By Pat Pratt
As the first part of this series addressed the law enforcement aspect of dealing with mental health issues in the community, this, the second part, will focus on a new stop gap measure that comes in the form of a mental health professional who works with authorities on the front lines during crises situations.
As law enforcement struggles to meet the needs of the mentally ill with few resources available in the wake of years of funding cuts, at least some light can be seen at the end of the tunnel under Gov. Jay Nixon’s mental health initiative.
Mathew Gass is the Director of ER Diversion and Satellite Clinics for Burrell Mental Health. He said programs instituted to fill the gap under that initiative, some aimed at assisting law enforcement and some addressing the lack of acute psychiatric care, are working to eliminate some of the problems highlighted in the first part of this series.
“The governor strictly put these in to address some problems with service delivery, such as traditional funding streams, people needing mental health services that may not have insurance and to address the long term problem of people with mental illness not having long term treatment. And not having case managers, folks that can help them meet their psychiatry needs and their physical health needs,” Gass said.
Under the initiative, emergency room diversion funding appoints a caseworker to provide psychiatry services, case management and medication for mental and physical health. The caseworker will focus on people who are using the emergency room on a repetitive basis for mental health reasons.
“If we can get them engaged and they want to do that, then we can get them connected,” Gass said. “We get referrals from the folks at Bothwell (Regional Health Center). We were actually given approval to increase our services in adding another master’s level professional and another caseworker that’s going to manage the high utilization of the ER at Katy Trail (Community Health).”
Another aspect in the initiative addresses the “gap” in mental health services and comes in the form of the community mental health liaison, whose primary function is to assist law enforcement and the courts with individuals who exhibit mental illness.
“The average person, if they have a family member in an acute crisis, they call 911. So, police are often the first responders,” Gass said. “With that being the case, how do we support law enforcement? The way the governor decided to support them was through a new initiative that provides community health liaisons across the state.”
Each administrative agency, such as Burrell, which serves 10 counties, has at least one liaison based on population. The position is funded through the Department of Mental Health and also receives assistance from the Missouri Coalition of Community Mental Health Centers. During the roll out of the program, partnerships were also formed with the Missouri Sheriff’s Association, the Missouri Police Chiefs Association and the Missouri State Highway Patrol.
Jessica Cox, a master’s level certified mental health professional, is working in Pettis County as the community mental health liaison. As such, she works closely with police in crises, offering counseling and referrals that are often unavailable and unknown to law enforcement.
“She is going to be taking referrals. If an officer says, ‘I’ve got John Smith over here, I’ve been called three times, and he’s got an alcohol issue or some psychosis.’ We are going to get the referral and a member of our community mental center is going to outreach them. Knock on their door and offer them mental health services. In addition to that we are going to follow them for 30 to 60 days, touching base with them,” Gass said.
The community liaison will also help law enforcement in locating beds and with commitments and offering access to a 24-hour hotline staffed by a mental health professional. A new program that will provide officers with tablet computers that offer 24/7 contact with mental health professionals is in the works, Gass said.
“We have started some conversations with Commander (Larry) Ward at the Sedalia Police (Department), but it will be the first place in the nation to do virtual crisis intervention,” Gass said. “We are going to give law enforcement officers an iPad and our on-call person will have an iPad as well. They can hit a button and it will come to the on-call. What you will get is real time face-to-face assessment of the situation.”
Developing training opportunities for law enforcement in dealing with mental health-related issues is another function of the community liaison.
“Jessica makes contact on a monthly basis with judges and most sheriffs’ departments and then we also work with large and small police departments,” Gass said. “Right now, we are working on POST certification to provide law enforcement training in relation to mental health at no charge to them.”
More and more officers are becoming trained in crisis intervention, Gass said. The 40-hour training is offered at no cost to law enforcement and the curriculum is established by area crisis intervention training panels composed of police, mental health professionals and members of the community.
“It’s not me as a mental health professional telling a police officer how to do their job. It’s law enforcement officers who are experienced in this sharing knowledge and resources and training,” Gass said.
There are drawbacks to the community mental health liaison position. They cannot provide coverage 24/7 and they cannot create beds that do not exist or get people into services that do not exist.
The closest in-patient acute facility to Sedalia is Royal Oaks in Windsor with 40 beds, but only eight of those are for adults.
“We constantly see reduction of in-patient care services. We operate Royal Oaks and it’s an acute care facility, but the capacity of that is limited,” said Mel Fetter, CEO of Pathways Community Health. “There are constantly more pressures on facilities like Royal Oaks to accept patients and we have a maximum number of beds and it continues to put pressure on the rest of the system within the state.”
With more cuts slated for mental health, the future is uncertain. While law enforcement and many in mental health are lauding Nixon’s initiative, the veto of the budget passed by the legislature cut $34 million from mental health programs.
Locally, this eliminates funding for an emergency mental health services pilot initiative in Kansas City totaling $2.5 million, cuts funding for a program for secure detox services in northwest Missouri, not fully implemented, totaling $750,000, and eliminates two new psychiatric resident positions at the University of Missouri-Columbia.
For news and information on mental health, visit the Missouri Department of Mental Health at dmh.mo.gov. If you or a loved one are suffering a mental health crisis, Burrell Behavioral Health operates a 24-hour crisis hotline, 800-395-2132, in central Missouri.
