Local police wait hours with people in mental health crisis
May 25, 2008: A 12-year-old girl is home alone with her 15-year-old brother when he starts acting strangely.
He tells her to come down to his room and close her eyes.
When she opens her eyes, he’s holding a plastic shopping bag. She tries to leave, but he crosses his arms around her neck and starts to squeeze.
She screams for him to stop. At one point, she tries to fake unconsciousness, but it doesn’t stop him.
Finally, she grabs an aluminum bat leaning against his desk and swings it behind herself until he lets go. She escapes and calls the police.
Concerned he could hurt himself or someone else, police take the boy into custody on an emergency mental detention.
Officers take him to the hospital for a medical exam, a requirement for admission to mental health treatment.
An officer sits with him for four hours until he gets medical clearance and can be admitted for mental health treatment.
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Police don’t want to leave a dangerous or unstable person alone in a hospital waiting room.
Nor do they want to leave streets unpatrolled.
But they don’t have much choice.
Police in Rock County are spending hours—sometimes as many as eight hours—sitting in hospital waiting rooms until people in custody on involuntary mental detentions get a medical check so they can be admitted for mental health treatment.
That pulls police off patrol, and it makes for a long night for the person in crisis, Janesville police officer Aaron Ellis said.
“It’s uncomfortable. Not just for us, but for the patient,” Ellis said.
State statutes require police to stay with involuntarily detained people until they are accepted by a receiving facility, Rock County Corporation Counsel Jeff Kuglitsch said. The emergency room at Mercy is not a psychiatric treatment facility, so officers are required to stay, Kuglitsch said.
It’s not Rock County’s idea to have police and people in crisis sit in the emergency room. Receiving facilities such as Mendota or Winnebago mental health institutes require patients to be checked over by a medical doctor before they can walk in the door.
Mendota and Winnebago are not medical hospitals, and they want assurance that a patient is not having a medical crisis on top of a mental health one, Rock County Human Services Director Charmian Klyve said.
That leaves people with a mental health emergency waiting for two ... four ... even up to eight hours for medical clearance before they can begin getting the treatment they need.
And in Rock County, it means a cop is waiting with them.
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June 11, 2008: A 17-year-old girl threatens to kill herself with a butcher knife. Her mother’s boyfriend gets cut on the hand when he tries to disarm her.
The girl has a history of anger management and attention deficit hyperactivity disorder. The previous week she had been taken to the hospital after overdosing on the painkiller Vicodin.
Officers take her into custody on an emergency mental detention and drive her to Mercy Hospital for medical clearance.
Two hours later, an officer still is in the waiting room with the girl and her mother. It’s shift change time, and another officer comes in for relief.
Sitting with police in the waiting room is embarrassing for the girl and her family, the girl’s mother tells the officer.
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It’s been an ongoing issue since Rock County closed its inpatient psychiatric facility in June 2002: Who’s responsible for people on emergency mental detention as they move through the channels to treatment?
The job has fallen to police who often are the first responders. Officers drive people to the hospital and wait with them. Behind the scenes, Rock County Crisis Intervention gets the ball rolling to determine if the person needs long-term care, outpatient treatment or neither.
Normally after the hospital visit, officers take people back to crisis intervention where they can be evaluated fully.
The long waits are not a problem with any particular hospital; it happens around the county, Evansville Police Lt. Art Phillips said.
He understands emergency personnel first need to treat patients who come in bleeding or having a heart attack as opposed to someone who’s not physically injured, Phillips said.
The problem, Ellis said, is having an officer sitting in the waiting room means one less body in a squad car.
“The time and the resources alone are a burden to any police department, no matter how many officers you have,” Ellis said.
In Evansville, an emergency mental detention could mean no officers are left to patrol, Phillips said.
He’s fed up.
“Why is it the responsibility of the police to stay at the hospital?” Phillips said. “I don’t understand why we have to remain there when we have nothing to do with it.”
Even if the patient is admitted into the psychiatric ward at Mercy, her or she first would need medical clearance from Mercy doctors, Klyve said.
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October 21, 2007: A drunken man punches out three windows at a business on Locust Street in Janesville. When police arrive, they decide he’s not suicidal or dangerous, but he is drunk and needs to go to detox.
But before he can be admitted to a facility in Madison, he needs medical clearance. In the emergency waiting room, the man gets mad about the wait. He is combative and accuses officers of framing him.
After 90 minutes, emergency room workers put a Band-Aid on the man’s hand.
Now he’s cleared to go.
