Wednesday, October 30, 2013

Tip 'o the hat

A couple weeks ago, I posted a blog about the increase in mental health cases that are handled by the Lincoln Police Department. The increase in these cases during the past dozen years has been dramatic--even when population growth has taken into account. I am not completely confident in conclusively identifying the cause of this increase, and suspect that a few different factors may be at work. I am, however, of the opinion that one of those factors is that community-based outpatient care and support for people with chronic mental illnesses simply has not kept up with the need.

As I have asked before, for what other chronic medical condition, normally controlled with outpatient care, is the response in the event of an acute episode to call the police? Would we rely on the police as the basic response to an epileptic seizure? Would our first impulse in the event of an diabetic reaction be to call the cops? Yet, this is precisely what happens with depressing regularity when a person with a mental illness suffers a psychiatric crisis. I am not the only one who sees the reliance on the police in the absence of more appropriate services as a problem.

While I think we can do better, I also acknowledge that the police have, as part of their fundamental purpose, a mission of protecting people, and assisting those in need. It's simply a pity that we often can do no better than summon someone with the power to use force and to arrest as the primary caregiver.

After posting the data on these incidents, however, Sgt. John Walsh caught up with me. Sgt. Walsh has taken over the role as LPD's liaison on matters involving the mental health system from Capt. Joe Wright, who recently retired to accept a position as the security director for the Lincoln Public Schools. Sgt. Walsh wanted to make sure I was familiar with the work of the Mental Health Association of Nebraska. You can read more about what the association is doing in collaboration with the police department at their website.

Here we have a non-organization, led primarily by volunteers who are themselves consumers of mental health services,  reaching out to help the police, and to help other people with mental illnesses in need of some community-based services, one on one. Here is the updated data that Sgt. Walsh sent to his colleagues yesterday morning:

MHA would like to thank the over 150 officers on the department who have made over 400 referrals to their program in the last two years.  They have made contact with over 50% of the people you have referred and over 80% of those folks have accepted services from them.  MHA is operated on a grant from the sale of LGH W, and state funds received after the regional centers closed.
Recently MHA has sent me the names of those you have referred during April, May and June.  We have looked at calls for service three months before the referral and three months after.  Included in the numbers below are those who have accepted and those who have not been located or accepted help.  Below are the results of those 52 referrals:  
                                       Before                                  After
Arrest/suspect                  19                                       14 
Victim                                 46                                       26 
Mental Health Inv.            75                                       12
That is an impressive result, showing that when the MHAN is able to find and contact the referral, his or her risk of arrest or victimization drops considerably, as does the frequency of police involvement in subsequent mental health investigations. The need remains large, but the Mental Health Association of Nebraska, is doing a great job trying to do something productive, and I tip my hat to them.


Anonymous said...

Increasing over-prescription of psychiatric drugs might be a big part of the problem. These drugs can have serious side effects including suicidal and homicidal ideation, especially when the patient decides to start altering or ceasing the dosage on their own. If you're not suicidal now, just start taking anti-depressants, and you'll probably be suicidal then.

The police don't generally release info about prescribed psych drugs and suicides/attempts in public statements, but academic researchers do pull police reports and autopsy reports to extract that info, because they are quite interested in that common factor.

Lucas Peterson said...

Mr. Cassidy, it's insensitive to insinuate that Police have more pressing issues to deal with than a person's mental health crisis. It's the job of the police to respond to a crisis of any nature and to any degree. I do agree that mental health therapists are a more appropriate avenue for treatment but I do take considerable issue with your bias that Police shouldn't intervene for mental health episodes, regardless of their severity. Mental illness is no laughing matter and it's a matter of life or death. Just ask that poor family who lost their sweet daughter because she decided to jump off a building downtown. How is that any different than the homeless downtown who go to detox because they drink to mask their issues with alcohol and drugs? I was raised to believe that if you are not a part of the solution, then you are a part of the problem. And I find your blog posting to be problematic as a person who lives with PTSD and is well aware of the lack of empathy this community and elected officials have towards the mentally ill. It took me several attempts to find a specialist to address my needs so then I can cope but many people figure that police are there to help to assist, but really they dumped to a warehouse and are treated as inconvenience when they go to Bryan West, Cornhusker Place, etc etc. I share the concern that the resources are limited but you are dealt with a bad hand of cards here and I'm astonished you want to fold. I'd have a few choice words to your face so be thankful for the internet.

Tom Casady said...