Bobby Alvary was not just down on his luck, his good fortune had entirely left the State of Missouri (likely bound for warmer temperatures). He was homeless, but even more than that, he had lost that one thing that makes the difference between giving up and getting up – and that was hope. He had been hospitalized numerous times and remained in poor physical and mental health. In short, there just wasn’t much further down he could go. That is when he happened onto Burrell Behavioral Health, and after his first appointment, was linked with a support team, including a licensed counselor and a community support worker. That was 16 months ago, and he hasn’t been in the hospital since. He obtains regular medical advice for all his health issues, has a place that he calls home, and is truly engaged in his recovery. With his self-esteem restored, he resumed his love of drawing, and entered one of his pieces into the Director’s Creativity Showcase, an art contest sponsored by the Missouri Department of Mental Health and the Missouri Mental Health Foundation. The Showcase, which dates back to 1979, has succeeded in acquainting the public with the talents of the people served by the Department of Mental Health. With more than 300 entries of artwork and crafts, his drawing, titled “Italia,” placed second! More information on the event can be found at the Foundation’s website at: http://missourimhf.org/view-event.php?id=207&table=schedule
Bobby indicates that the inspiration for his piece came from his experiences with the power of women, stating, “They are not the weakest people, just like my ladies of Burrell.”
Way to go, Mr. Alvary! What a wonderful accomplishment, a beautiful piece of art, and great story of its creation! We hope your tale is as inspiring to others as it was to us!
Information provided with permission of artist Bobby Alvary.
NIXA, Mo.– – It’s one of the most common learning disabilities in the world but good luck getting it diagnosed and treated. The numbers are as high as 1 in 5– that many kids are thought to have dyslexia.
Experts say ignoring those numbers can be detrimental because people with dyslexia learn differently, so differently that if we try to teach them in a traditional classroom they’re often labeled “dumb” or “illiterate,” and finally one Ozarks public school is doing something about it.
To read the full article, please click HERE
WASHINGTON — Hospitals across Missouri have dramatically cut their psychiatric beds over the past two decades, reducing capacity to provide acute inpatient care for the mentally ill by 40 percent since 1990.
Now, mental health advocates fear that trend will accelerate — widening a major coverage gap at a time when there is new focus on mental health care — if Republicans in the state legislature kill Gov. Jay Nixon’s push to expand Medicaid.
Keith Schafer, the director of the Missouri Department of Mental Health, said hospitals will have to make dramatic cuts if the state rejects Medicaid expansion, and psychiatric units will be among the first things to come under the knife.
“We could lose a significant number of the beds left,” he said.
Todd Schaible, president and CEO of Springfield’s Burrell Behavioral Health, called the issue a “sleeping giant” in the politically charged debate over expanding Medicaid.
Angela Acree didn’t have any experience with the mental health system until the night her younger brother had a psychotic episode and was hospitalized.
Acree quickly learned that psychiatric beds can be far away, family members may not always know where their relatives are hospitalized and the mentally ill can be discharged before their relatives think they’re ready.
“People always wonder why there are so many homeless people,” said Acree, an attorney. “It was fortunate that my brother was pretty compliant. Others are not so fortunate. They just walk off and end up living in a storm grate. It’s pretty horrible.”
Acree’s younger brother, Greg, 52, who suffers from schizophrenia, was hospitalized after a psychotic episode in January 2012. He was initially taken to Cox South and then to a facility in Nevada before being sent to a residential care facility in Nixa. He is currently living in an apartment run by Burrell Behavioral Health.
When a frightened family called Burrell Behavioral Health about their adolescent son who had expressed homicidal thoughts, a treatment team stepped in to work with the boy and the family.
This is not an uncommon scenario for Burrell and other mental health agencies. The boy had been hospitalized several times but was discharged after a few days only to regress. He needed intensive management to ensure that he took his medication and got help to control his emotions and behaviors.
Without that, the young boy could have become a headline, like Adam Lanza and others with unchecked mental illnesses.
With proposed legislation in the U.S. Senate, mental health services at community clinics such as Burrell Behavioral Health would get the funding needed to provide 24-hour psychiatric care and integrated medical and mental health services for many more people like Lanza and the young boy at Burrell.
Therapist Sarah Johnson keeps candy in her office. It’s meant to counter the painful experience for children who visit.
Rape. Neglect. Physical abuse.
A counselor for teens who have abused drugs or alcohol, Sarah sometimes tears up when she listens to what the kids say, but she never cries in front of them. She doesn’t want the focus to be on herself.
The children are usually 12 to 17 years old. Their addictions are serious enough to have brought them here, but many of the teens haven’t grasped just how serious. Maybe they haven’t done jail time — yet.
Often their families don’t know the full extent of their drug use, which sometimes starts as early as age 5.
A lot of the children like sour candy. There’s also usually a mixture of chocolate and hard candy. She doesn’t place any limits on the sweets.
“They all get candy here,” Sarah said. “I tell them when you’re in my office you get as much as you want.”
Residents at the Regency Mobile Home Park, which will close in the spring, were given the chance last night to reach out for guidance from local social service organizations as they prepare to leave the park.
Representatives from city government, the Columbia Housing Authority, Burrell Behavioral Health and Mid-Missouri Legal Services were at the trailer park, 2701 E. Nifong Blvd., to advise residents on services that might help ease the burden of leaving the park and finding a new home.
The Regency property was rezoned last month to allow for the construction of a student apartment complex. After a public outcry over the amount of notice Regency residents were given that the park was closing, Aspen Heights, a Texas-based student housing company that is purchasing the site, offered financial incentives to residents and extended the closure of the park from Feb. 29 to April 30, or May 31 for families with school-age children.