Marion County Response to Mental Health Incidents to be State Model

The Oregon Legislature renewed funding for special mental health crisis response teams in Salem and Marion County, and added an additional $7 million to the pot for other counties. The mobile crisis teams work to diffuse messy situations and avoid jailing and arresting people who have a mental health crisis, and the the number of people admitted to the state hospital from the county has dropped steadily.

Lt. Chris Baldrige said that traditionally, the police response to disorderly conduct and public disturbances was to throw the lawbook at the situation, and diffuse the conflict by arresting people so they were out of harm’s way. “We were utilizing our laws to fix the problem.”

Law and order became the response, even as people acted out because of untreated mental illness or drug and alcohol issues.

Such an approach was bad for the county jail, which swelled trying to house these individuals; it was bad for police, who were tied up in messy situations that took their focus off responding to more serious crimes, and it was certainly bad for the people in crisis, who ended up stuck in the criminal justice system when what they really needed were psychiatric services.

The Marion County Sheriff, in close conjunction with Salem Police, has moved away from this old approach and, backed by state funding, deployed two crisis response teams which pair a policeman with a mental health specialist to respond to incidents where mental illness is a likely cause of the disturbance.

“The end goal is to decriminalize this population,” said Marion County Undersheriff Troy Clausen.

“Our primary emphasis with the mobile team is to slow people and the situation down,”  said Deputy Cliff Self, one of two officers assigned full time to the mobile crisis units, the other being Officer Eric Brown of the Salem Police, who has been freed by his supervisors to go outside the city limits when needed.

Self’s partner, Joey Phillippi, said they can spend up to 90 minutes with an individual, which allows the regular officers to move onto the next call. “We’re able to take the time with them that they don’t have,” she said.

As a result, out of nearly 500 calls, nearly half of the incidents end without the mobile crisis teams needing to take people into custody or somewhere else other than back home. About 40 were taken to the county’s psychiatric crisis center, 80 were brought to the Salem Hospital while in custody and only 23 were taken to jail.

“It’s a much more thoughtful process of law enforcement,” Baldridge said.

Phillippi said these people often pose a much greater risk to themselves than others, and said it was common for them to talk people down from suicidal situations.

The approach that was piloted in Marion County could become a state model. The Legislature renewed its funding this summer, and added $7 million more for crisis intervention teams in other communities, as well as $6.5 million for jail diversion programs.

“Being a smaller community, it doesn’t take as much as it would take in Portland to have an impact,” said Chris Bouneff, director of the Oregon chapter of the National Alliance on Mental Illness.

The Portland Police Bureau has invested in its own crisis intervention teams -- part of a court order that found the police had violated the civil rights of people with mental illness by using excessive force. And while the state made its investments in Marion County without a court order, the state, too, has come under federal scrutiny for housing too many people in the state mental hospital who should be getting services in their community.

Steady Drop in Hospital Admissions

It’s hard to quantify the impact of the proactive, progressive approach taken by Marion County law enforcement -- the annual jail bookings have declined from 20,000 to 14,000 in the past four years, but not all of that can be pinpointed to jail diversion from the crisis units.

But the data does bear out the county’s success in diverting people from the state mental hospital. Ann-Marie Bandfield of the Marion County Health Department said that the number of people who have been sent to the Oregon State Hospital because they were mentally unfit to stand trial has dropped from 84 in 2011 to 78 in 2012 to 72 in 2013, 68 in 2014, and only 53 this year, which puts it on track to reduce such “aid and assist” referrals to the state hospital even further.

Contrasting Marion County’s progress, the statewide numbers for these admissions has only grown in recent years from 286 in 2010 to 365 in 2012 to 459 in 2014, according to statistics provided by the Oregon State Hospital. With still two months to go in 2015, the hospital is on pace to eclipse 500 patients who are admitted at the state hospital so they can be stabilized while awaiting trial, often on petty misdemeanor charges.

Marion County, which Bandfield points out has seven state institutions, including prisons and the state hospital, has sent more than its share of the population to the state hospital for a long time, traditionally second only to much-larger Multnomah County. But Lane County, which includes Eugene, has now passed Marion, with 74 admissions this year.

Other counties that send a disproportionate share of people to the state hospital include Douglas and Klamath counties, as well as all of the coastal counties, except Curry.

The Marion County program was part of a $44 million investment the Legislature made in mental health services in 2013, which was then renewed this summer. Oregon Health Authority spokeswoman Patricia Feeney said the agency will release its requests for proposal soon, which will allow other counties to bid on the $7 million in new funds for the 2015-2017 budget cycle.

Funding these type of approaches will always be tricky, and it’s an open concern that the state would cut these crisis teams from the state general fund in the next economic downturn. While it may help the state save on state hospital expenses, the costs for policing and county jails are more fixed. Marion County will be able to avoid wasting resources criminalizing chronic mental illness, but the public safety resources will be simply better utilized, and the city of Salem and the county would be unlikely to reduce spending on police.

Bouneff said the state’s funding formula was better than in the past, when funds were doled out proportionately to each county -- often leaving the counties unable to have enough money to actually implement a program. By limiting the money to a bidding process, Marion County in this case was able to makeover its approach to handling mental health incidents, even if some counties went unfunded

Follow-Up and Follow Through

After the crisis is averted, a third team in Marion County -- the crisis outreach response team -- works to follow up on the individuals involved in the incidents to assess their situation and connect them if possible with resources that will get at the root cause of their problem, such as mental health or addictions treatment, housing or transportation.

James Ferraris, deputy chief of the Salem Police, said the wraparound services in turn help prevent repeated calls for the same people. “They’re less likely to focus on criminality, and that lets us focus our calls of services on issues that are not so chronic.”

With one man, who had 31 contacts with police in 2012, they found he simply had no way around Salem, which has no bus service on nights or weekends. “He didn’t have transportation, and he was using the police as a taxi service,” said Bandfield.

“The sheriff got creative and released a bicycle for his use,” Clausen said. They still get calls about this man, but they’re down to three a year now that he has wheels.

Chris can be reached at [email protected]

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