“Emergency room or jail” a system struggling to deal with mental health crisis

Mental Health

LANSING, Mich. (WLNS)— When people need help, they often call 9-1-1 and hear the words…..

“9-1-1 what’s your emergency.”

Emergency dispatchers say in today’s world, a lot of people are answering that questions, by asking for help as they deal with a mental health crisis. Leaving first responders with the difficult decision, on how to respond.

“Emergency Room or Jail”

“When the police get a call if they have to take someone somewhere,  typically it’s the emergency department or jail.  A lot of times,  jail is if the police don’t know what else to do with them,” said Doctor Jennifer Johnson a Professor of Psychiatry and Behavioral Medicine at Michigan State University.

She says, most inmates in county jails are dealing with multiple traumatic experiences, including issues related to depression, anxiety, post-traumatic stress disorder, and substance use disorder.    

One in every 34 people in the US is justice-involved at any given time, and so we can’t ignore it because it’s us. It’s our friends, and neighbors it’s our communities,  it’s not a problem that’s off somewhere isolated.” said Johnson.

The Problem

When it comes to dealing with someone whose mental health is in crisis, while they’re also in jail, the challenge increases. Treatment, often time is just about survival.

“It’s like they’re living in the sort of crisis of the crisis. It’s not like you are sitting down having some conversation that would even be normal outpatient mental health treatment. You are just trying to keep people alive when they are in jail.”

Enter people like KC Brown, she works at the Ingham County Sheriff’s Office as the supervisor for the  Correctional Assessment and Treatment Service program(CATS Program).

“I think that’s probably one of the biggest challenges is because of somebody’s behavior health need is not being met in the community that could certainly um build a situation that may cause strain,” said Brown.

Ingham County Sheriff Scott Wriggelsworth says the real issue, is the lack of services for those who need help, before they end up in the correctional system.

“The biggest challenge is to be able to provide all the right resources for the clients, I think there’s a lot of assumptions made because somebody is in jail that they have the appropriate level of care to manage their behavioral health need and that’s not always the case.” 

What’s being done currently

In Ingham County, the CATS Program served 891 inmates within the county jail. Of those, 324 had issues with substance abuse, 331 used crisis service, 180 received behavioral health service, and 56 benefitted from jail re-entry services.

The silver lining about some of these cases, Sheriff Wriggelsworth says inmates realize they need help and ask for it themselves, making a decision, they wouldn’t make on the outside.

What’s next?

Officials from the CATS Program, Community Mental Health, and the Ingham County Jail medical team say they’re all working together to help expand treatment, and recovery services for inmates, but KC Brown says in a time of growing need, more can be done.

“We’d like to add more staff, I would love to be able to provide more individualized programming for each client as needed like to be able to do more interviews as they’re leaving the facility in order to reduce our recidivism as much as possible for some of our jail re-entries.”  

Dr. Johnson agrees, and says things won’t change, until people decide to care.

“It’s a systemic problem, that I think is ultimately all of our fault’s, because until people decide that they care and they will support legislative and financial reforms, especially beefing up community mental health for vulnerable folks, this will just keep happening and it’s not the jail’s fault, it’s not the police fault. It’s our fault.”

Stepping up to reduce mental illness in jails

The national Stepping Up Initiative is helping hundreds of counties nationwide reduce the number of people with mental illnesses in jails. A Michigan State University professor and her colleague have been awarded a grant to study how the program works and determine what techniques can be adopted to improve treatment for individuals with mental illnesses  and keep them out of jail.

“Our primary goal is to learn more about how county agencies can work together to reduce the number of mentally ill people in county jails,” said Dr. Jennifer Johnson, “It’s a chance to learn what works and how we can help counties address these problems.”

The National Institute of Mental Health awarded Johnson and George Mason University Professor Faye Taxman a $3.2 million, five-year grant to study the national Stepping Up Initiative.

About two-thirds of individuals in jails have mental health problems, many of them serious, and an estimated three-quarters of them also have substance abuse problems. Yet most jails are ill-equipped to deal with those complex issues.

“Many people in jail are there because of their mental health problems – they went off their medications and were acting erratically,” Johnson said. “When the police don’t know where to take someone, they take them to the jail. Most people go through the jails so quickly that it’s tough for most jails to effectively coordinate services afterward, meaning that they are back out, still not taking medications, and it becomes a vicious cycle. Stepping Up helps counties plug the gaps in a fractured system so that people who would be better served by mental health treatment aren’t filling up the county jails.”  

The Stepping Up Initiative, led by the Council of State Governments, the National Association of Counties and the American Psychiatric Foundation, was created to help counties redirect individuals with mental illnesses into treatment and reduce their numbers in jails. More than 500 counties in 43 states, including 20 counties in Michigan, participate in the initiative.

Learn more about the initiative in the video below.

Get Help

If you or someone you know is struggling, you can get mental health assistance by clicking here.

“Anytime somebody is in crisis and likely find themselves in jail on that day or the next day means there’s a likely victim in the middle of that, And with paying attention more attention to mental health maybe as a community that should be raising awareness about how important that really is,” said Sheriff Wriggelsworth.

The number for the National for National Suicide Prevention Hotline at 1-800-273-TALK.

The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. They’re committed to improving crisis services and advancing suicide prevention by empowering individuals, advancing professional best practices, and building awareness.

You can also find help by clicking here.

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