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Archive for Monday, October 14, 2013

Mental health crisis calls — doubled in past decade — weigh on minds of police, health agencies

October 14, 2013

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Sgt. David Hogue, shown here in a Journal-World file photo, is now the sergeant of the department's community services division after spending years as a crisis negotiator.

Sgt. David Hogue, shown here in a Journal-World file photo, is now the sergeant of the department's community services division after spending years as a crisis negotiator.

David Hogue had just changed into his civilian clothes and prepared to go home after a day’s work at the Lawrence Police Department when he got the call from his sergeant.

Hogue, at the time a crisis negotiator, heard that patrol officers hadn't been able to draw out a man holed up in his apartment all day with a gun and plans to end his life.

Hogue hurried to the apartment and began pulling together details. The man’s girlfriend said that financial problems and a recent arrest caused the man to believe he could no longer pursue his dream of becoming a law enforcement officer.

So Hogue approached the apartment and assured the man it was still possible. Unable to make face-to-face contact and unsure of the man’s condition, Hogue continued to talk through the wall for half an hour. To no answer.

•••

The call, a little less than five years ago, was one of many in an ongoing swell of mental health crisis calls. Police say such calls have doubled in the last decade. In response, law enforcement and mental health care officials have increased training for first-line responders and are working on cultural changes within law enforcement to make it easier and more acceptable for the responders themselves to ask for help.

In 2010, Lawrence police responded to 1,651 “check welfare” calls, the category that includes mental health-related calls. Last year, that number grew to 1,769. Suicide attempts accounted for 369 calls in 2010 and 414 calls in 2012.

Often the subjects of the crisis calls land first at Lawrence Memorial Hospital. Janice Early, LMH spokeswoman, said 64 percent of patients admitted to the hospital’s Crisis Stabilization Service are transferred to an inpatient treatment facility such as Stormont-Vail West in Topeka or Osawatomie State Hospital, about 60 miles southeast of Lawrence.

LMH’s Crisis Stabilization Service opened as a separate section of the emergency department in 2004, cared for an average of 682 patients a year from 2008 to 2012 and is projected to care for 718 this year, down from 748 in 2012, according to Early, who said the majority of patients suffered from depression, suicidal thoughts or acute psychiatric illness.

For police processing such cases, it is a time- and resource-intensive process, said Sgt. Trent McKinley, a Lawrence Police Department spokesman. At least two officers must go to a mental health call, one must stay with the patient at LMH during a two-and-a-half-hour screening and two must take the patient to his next placement, often Osawatomie. Many patients can stay at Osawatomie for only 72 hours, and often that’s not enough, McKinley said.

“In our experience that doesn’t appear to be enough time to get someone truly leveled off,” McKinley said. “We almost run calls on them again immediately.”

•••

Last year, Bert Nash instructors and Lawrence Police conducted 11-hour mental health first-aid training sessions. Police Chief Tarik Khatib required every department employee, including civilians, to take the course, which puts participants through a variety of role-playing scenarios. The training sessions are part of an effort by area law enforcement and health agencies to roll out measures to not only better handle mental health crises but to cope with their occasionally traumatic, often stressful, nature.

Patricia Roach Smith, chief operations officer of Bert Nash, said the center has about 20 employees on call to help police, the sheriff’s department and fire and medical workers as part of a crisis response team. Smith said Bert Nash is also in ongoing discussions with the police department to expand the center’s availability to be on call — perhaps by identifying subjects already assigned a case manager at the center.

“I hear very clearly from law enforcement that this is a big deal,” Smith said.

Bert Nash has also assigned a social worker and case manager to the Douglas County Jail, where each spends 25 hours a week, and a full-time staff member in the Jail’s re-entry program.

Meanwhile, the Rev. Paul Taylor, a local pastor, is part of a group of chaplains that serve each of Lawrence’s and Douglas County’s emergency service agencies. And within the past year, Lawrence Police and the Douglas County Sheriff’s Department have begun initiatives to establish peer-counseling programs. Hogue, now a sergeant of the police department's community service division, said the department plans to train staff interested in being peer counselors later this month, with another round of training to follow in early 2014. The measure, though designed to address traumatic events, also reflects what Hogue and Taylor recognize as a more positive trend during this decade.

“There’s been a transition in the culture of society in general where issues related to mental health are coming to the forefront,” Taylor said. “(Emergency personnel) are all under extreme pressure and the old culture used to be to tough it out and keep going. If you ever came to a place where you couldn’t do that, maybe it was time to find another career. I’m grateful that that mindset has been gradually eroding.”

A little less than five years ago, as Hogue stood outside a Lawrence apartment one warm evening, the now 11-year veteran knew he would need someone to talk to by night’s end, no matter how the crisis concluded.

•••

Hogue wanted the man’s girlfriend to be honest. He didn’t want to convey that all would be well for the couple if the girlfriend intended to break off the relationship once the man was stabilized. Once he felt comfortable enough gauging her intentions, he knew he had another “hook” he could use to try to draw the man to safety ­— the other being a hope for a future in law enforcement.

But Hogue hadn’t heard from him in awhile and, worse, he couldn’t stop wondering what he would do if he heard a gunshot. The old advice Hogue recalled in years past was to not become emotionally attached while attempting to diffuse such crises. “That’s B.S.,” he says now. “It’s not possible. For me, now supervising crisis negotiators, I don’t tell people not to get emotionally involved because you can’t do that.”

