Police often first resort for mental health patients
Knoxville Journal-Express - 5/12/2017
The first responders for many mental health issues are law enforcement.
It's hard to track specifically how many times officers deal with mental health issues, because the calls can involve multiple things. For instance, mental health treatment could come from a welfare check on a suicidal subject or a domestic assault.
However, law enforcement face these issues multiple times a week in Marion County. It's faced in all areas, from Pella to Knoxville to the rural areas.
"It really varies. It's very routine for us to deal with someone who has maybe made a suicidal statement, or maybe is feeling depressed, or having some sort of short term episode," said. Lt. Paul Haase, of the Pella Police Department. "Then we deal with people that have more advanced mental health problems like schizophrenia, bipolar disorders, things of that nature. It really goes across the board on what we see."
Calls also vary from either a domestic call to a disturbance call. A domestic call could be an example of a family member that needs help dealing with someone who is suicidal.
"That's where we talk to them and get a feel for what's going on in their head. What they're thinking, what their problem is," said Pella police officer Tim Donelson. "Then we determine if we need to get them some counseling, or minor help to solve the problem. It may also be more advanced, like taking them to the hospital, or calling their doctor."
Officers may also try to reach out to family members or friends to fill in more of the blanks about that person's mental health history.
Sometimes that family member or friend may be able to come get the person in crisis. Other times, officers may need to take that person to the emergency room for further treatment.
In these situations, law enforcement are asked to determine what would be the best treatment for someone experiencing a mental health crisis. While law enforcement is now mandated to be trained in handling a resident with mental health, they're also not licensed doctors.
"It's something that we as a department deal with the best that we can with what we've got to work with," Donelson said. "We enforce laws, but we're also here to help and protect people. Even those with mental health issues."
The police can transport someone to an emergency room, but local hospitals are not equipped to deal with someone having a psychotic or violent episode, Haase said. But, that person also does not belong in jail, he continued.
So, the officers work with hospital, while hospital staff try to find an available inpatient bed in Iowa.
Especially for patients who are violent, officers must then standby at the hospital, pulling them off their patrols for long periods of time.
Additionally, police may answer a call that may not seem like a mental health crisis at first. Later, police may find that the person that was called in for alcohol or drug usage was also having a mental health crisis.
Because law enforcement is usually the first on scene to handle a resident handling a mental health crisis, the crisis has gone from someone else's problem to law enforcement's problem, Haase said.
TRAINING LAW ENFORCEMENT
Struggling to find help: A Knoxville man's struggle with mental illness and the lawKNOXVILLE - Odie Anderson has spent most of his life troubled and on the run. According to his mother, Patti Anderson, he has been diagnosed with many mental ailments, and has been a menace to himself, the state and law enforcement.
As a part of Pella'sPolice Department inservice training, Haase said the department tries to work in mental health training within at least one monthly inservice training per year.
The department holds monthly inservice training, which covers many various topics officers need to updated on within their job.
"The state mandated [mental health] training about three to four years ago, I believe. Then the Iowa Law Enforcement Academy put together training for mental health," Haase said. "It's something we've worked into our normal inservice training. It's not new, but it's something that's always evolving and always changing."
All Marion County law enforcement, including the Knoxville Police Department and the Marion County Sheriff's Office, also recently completed training in de-escalation and psychological first aid in December of 2016.
This training helped with understanding how to handle someone who may be mentally unstable.
Law enforcement as a whole has pushed to better understand how to handle someone having a mental health crisis, instead of just putting them in jail, Haase said.
It's not that the police department has never dealt with someone experiencing a mental health crisis prior to the more recent emphasis in training, but they know how to better identify and handle those residents experiencing a mental health crisis.
"When I started here 22 years ago, we had no training [in mental health], and I think I had about an hour of mental health training in the [law enforcement] academy," Donelson said. "Since then, our monthly inservice training, especially in the last few years, has been much better I guess you could say."
Haase agreed with Donelson's statement, saying that when he became an officer about 15 years ago, there was only a small block of training concerning mental health when he attended the law enforcement academy. Now, Haase estimates that law enforcement academies require about 40 hours of crisis intervention training.
"It's another one of those areas that law enforcement said, 'Hey. There's a problem here. We need to train our officers better to deal with people that are in crisis,'" Haase said.
