is a primary goal.
Current efforts, such as the creation of the Continuity of Care Query, do not guarantee services simply because someone has been identified as a client of the state. Instead, access to care depends on whether the local mental health authority has a contract to provide services with the jail. The Court Liaison program is piloting its second cohort, however, Gundu said, the continuity of care should already be happening; it should not require a liaison in order to access.
“This is why we say that a public health issue has become a public safety issue because you don’t provide the right care at the right time at the right place,” Gundu said.
A crucial time to act
The next meeting for this year’s Sunset Review is tentatively scheduled for Nov. 18. TJP encourages Texans to submit comments, concerns, and proposed solutions to the Sunset Commission via the public input form.
For Winter, the consequences of failing to act are irreversible.
“I can’t get my hands on my son,” she said. “I always got him back. I always got him back. And I’m never going to get him back. Never.”
Editorial Team:
Sahar Fatima, Lead Editor
Carolyn Copeland, Top Editor
Stephanie Harris, Copy Editor
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