Police, others seek mental health funding and training

There are well-trained professionals and volunteers in Jasper County who are credited with making great strides in working with the mentally ill, but when there’s a patient in a serious crisis, who’s trained to deal with those cases, and who pays for those services?

More often than not, law enforcement is called in to deal with emergency mental health situations. While anyone can develop strong verbal de-escalation skills, police tend to have the equipment and authority to deal with most types of crisis situations.

Funding limitations in local, state and federal funding through the years led law enforcement agencies to pursue training and equipment from wherever it’s available. Other groups, such as National Alliance for the Mentally Ill, are trying to supplement law enforcement and the medical professions with grants and special programs.

Optimae Life Services’ Newton facility offers a variety of programs for clients, along with some that benefit the community as a whole. Officers from the Newton Police Department will receive training in the months ahead in a new Optimae program that began Oct. 1. The program allows NPD, first-responders and other agencies to refer those in need of mental health assistance, substance abuse counseling, housing and other needs to Optimae.

Newton Police Chief Rob Burdess praises the referral program and its training.

“Optimae’s new program may be a great opportunity for our community,” Burdess said. “In addition, the need for emergency mental health care facilities is dire, and our local resources do not have the capacity to properly handle these subjects beyond a few hours. Longer-term care is needed.”

Burdess said while he’s excited about programs like the one at Optimae, he knows there is a need for many more programs that offer direct care.

“Training is critical, but it does not tackle the big issue of emergency treatment and long term care,” he said.

Jasper County Sheriff John Halferty said his agency would benefit greatly from more availability of beds and psychiatrists. In addition to having a deputy stay by the side of court-committed patient who is being assessed in an emergency room, if an initial court-ordered hold expires, the sheriff must consult with the county attorney’s office, and a judge’s order is needed to extend a court-ordered commitment to keep the patient and/or the public safe.

The sheriff’s office has averaged 42.5 mental health transports per month since the beginning of 2014, with this year’s spike being 58 during the month of January.

If none of the sheriff’s three on-call drivers are available, Halferty must send one of his regular deputies out of the county for transporting the patient.

The three drivers also handle juvenile transports and correctional facility placement orders, but Halferty said the mental health transports eat up a great deal of time and expense. Eight of the 32 people transported by the department in September were taken to Skiff Medical Center for mental health evaluations.

Halferty said suspects who have substance-abuse issues frequently have mental illness issues that are the both part of what drives the person further into alcohol or street drugs, and those substances, in turn, reduce or eliminate the helpful effects of medicine, and make illness symptoms worse.

The comorbidity, or accompanying illness, that seems to often affect the mentally ill is chemical dependency. Whether the prevailing theory is that one causes the other, or simply that addiction and mental illness seem to exist together, it certainly creates legal, moral and medical dilemmas for many first responders.

Halferty said it’s common for a person to be struggling with both mental health and substance abuse issues — and not simply because of the prevalence of methamphetamine in Iowa.

“I’ve read about studies that show one-fourth of those who use street drugs regularly have serious mental illness, but I wonder if that could be as high as one-third,” Halferty said.

Jody Eaton is not only the Community Services Director/Central Point Coordinator for Jasper County for CICS; she’s also the CEO of Central Iowa Crisis Services.

CICS is a 10-county region created by state code, officially renamed in July 2014, responsible for the implementation and funding of mental health services. She said not only is there a shortage of psychiatrists, but also a shortage of “mid-range” specialists — case managers, social workers and others who don’t require malpractice insurance, but who are still specially trained and needed for a variety of services.

CICS helps fund law enforcement, medical and therapy programs in each region, such as Optimae and Capstone.

“This is the second budget year since we had a major reorganization of state services,” Eaton said. “Legislation repealed the previous county system and required counties to form regions through a 28E agreement by June 30, 2014. Funding previously came from county property taxes, state and federal funds provided to each county.”

Eaton said one of her aims is to help other agencies get proper funding support to take some of the pressure off of emergency services.

“If we can help reduce, even slightly, the number of mental-health cases in an ER, then we are making progress,” Eaton said.

There are not enough psychiatrists nationwide, according to many in the mental health community. Local NAMI chapters also help pay for staff who provide services. NAMI Jasper County President Bill Ehler said that’s a role that needs more professionals in place before much real progress can be made on certain fronts.

“Not only are the challenges not the same in mental health as they were in the past, the resources are not the same, either,” Ehler said. “Take all these mass shootings, for example. Let’s see major changes happen and psychiatrists end up assessing people in some kind of new format. Well, where are those psychiatrists going to come from?”

Even Vice President Joe Biden, in a 2014 address to an American Psychiatric Association meeting, acknowledged the U.S. needs to recruit and train more psychiatrists.

Dr. Dan Wright, an emergency room doctor at Skiff, said psychiatrists tend to be on the low end of salary ranges for doctors, so there is a diminished number graduating and entering the medical field.

“If a medical student wanted to become a psychiatrist right now, it would probably be pretty easy to get funding for school,” Wright said. “There are simply not enough psychiatrists in the U.S. — especially in places that are away from major cities.”

Contact Jason W. Brooks at 641-792-3121 ext. 6532 or jbrooks@newtondailynews.com