Because the man is combative, he can’t ride with the civilian security company contracted to drive patients. A Rock County sheriff’s deputy must be pulled off patrol to drive him to Madison.
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A subcommittee of the Rock County Criminal Justice Coordinating Council has tackled the issue of long wait times for medical clearance. The subcommittee includes mental health advocates and representatives of law enforcement, Rock County Court and the district attorney’s office.
Rich Gruber, a Mercy Health Systems vice president, has been brought into the committee’s conversation. It’s a debate Gruber says has been going on for five years.
Mercy cannot assume responsibility of people in crisis because Mercy’s security company has a “hands off” approach, Gruber has said.
Crisis intervention can’t come to the emergency room and take over, either, Klyve said.
“What do we do with him if he decides he’s going to walk?” Klyve said. “We have no police powers. We have also no personal knowledge of anything that happened out at the scene (when police got involved), so we’ve got no basis to hold the person.”
Gruber has said Mercy will work internally to make sure mental health professionals can arrive quickly to the emergency room to help with medical clearance.
But he has said that the real responsibility lies with the county to take care of its own.
Situations taken from Janesville Police Department records.
WHAT IS EMERGENCY DETENTION?
Emergency detentions, including holds under state statute 51.15 or 51.45, work like an arrest but are not criminal, said Eugene Dumas with the Rock County Corporation Counsel’s Office.
Officers place an intoxicated person or a person going through a mental health crisis into protective custody so they don’t hurt themselves or others.
Under state statutes, this starts a series of court appearances to balance a person’s personal liberty and their need for treatment and protection, Dumas said.
A detention under chapter 51 of state statutes is not a criminal charge, Dumas said. In some cases, people who have criminal charges against them and move through those proceedings as well, Dumas said.
Jul 22, 2008 at 6:24 p.m.
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Of course it is all about the money! Nothing is free in this world. I'm a tax payer and am tired of all my money going out the window, but it is a fact so life (if you work and pay taxes) There is no easy answer to this problem. You can't blame JPD, Crisis, or Mercy alone. Mercy has to treat emergencies first. Hopefully they would know that they have a JPD officer with a person on any type of hold waitng and push them along a little faster if possible. It is in everyones best interest to get the police back out on the street. However, if you have someone acting out enough due to mental illness or drug/alcohol consumption, probably a good idea to have someone (ie JPD) who can go "hands on" with the person should they decide to act out. Who would be screaming loudly if they are sitting in the ER waiting room minding their own business and are attacked, harrassed, or whatever? Who would be to blame then? Crisis staff can not go hands on with the people either, nor their hired out security officers. As for MYTWO CENTS: "heres an idea...hire the right medical staff at rock county health care center so that the patient can be medical cleared there." The health care center would need a lab and other medical equipment that is going to cost way too much let alone the staff to run it. The county has already cut back on staff, YES DUE TO MONEY, but get over it and used to it, it is a fact that can't be changed. Unless you like to pay higher and higher taxes. And to rims "Rock County crisis is a joke. It's far and in between when they actually refer people for a mandatory hold. They(the person in crisis) tells them what they want to hear and they 9/10 let them go home. Until some one calls them in again. We know this from experience. It's a vicious game they play." First of all Crisis doesnt write the mandatory hold, law enforcement has to do it. They get to go home from telling what they want to hear because otherwise the person in crisis's rights would be being violated. It is not a game! It is amazing what people think crisis can and can not do. They have no magic wand to cure every situation that they are called upon for. There is no answer or cure to every situation. The crisis department is already over budget for the year and it is only July. So you think they spend all that money doing nothing? No it is going to all the state institutions and UW Hospital to pay for all the people that are detained and put in the hospital. Not to mention the cost associated with all the people going to detox. There are no answers right now. JPD, Crisis and local hospital ER's need to work TOGETHER to get these folks where they need to be and stop fighting between themselves, pointing fingers, and blamming the other for the problems. It is a social problem that is not going to go away. EVER.
Jul 21, 2008 at 4:54 p.m.
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Your article highlighted extreme cases. No one questions the need for improved care of adolescents. Currently there are NO facilities in Rock Co. for people under 18 years of age. They must be transferred to another area, and that, unfortunately takes a great deal of time. I'm sorry the police are tied up, but until the state statutes no longer require the individual to be IN CUSTODY until admitted to an approved receiving facility, this can't be helped. If there is no attempt to harm self, there is NO NEED to bring these people to Mercy Hospital. They can go directly to Crisis, which should speed things up considerably. Also, what your article fails to mention is that the majority of people seen in the ER for mental health issues are well known to the ER because they come in all the time. In some cases, a person is admitted, signs out against medical advice the next day, and shows up again 2 days later. You cannot force people to take good care of themselves, stay on their medication, or be responsible. NO EASY ANSWER, and no one is solely at fault...not the hospital, not Rock County.
