Sunday, February 9, 2014

Mental health a growing concern statewide

Posted: Saturday, February 1, 2014 7:50 pm | Updated: 7:55 pm, Sat Feb 1, 2014.
Jimmy Lee Dykes’ neighbors knew something was amiss about him long before he shot a bus driver and kidnapped a young boy one year ago. “He’s the type that thinks the government’s out to get him,” Michael Creel told the Dothan Eagle on the day the hostage crisis began. “He’s not right in the head.” Another neighbor, James Edward Davis Jr., reported Dykes to authorities after Dykes allegedly displayed a gun in a threatening manner to him and his daughter about a month prior.
Unfortunately, options for dealing with the mentally ill are more limited than they were just a few years ago.
Probate judges are charged with the task of deciding whether to commit an individual, yet a lack of inpatient care throughout the state has created what local judges call a revolving door of patients.
“We are at crisis in the mental health world,” Houston County Probate Judge Patrick Davenport said.
At the heart of the crisis is the statewide shut down of state-run mental health hospitals.
“There were approximately 6,000 beds in state hospitals 10 years ago,” Davenport said. “Today there are 268. Now we have an allocation for Houston County of seven beds in long-term state hospital care.”
Davenport said there were about 500 mental health commitments made last year in Houston County alone.
“From what I’m seeing, it’s kind of a revolving door situation,” said Dale County Probate Sharon Michalic. “You see these people repeat, the same ones in and out. I attribute a lot of that to closing our state hospitals.”
Davenport explained that with so few beds available, people are being discharged from the few remaining beds (such as at the SpectraCare-sponsored New Day Hospital in Ozark) much quicker than in the past, even if they’re not fully stabilized.
“Because of the lack of long-term beds, in many cases there’s no real effective long-term treatment because of the pressure being put on the system,” Davenport said. “They go to inpatient treatment but nobody ever gets their (court-mandated) 150 days because the doctors who are needing to treat the new folks release those existing folks.”
Both probate judges said SpectraCare and other mental health agencies do a good job handling their increased burdens, but they are underfunded and simply don’t have enough resources to fully solve the growing problem.
“What’s happening too often is that we have the seriously mentally ill that are having to be removed and stepped down (to outpatient care) too quickly because there’s so many folks needing the inpatient beds,” Davenport said. “It’s a revolving door of the mentally ill, and that door is ever-increasingly growing.”
To drive home his point, Davenport relayed a story of a woman he represented as a probate lawyer 12 years ago who was recently brought in for another mental health hearing, her latest in a long line.
Law enforcement also faces increased responsibility.
When called to scenes of domestic violence or other threatening situations, mental illness often reveals itself as a cause of the problem.
Houston County Sheriff’s Capt. Jeff Carlisle said he’s personally seen an increase in those situations.
“We deal with these people more frequently because they’re not in the state hospitals,” Carlisle said. “Now we’re dealing with outpatient care, but the problem is they’re often not secure and these people can walk away, creating a safety issue for themselves and the public.”
Still, residents are stressed to take action if signs of mental illness become apparent and dangerous.
Concerned family members, neighbors or even strangers can file a petition with the probate court, but must follow some strict guidelines.
First, a petition must be filed to the probate judge alleging an individual is mentally ill and poses an imminent danger of substantial bodily harm to themselves or others.
That danger must be based on specific acts, behavior, attempts or threats.
“It could be a specific act or a failure to act – somebody’s not eating, not taking care of themselves, refusing treatment,” Davenport said. “It could be an act of brandishing a firearm or making verbal threats that they’re going to harm themselves or others.”
Davenport said the proper way to handle a situation in which a resident is concerned about his or her neighbor’s mental health is to call the Department of Human Resources.
“Call DHR, make a report, and adult services will go make a wellness visit,” Davenport said. “They will check on the individual in question and they can take in enough info to determine whether he meets the standard.”
Law enforcement must be contacted if an imminent threat presents itself.
Carlisle said officers are trained to act defensively when responding to situations involving mental instability.
Unfortunately, Carlisle, Michalic and Davenport all said they only see those instances increasing unless major changes are made.
While the state sought to save money by closing the hospitals, local officials said they aren’t convinced the move hasn’t actually cost money.
“We’ve got twice as many commitments now as when the state hospitals were closed,” Davenport said. “I don’t know if it’s paid. I can imagine we’ve paid a lot more in other areas. I know for a fact we’ve got more sick people on the street now than we did before.”
He said the two biggest changes that need to be made are more inpatient beds and more group-home beds, because that will provide individuals a safer step-down mechanism to work toward making them productive citizens.

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