Complexity of mental health issues adding further strain to city services in Oregon

Amanda Loman, The World

The more and more she talks about it, the higher Jodi Fritts-Matthey’s voice gets.

"I just get so frustrated,” Fritts-Matthey said.

The Gold Beach city manager was echoing the frustration and desperation that many of the state's rural officials are struggling with because of the tremendous void of services available for people with mental health issues.

"Neither the city nor the county offer mental health services, so there has been a significant impact on my police department," Fritts-Matthey said. "We spend a horrific amount of time responding to the mentally ill and not doing the law enforcement side of the job, but we deal with it because we have to.

"But they need mental health services — not a cop."

Across the South Coast and throughout all of Oregon's rural counties, mental health care has slowly eroded and is near to non-existent.

Between July 1, 2013 and March 31, 2014, the Department of Justice reported Oregon's severe and persistent mental illness population rose 24 percent from 26,741 to 33,252.

With more insured as of Jan. 1, 2014, increased access has put further strain on the health care system as the current number of providers is unable to meet the demand.

"With the expansion of the Affordable Care Act and the Oregon Health Plan, 8,000 more people have insurance in Coos and Curry County," Coos County Mental Health Director David Geels said. "The number of providers did not change so there's no way the system can respond to the growth."

That dramatic rise in the number of people needing care has local and state leaders struggling to find answers. In the meantime, local first responders have had to bear a burden they are least prepared to address.

Law enforcement is so tied up with responding to calls that Fritts-Matthey estimated her police department spends more than 50 percent of its time contacting people with mental health issues.

"I feel the citizens are not getting what they pay for in law enforcement," Fritts-Matthey said. "It falls on the city because no one will deal with it, and the people who should be responding are not responding appropriately."

Unless a person is an imminent danger to him or herself or others, there isn’t much law enforcement can do, Bay Area Hospital clinical social worker Lisa Rojas said.

"The biggest stressors for the police are the ones who get into trouble, but not enough to get committed," Rojas said. "So if we can't commit them, they're just back on the street again, and that's just the revolving door that's just so frustrating for everyone."

Even when law enforcement utilizes its two treatment options, the local hospital or jail, there remains a difficulty providing a continuum of care, which leads to the cyclical nature of responding to people with mental health issues.

In one of the most extreme cases reported throughout Oregon, Fritts-Matthey said her police department had to respond to one person 10 times over a 12-hour period.

Compounding the increased need for service is the lack of training in dealing with these situations, as well as being able to provide an effective solution for the person's needs.

"We're not trained to deal with it, and when there's a one- or two-day workshop, we'll try and send our guys, but we have a small police force," Fritts-Matthey said.

Fritts-Matthey credited Police Chief Dixon Andrews for applying his wealth of experience with training and mitigating some of the difficult incidents, but there still remains an overall lack of training for mental crises.

"A lot of what he does is counseling, so he knows a lot of the ways to talk someone off the ledge, so to speak," Fritts-Matthey said. "He's been a huge asset, but he's not going to be here forever.”

For those who need involuntary treatment, the lack of availability of beds has put further stress on local law enforcement.

While attending a local public safety coordinating council meeting, Fritts-Matthey discovered the lack of resources extended to the state as officers had to escort a person with mental health issues nine hours one-way just to find a bed.

"When they have to take a mentally ill person, they take them to John Day," Fritts-Matthey said. "I just can't believe there is no other facility in the state, whether it be in Ashland or Medford, and they have to take the person to eastern Oregon. That's insanity to me."

With the city already dealing with limited financial resources, Fritts-Matthey said it can't provide the proper treatment and care without outside assistance.

"In our smaller town, we bring in roughly $500,000 in tax revenue, but between the police and fire department, public safety accounts for $800,000," Fritts-Matthey said. "Taxes don't cover public safety, so we have to get a portion from things like the municipal court and franchise fees, but at some point, it's going to get where law enforcement exceeds all revenue. These people deserve the right type of treatment, and the state needs to figure out something to help them." County seats feeling residual effect of jails

Much like the Curry County seat of Gold Beach, the presence of the jail has buoyed the number of contacts for people with mental health issues in Coquille.

"We can definitely see an increase in the number of contacts," Coquille Police Chief Janice Blue said. "We have the jail in the town so we have the residual effect from all the individuals from other cities (in the county)."

With the police more often than not having to contact or re-arrest the same individuals, Blue said the cyclical nature of the events is indicative of the state of mental health services and the lack of resources.

"It's hard because it reflects on us as an agency that we are continually having to arrest the same individual over and over again," Blue said. "Usually, it is due because they need services that just aren't available. Mental health issues don't belong in jail, but there aren't many services available locally that can help them."

More often than not, the site of the county jail, in county seats around the state, have seen the same increase in contacts and effect on city services.

Nolan Young, city manager for The Dalles, said the rise in mental health calls has impacted police responsiveness because of the diversion of manpower, in addition to placing additional costs on the department.

"There's probably a time when there are high call loads and where it becomes a challenge to respond to everything," Young said. "It costs us money because we have to pay overtime, and there's also the cost of transport. We have to hold a person at the hospital until a bed comes available and sometimes it will take hours and hours until we can find a bed." Nuisance calls affecting city services in Bay Area

Scouring the daily North Bend and Coos Bay police logs, the number of “mental subject” calls is rising at an alarming rate, with names of the same individuals appearing at all hours of the night and throughout town.

As the site of the county’s mental health services and Bay Area Hospital, Mayor Crystal Shoji said it was no coincidence the growing number of people with mental health issues has affected the area.

"The Bay Area has become the area of interest for people who need help because the government has put those services here," Shoji said. "Coos Bay has had to play the part of the inner city and assume responsibility for Coos County. It's hard to absorb because these things keep on coming back and they affect things like police, tourism and, really, all of our city services."

North Bend is no different. Police Chief Robert Kappelman said the department is often inundated with calls to which they are required to respond.

"Those people are frequent users of the police system so that if they generate calls to police, we can't choose not to respond," Kappelman said.

Three weeks ago, Kappelman said the issues with responding to mental health calls were especially visible due to repeated calls from one individual.

"We've been dealing with a person advancing in the stages of Alzheimer's disease, and we received over 60 911 calls," Kappelman said. "It ties up the 911 system and diverts officers from a necessary 911 call."

On Jan. 19, the same woman called the Albany Police Department more than 30 times before North Bend police could respond and warn the subject for misusing 911.

The calls to respond to mental health issues have even seeped into North Bend's parks.

Despite community members' attempts to clean up and make local parks more appealing, there has been an increase in the number of calls for patrol.

As a result of the safety concerns at Simpson and Ferry Road Parks, Kappelman said the department has planned to increase presence in the parks with the Police and Residents Cooperating with Compassion program.

The program, which begins in the late spring, will train reserve officers in crisis intervention, dealing with people with mental health issues and bike patrol operations.

"We've had some issues with homeless and mentally ill in our parks and as a result, people don't feel the park is safe to use," Kappelman said. "At the same time, it's not fair to homeless or mentally ill, who feel that is the safe place for them to be."

But even as North Bend tries to bridge the gap between the community and people with mental health issues, the question of how to provide and maintain the continuum of care remains, with treatment a voluntary process.

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