Jul 21, 2008 at 12:03 a.m.
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BOTTOM LINE IS THAT WE NEED CRISIS INTERVENTION, WE NEED LAW ENFORCEMENT. SO WHY CAN'T WE JUST PUT TWO AND TWO TOGETHER AND DO WHATS RIGHT AND NOT WHATS WRONG. HERES THE BEST IDEA...POLICE ARE COMPLAINING ABOUT THE TIME THEY ARE SPENDING WITH THESE PEOPLE...SO WHY CAN'T ROCK COUNTY HIRE SOME PART-TIME OR AN ON-CALL POLICE OFFICER THAT CAN RESPOND TO THESE SITUATIONS. WHEN THE OFFICER IS IN ROUTE TO MERCY HOSPITAL THE ON-CALL OFFICER CAN BE CALLED AND TAKE OVER FOR HIM OR HER AT THE HOSPITAL. END OF STORY. ROCK COUNTY WANTS TO COMPLAIN ABOUT THE COST FOR AN ON-CALL OFFICER THEN THINK ABOUT THE TIME THAT IS WASTED FROM DAY TO DAY WITH THESE SITUATONS AND THEN ADD THEM UP AT THE END OF THE MONTH OR YEAR. AND THATS MY2CENTS
Jul 20, 2008 at 10:46 p.m.
Jul 20, 2008 at 9:22 p.m.
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So, how do we get from problems with treatment/holding of people in crisis to trashing Mercy Hospital? Mercy is a facility licensed for medical treatment with a few beds dedicated for inpatient psychiatric care. It is not a psychiatric hospital.
Jul 20, 2008 at 8:58 p.m.
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Having worked for JPD for years, the system is ridiculous and a waste of manpower. Even with no type of medical issue an officer has to "babysit" a person for hours. If an officer has to take a person for a med clearance you're looking at a MINIMUM of 3 hours. Ther is your tax dollars at work.
Jul 20, 2008 at 3:53 p.m.
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Farmlife08 - the cops need the gas guzzling SUV's, ATV's, and boats...what if one of the mentally ill go for a swim or run into a field. Plus it's WAY more comfortable to sit in an SUV for hours waiting for crisis than in the back seat of a crown vic.
Jul 20, 2008 at 3:06 p.m.
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And why is everyone equating a hold with jail time or related criminal offense? That's extremely rare.
Jul 20, 2008 at 3:05 p.m.
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The hospital floor is one of the most depressing places I've ever been. There is little one on one interaction during treatment. The Crisis Center refuses to communicate with patients and there is no follow up. The lawyers they appoint are useless. There are a lot of costs involved for someone on a mandatory legal hold while there is not for someone who is in jail (you pay for your useless lawyer AND for crisis stabilization - why aren't we charging criminals for police time?), and people aren't treated like they're human or like they have treatment options. Before and after court appearances individuals are locked into general booking at the jail. Those are things that are issues due to lack of money; they're issues because people in the mental health field have huge egos and don't treat patients like they are human beings. Not everyone on a psychiatric hold is in detox or an extreme schizophrenic.
Jul 20, 2008 at 1:52 p.m.
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melstew: so, it SOUNDS like you are saying that, once a person gets through their jail/prison sentence, release them and wait for them to come back through the judicial system?
Allowing them to get prompt and adequate care is more cost effective. THEN, they can become contributing members of society again. Why send them to jail/prison when they just need a little TLC from the psychiatrist getting them on the right medications and into other support programs?
Jul 20, 2008 at 1:49 p.m.
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The joke here is many people brought in for a 51.15 (threat to self or others) is changed to a 51.45 (drug or alcohol) hold. Because the person is pushed through the medical clearance and the paper work is easier.
Example: 40ish female, home alone and drunk. Calls family and friends to say she is going to kill herself. Police arrive and she has a knife in her hands. She is taken into custody and driven to Mercy. She is medically cleared because her alcohol level isn't life threatening. She is driven to the Rock County Health Care Center. Police mention the suicide threat. The Crisis worker says they must treat the intoxication first. Police switch the form to a 51.45. The person is admitted to detox and never gets treatment for being suicidal. Person is back home within 48 hours in most cases.
I understand people talk trash when drunk. But some true feelings are also spoken. Her threats should have been taken serious since she made the phone calls to say goodbye, chosen her weapon, and restated the threat to the police. It was a transfer of liability 101.
