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Jails, courts 'stopgap' for mental health

Springfield News-Sun (Ohio) - 4/1/2015

April 01--Local police and corrections officers continue to strengthen ties with mental health professionals as the need for specialized training and coordinated services increases.

Butler County agencies such as Transitional Living, Inc. and Community Behavioral Health, which provide mental health and addiction services, as well as the Ohio Attorney General's Office, are increasingly offering mental health response training to police officers.

Major Mark Hoffman of Middletown Division of Police said each officer does receive some mental health training as part of their recruitment, but there are also in-house and online opportunities for learning how to deal with people suffering from a mental illness.

"When you deal with a mental health issue, keep in mind they may not be thinking in the same manner as someone without (it)," Hoffman said. "They might see the officer as a threat. You try to be a calming presence."

In recent decades with fewer psychiatric beds and facilities available, Hoffman said police departments and court systems have become "stopgap measures" to help those in need.

The national nonprofit Treatment Advocacy Center estimates the percentage of jail inmates with a mental illness at between 7 percent and 10 percent, with some facilities reporting as high as 20 percent.

"A lot of these people don't fit in with the normal jail population," said Captain Dennis Adams, warden of Butler County Jail.

The Butler County Jail in the last five years made the "needs-driven decision" to create a forensics pod for male inmates with mental health and addiction issues, such as substance abuse, severe depression, schizophrenia and bipolar disorder, Adams said.

The pod has the capacity for 96 inmates and is usually always full, he said.

Inside that forensics pod are now six full-time mental health professionals, including four forensic social workers and a case coordinator from Transitional Living, and an inmate services coordinator for substance abuse from Community Behavioral Health.

But Adams said there are at least 20 other mental health professionals who come in and out of the jail to coordinate services for inmates.

"They've been a tremendous help; it's not just about holding someone (in jail), you want to impact the community," Adams said.

The jail-based program receives about $260,000 annually from the Butler County Mental Health Board to cover the salaries of four positions, said Scott Rasmus, executive director of the mental health board.

Rasmus said the jail-based workers provide crisis intervention, medication management, care coordination, assessments and referrals to the inmates in need.

"When you look at the statistics, about 50 percent of the inmate population has mental illness ... it makes sense we're there," Rasmus said.

Kathy Becker, CEO of Transitional Living, said forensics staff inside the jail make contact with an average 550 inmates each month. Some inmates are suicidal or homicidal, while others are psychotic after stopping their medication.

"With the number of hospital beds reduced, people end up here that would go to a mental health facility," Adams said. "In the last 10-15 years, we've seen an influx; it's changed the face of corrections."

Kimberly Back, licensed independent social worker and clinical director at Transitional Living, said before the inmate is discharged from the jail, the forensics staff creates a discharge plan with follow-up appointments and coordination of services in areas of housing, substance abuse and developmental disabilities.

"To make sure that continuity of care is there," Back said.

Since mid-February, Matt Brashear from Community Behavioral Health has been working full time in the jail to prepare inmates for re-entry into the community through intensive drug and alcohol therapy and help from Butler Tech to get a GED.

"Individuals are more receptive to seeking help when they first get in (jail)," Brashear said. "... Their life has been affected to the point where they are really starting to understand the consequences of their behavior."

Becker said with the help of local police, she proactively seeks out homeless people and others on the street that may need mental health services. About a third of the U.S. homeless population has a serious mental illness, according to Treatment Advocacy Center.

On a weekly basis, Becker said she rides along with a police officer in Hamilton, Middletown, Fairfield or other parts of Butler County. She gets the most referrals for service from police officers because they work 24 hours a day.

Becker said she's also hosted training for officers to learn signs and symptoms of mental illness and how to de-escalate situations.

During a ride-along Monday with Becker, Hamilton police Officer Terry Kiefer said it's made his job "100 percent" easier.

"It's given us options to use, avenues to take, who and how to get in contact with people," Kiefer said. "Just the way to talk to people and not to jump to any conclusions."

Kiefer said he's had Becker along for rides for over 10 years. During the five-hour rides, the two discuss past or ongoing clients while responding to calls and coordinating follow-up services with appropriate agencies.

In West Chester, police Officer Tim Mintkenbaugh said the department often calls on Transitional Living when they need help with a suicidal person.

"Time is of the essence for many of these situations," Mintkenbaugh said. "Mental health issues are one of the paramount things to be trained for as an agency. It's terrible and unfortunate when one ends up on the wrong side of call."

Mintkenbaugh said he went through a 40-hour mental health response training by Mental Health America, and he's actively pursuing an in-house training opportunity for his colleagues.

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