"Mental health is one of those things that presents itself in so many of the aspects of what we do when dealing with criminal activity. The more education we receive, the more we realize how often it is that this is tied to some mental health issue or mental health problem someone may have."
SHERIFF SKEPTICAL PEOPLE RECEIVE NEEDED TREATMENT
An early diagnosisJane's first year at Central College has been challenging. She and her roommate did not get along, she was missing home, she felt overwhelmed most of the time - and she was diagnosed with Type 2 bipolar disorder, generalized anxiety disorder and displacement disorder.
Marion County Sheriff Jason Sandholdt gets frustrated with the system, he said. For those in a crisis situation to go from a violent episode to back on the streets in a few hours or a couple of days, leaves him skeptical they received necessary treatment.
"The people, in my opinion, aren't getting the true help they need during that crisis situation," Sandholdt said. "They might go for a 72-hour evaluation, but then they're returned back to their environment and their problems over that 72 hours probably weren't fixed."
Sandholdt he said the county has made progress in various areas.
"We're making steps in the right direction with telepsych," Sandholdt said. "We're making steps in the right direction with public health recognizing that there's an issue that needs to be fixed. We are making progress with the public health side of it, with the hospital side of it, with the telepsych side of it.
"But the hard part is, we don't have those facilities. Pella hospital, Knoxville hospital, don't have acute mental health rooms or beds that they can keep somebody for 72 hours."
Sandholdt said law enforcement has taken individuals into an emergency room after a standoff, only to see them back at home or on the streets hours later.
"When you take somebody and you wanna get them the help they need," Sandholdt said. "But yet, they're kicked loose and you're like, 'OK, in four hours of being at the local ER, they did not get the help that they need.'"
WHEN PATIENTS SLIP THROUGH THE CRACKS
The Treatment Advocacy Center, a nonprofit dedicated to improving mental health treatment, estimates one in every three mass killings is caused by an individual with an untreated mental illness.
There are numerous cases in Iowa and around the country that show the potential consequences of those who struggle with mental illness that for one reason or another can't or don't get help.
Among the high profile killings have been the 2009 murder of Ed Thomas in Aplington-Parkersburg. He was shot dead in the school's high school weight room. Pulling the trigger was Mark Becker, a former player.
Thomas was a family friend of the Beckers, and a notable figure in the community. He gained national headlines in part for his leadership in pulling Parkersburg through a tragic tornado.
Mark Becker was sentenced to life without parole. His parents have become vocal advocates for mental illness treatment in the state. His mother, Joan Becker, wrote a book titled "Sentenced to Life: Mental Illness, Tragedy and Transformation," which was released in 2015.
She writes of Mark Becker's struggles of mental illness that began in middle school. In multiple media interviews and her book, Joan outlines how she and her husband feel the mental health system in the state failed their son.
"Dave and I were frustrated with 'the system,' since at this time we still did not know if there was a diagnosis," she wrote. "Are there side effects of the medication we should be aware of? Who is Mark going to be accountable to? And what was our role supposed to be in Mark's treatment? I was angry...at Mark and with the committal; but mostly at myself for not understanding how the mental health system was supposed to work! This is where you need to begin not just knocking on doors to get answers, but you need to pound those doors down if you are not getting answers."
A jury rejected Mark Becker's defense of insanity and convicted him of first degree murder. He has since been diagnosed with paranoid schizophrenia, according to family.
Other cases include an April murder in Bondurant. The Polk County Sheriff's Office charged 28-year-old Chase Nicholson with murdering his two parents and sister. A family member has detailed Nicholson's struggles with mental illness through the media.
Nationally, the 2012 Sandy Hook Elementary School mass shooting in Newton, Massachusetts has been linked to not only mental illness, but a lack of treatment. Adam Lanza shot and killed his mother, then shot 20 kids and six educators at the elementary school, before he took his own life.
The Office of the Child Advocate in Connecticut, released a report in 2014 that concluded Lanza had an untreated mental illness.
"It is fair to surmise that, had [Adam Lanza's] mental illness been adequately treated in the last years of his life, one predisposing factor to the tragedy of Sandy Hook might have been mitigated," the report said.
The office's report did not specifically assign negligence, and neither did the Connecticut state attorney's office in a separate report.