The man, Hogue said, eventually exited the apartment unarmed and would later get the help he needed. A tactical team soon moved in and put the man in handcuffs. Several yards away, Hogue stood, now sure it was all right to get sucked in so long as he had an outlet of his own, in this case his wife and his co-workers.

“All I wanted to do was hug the kid,” Hogue said. “I wanted to literally run over there and hug this kid because I was so glad that he came out.”

Comments

Scott Morgan 1 year, 3 months ago

It should be noted around 10 years ago we lost a wonderful psych unit at LMH. In the biz, we are known as a city without mental health holding ability. No 24 hour services.

This is what we do in Dg County.

Go to Topeka, go to Osawatomie, or when your feeling better make an appointment to see somebody.

Chelsea Kapfer 1 year, 3 months ago

I did my psych clinical rotation at Osawatomie. That place is not pretty. I mean no disrespect to the men and women working there at all-they are doing the best they can with the little resources they have. I also worked in a maximum security prison. The mental health staff is dedicated, extremely competent and stretched way too thin. Severely ill patients are warehoused and maintained with little expectation or hope of rehabilitation. It's a sad world we live in, where we let those that need help so badly get thrown away.

Scott Morgan 1 year, 3 months ago

I am thrilled that the LJW has done away with anonymous comments but I now realize that there is the possibility for confusion when there are multiple people with the same name.

I'm not making any comments one way or another on the article or the previous comment by "Scott Morgan" but I have been asked if I am the Scott Morgan who posted and I am not. I am, for better or worse, the Scott Morgan who spent eight interesting years on the school board.

Ron Holzwarth 1 year, 3 months ago

Clipped from the above article:
Many patients can stay at Osawatomie for only 72 hours, and often that’s not enough, McKinley said. “In our experience that doesn’t appear to be enough time to get someone truly leveled off,” McKinley said. “We almost run calls on them again immediately.”

It is truly unfortunate that everyone does not have access to the same level of mental health care as local veterans do. At the VA psychiatric wards in Topeka, discharge in less than a week is very rare.

Ron Holzwarth 1 year, 3 months ago

If you are seriously depressed, there are medications that can help a great deal. There really are. But you cannot get them without taking the first step of asking for them.

If you feel seriously depressed for more than a few days, and especially if it that seems to be your life, you should never hesitate to make that first phone call for help.

Especially if you feel at all suicidal! You don't have to admit that to anyone, just tell a professional that you are really depressed and there seems to be no real reason for you to feel that way.

If you have a private physician already, go talk to him or her. Any physician can immediately prescribe a medication for you that is likely to help, and also refer you to a psychiatrist if needed. And do not feel embarrassed to see a psychiatrist, a lot more people see them than will admit to it.

And, some of the medications are the $4 or $6 a month generic ones you hear about. So, being worried about the cost of medication is no excuse.

It is very important to keep in mind that almost all antidepressant medications take about six weeks to reach full effectiveness. There are a couple that work within hours, but they cannot be used for very long, and will require supervision for their use. So, don't wait until it is really bad to get on the path to a better life.

I am giving phone numbers here. If you think you might need these numbers, write them down. In a bad situation, you won't be in any kind of mood to try to look for them.

1) To talk to someone NOW, call Headquarters at 841-2345. Remember 84, then count. There is someone for you to talk to 24/7, 365 days a year. They can refer you to someone, they will know who you should call next.

2) If you don't have much money, call Bert Nash at 843-9192 (Lawrence and Eudora) and explain your problem and financial situation. There is a fee, but it should be within your means. If you are in Baldwin, same number with 888. (888) 843-9192.

3) If you are a KU student, call Watkins Health Center at 864-9500. Don't listen to the recording if you are in a big hurry, press 5 to talk to a nurse right away.

4) If you are a veteran, you can call the Veterans Administration hospital in Topeka at (800) 574-8387. But, it may take some time to get an appointment if you do not already have a VA patient card. I would certainly urge anyone that is possibly eligible for VA health care to take their DD-214 to Building One at 2200 Gage in Topeka and apply for one. There are also VA hospitals in Leavenworth and Kansas City, but the VA hospital in Topeka specializes in psychiatric services. If you have a VA patient card, it is good at any VA hospital anywhere in the USA. Get a patient data card before you need it, because you may need to apply for one and be approved, and that may take some time.

5) And, in a really bad situation, you can always call 911.

Leslie Swearingen 1 year, 3 months ago

So, why did they take him away in handcuffs? He was a sick man not a criminal.

Scott Morgan 1 year, 3 months ago

Sure as good made little green apples, this unfortunate young man is not alone. This type of situation in many forms happens enough in a city/county population of this size to warrant a mental health 24 hour facility.

I do think our officers and deputies are top rank. Include in this group our E.R. staff. But, they are not mental health experts.

Severe schizophrenia to simple medication dosage problems can manifest different behaviors even professionals need time to understand. Hence, at least 24 hour observations.

Folks suffering from severe mental illnesses are not dumb, they know what to say to get themselves out of uncomfortable situations. With an overnight lock-down facility time is given for medical records and histories to be evaluated.

Ex. Patient not taking, or abusing alcohol/street drugs with prescribed medications can be helped with time.

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