Special Report: Law enforcement and mental health

mental-health-and-law-enforcement-ten-sotvo

KIMT News 3 – Paperwork to get “committed” is filled out at the courthouse.

Once it’s signed, dated, and looked at by judge, deputies or “servants of the court,” are off to pick that someone up and sit with them sometimes days.

Deputy Cameron Manson and Chief Deputy Jeff Crooks have similar job duties.  One includes helping those who are presumed to be mentally ill.

“We’re taking deputies off the street doing other normal roles of patrol, serving papers, serving arrest warrants, and being expensive babysitters,” Deputy Manson said.

“We don’t have enough people and when we have people, multiple people, on the road at times dealing with mental health issues that are involved in Floyd County, we’re down deputies on the road,” Crooks said.

Their concerns are similar.  They want to help those who may have a mental illness.  The problem they and others across southern Minnesota and North Iowa are facing is too much time spent sitting with them while waiting at the hospital to get evaluated at a psychiatric unit.

“It’s a huge issue; it’s getting bigger and bigger.  When I started 12 years ago, we possibly did one, maybe two committals a week.  I would say we average one a week,” Crooks said.

You may or may not have heard what it takes to get someone “committed”.  The idea is meant to get people the mental health help they potentially need.

Here’s how it works.

Once someone is picked up in a squad car, they’re not arrested and they aren’t heading to jail.  They’re considered a “respondent.”  The next stop is a hospital or facility with psychiatric beds.

“Smaller agencies and when you have to deal with one subject, it takes a person off the road, now you possibly deal with two subjects — we’ve dealt with as many as five subjects in one day,” Crooks said.

The clock is ticking, especially for law enforcement with other duties at hand.

“We transport them up to the hospital, we have to check in at the emergency room and there’s where we have the problem.  It gets “bottlenecked” because a lot of times there’s no place for the patient because there’s no rooms available,” Manson said.

Manson can’t help but be honest.

“We take them to the emergency room and we’re sitting for several hours because many times the court order says deliver the person to Five East at Mercy.  Until we can actually hand them off to a Five East nurse, our committal is not completed,” Manson said.

Facilities like Five East are constantly full.

“Like many psychiatric units, we run at very high volumes.  We’re consistently assessing and reassessing our staffing.  On Five East, we have highly trained staff made up of case managers, social workers, nurses,” Rose Brantner said.

Brantner explains Five East is a hospital floor where patients are assessed, provided individual care and then constantly monitored and reassessed during their stay.   They could be sent home if found with no problem or they could be asked to stay until their court hearing 48 hours to five days later, but sometimes all 30 beds are taken.

“We want to provide care to everyone.  When we’re not able to provide it here, we make sure the patient gets to a facility that has available psychiatric beds,” Brantner said.

That’s the time-consuming issue for law enforcement.

Crooks and Manson explain when the closest facility like Five East is full, they travel miles upon miles to get someone the help they need.  They sit with the patient and wait until a bed clears up.

“We are in sense a babysitter doing security on that person in the emergency room until a bed opens upstairs in psychiatric ward or they call around to all the different state hospitals to see availability of beds, off we go on a transport,” Manson said.

Gov. Terry Branstad’s office says they recognize the tough job law enforcement and mental health advocates have, but they’re focused on modernizing health care.

Iowa has 720 facilities set up for someone who’s had paperwork filed to be committed.  According to the Iowa Department of Human Services bed tracking counter, 60 to 100 beds are open at all times across the state.  Instead of warehousing patients at Clarinda or Mount Pleasant, the two mental health facilities shut down last year by Branstad, only two remain.  Ben Hammes, communication director with Branstad’s officem says their focus is on community-based settings.

Magistrate Court Judge Patrick Byrne deals with those committed as much as deputies do.  Byrne doesn’t get a call unless no beds are available locally.

“Mental illness is a medical condition — it causes me concern anytime anybody has to sit in an emergency room waiting for medical treatment,” Byrne said.

Byrne says it’s on his radar that there is a growing problem when it comes to wait time for a patient.

“The delays that happen that I hear about are generally where folks are taken to the hospital by the emergency room and there are no local beds, and it’s difficult to find a bed somewhere else,” Byrne said.

Everyone with papers filed for their “committal” is appointed an attorney.  There’s a hearing 48 hours later where those like Byrne decide if they need court-ordered outpatient treatment, court-ordered inpatient treatment, or can be discharged to voluntarily seek treatment.

“We don’t have the problems here in North Iowa that they do in other places where in some other places it might be seven calendar days before you have your hearing. That’s very rare in Cerro Gordo County and North Iowa area,” Byrne said.

Those involved see the issue through their own eyes and they all have ways they believe it can be fixed.

“My profession, we get involved when it’s a crisis situation. If there’s more prevention out there and more people to help subjects with mental health, we’re working more and more on prevention. Then we don’t get to that crisis situation,” Crooks said.

The governor’s office agrees with Crooks.  Others say there needs to be more staff available to evaluate those needing help.

There are many reasons why beds may not be available for a patient.  It could be not wanting to mix males and females in the same room, behavior issues or maybe a room just isn’t clean and ready for the patient just yet.

All agree it’s an issue that doesn’t have an easy fix.

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