It's time for local governments to look at themselves. Instead of building new jails, new fire depts, new police stations, buying new gas guzzling SUV's, and adding personnel. They need to do with what they have, tighten their pocketbooks and start spending wisely. 4 wheelers, gators, boats, pick-up trucks, SUV's, trailers, etc. How many mental health care workers could the price of those "Maybe" needed once a year toys fund ? It's time to stop buying "what-if" toys. What's next, S.A.M. missles "just in case" terrorists fly over Rock County ?
Jul 20, 2008 at 1:47 p.m.
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Can't we just get a setting that is safe for these people? Having a mental illness DOES NOT mean you are an awful person or did something wrong. They deserve the same level of care and respect as anyone else! It's not their fault they received the genes with a mental illness! Rock County: let's pull together and take care of the vulnerable populations-- disabled, mentally ill, eldery, etc!
Jul 20, 2008 at 12:40 p.m.
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Redneck53511: Why blast me? My comments point out the need for local services. I was very much against the detox unit closing and I am all for parity laws requiring insurance companies to see mental health and substance problems as other illnesses and fund care accordingly. I also think it is shameful that many of the mentally ill and substance users cannot receive help when seeking it. Maybe you should reread my comments to gain a better understanding of where I am at.
Jul 20, 2008 at 12:30 p.m.
Jul 20, 2008 at 12:27 p.m.
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if the cops have to sit at the hospital with them it does suck but at lease we know were ther at and not the dounought shop oe off sleeping somewere like i caught them doing
Jul 20, 2008 at 11:41 a.m.
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do what you do with the rest of them, run them thru the court system, and send them to prison, thats an easy way for rock county to get rid of them. to hell with helping them with their problems,its no different now than it was 50 or 60 years ago,people in rock county who have mental health issues are not helped they are locked away in jails or prisons. its easier that way. then at least no one has to waste their time with them. an everyone is right,money is the name of the game.an about using mercy for the hospitals name, i wonder myself if they no the definition of the word, because there isnt a whole lot mercy shown. i feel terrible there is not very much help for mental health patients in this county especially if you dont have insurance. i think its time we start getting help for the mental health patients like we do substance abusers, example, something like the recap program that is offered to people at county jail. if others have ideas put them out there. because its time we quit locking them away like they did years ago.
Jul 20, 2008 at 11:39 a.m.
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I can tell you from personal experience only 1 out of 10 patients is having an AODA issues. The rest of them are in crisis stabilization.
The Crisis Center, the RCSO, the court system, and Mercy Hospital have serious issues beyond wait times.
Jul 20, 2008 at 5:38 a.m.
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Rock County crisis is a joke. It's far and in between when they actually refer people for a mandatory hold. They(the person in crisis) tells them what they want to hear and they 9/10 let them go home. Until some one calls them in again. We know this from experience. It's a vicious game they play.
Jul 20, 2008 at 5:19 a.m.
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I also wanted to mention that it is unfortunate that Mercy Hospital almost never admits these patients unless they have insurance coverage. Makes me wonder why the place uses "mercy" in its name anyway.
Jul 20, 2008 at 5:16 a.m.
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I think you're right, MY2CENTS; money is always No. 1 and to hell with the mentally ill and those with substance problems. Once again, Charmian Klyve and our County Board of Supervisors refused to listen to law enforcement or others involved in the care of these people when the decision was made to close the detox unit. Many of those in a mental health crisis were also under the influence at the time, placed on the detox unit and fully evaluated by Crisis Intervention once sober. The majority of the time, the crisis had passed and the person was referred back to an already established plan of care or assisted in gaining outpatient services. The need to send them to Mendota, UW Hospital or Winnebago usually never occurred. It is not cheap in money or law enforcement hours to continue the present plan as described in the article.
Jul 20, 2008 at 3:12 a.m.
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heres an idea...hire the right medical staff at rock county health care center so that the patient can be medical cleared there. health care center has security officers who can sit with the clients while they are being cleared. waiting for test results are whats taking so long. if they feel that the security officers are not qualifed to do so then train them so that they are or even place them in a secured holding cell that is monitered by medical staff while waiting. its not that hard to figure out. i don't want to hear about the cost either, if the sheriff's department can afford to get all these new cars then why can't we spend a little money where we NEED IT. reguardless something has to change, this old process is wasting to much time of an officer that should be out on the street protecting out city. instead of worring about the cost for everything why can't they worry about whats right and whats best for these people in need of extra attention.
and thats my2cents...
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