"I had a lady call me and say, 'I called the sheriff's office because my son was threatening suicide and he was threatening me, and you guys showed up and took him to jail. I thought you were going to take him to a mental health treatment center.' Well, that is the jail, unfortunately." -Yavapai Co. Sheriff Scott Mascher in May 2014
PRESCOTT- With calls like that one in mind, Mascher has taken the lead in creating the county-wide Mental Health Criminal Justice & Community Coalition.
The problem was defined in a three-part series in The Daily Courier last spring. "There was time when we had mental health hospitals," Superior Court Judge Celé Hancock said. "Then there was a change in which people said, 'You can't imprison people for being mentally ill.'"
Hancock, who presides over the county's mental health court, said, "So now, we're trying to cobble together (a system) to serve this part of our community."
The challenge, then and now, was, how the law enforcement and the justice system should deal with getting those people the help they need.
That's the reasoning behind the coalition. In a February meeting attendees included Mascher; Hancock; County Attorney Sheila Polk; Deputy County Attorney Jack Fields; Public Defender John Napper; Becky Payne, RN, the jail's health administrator; Dwight D'Evelyn and Capt. David Rhodes of the YCSO; Debra Kendall of the county's Adult Probation division; and Audrey Dorfman of the Verde Valley Mental Health Coalition.
"We're now working together as a team to work towards dealing with the mental health issues we have here on a local level," Mascher said.
"It should be the last resort, to put them in jail"
The first contact people with serious undiagnosed mental health issues is often with a police officer, who have generally had some training in the area, but not a high level of standardized, consistent training.
"Training the police is really the first (objective)," Hancock said. "They've got to get trained."
Mascher said he doesn't like having deputies arrest people who really haven't committed a major offense but need treatment.
"I can understand how a family doesn't want to call law enforcement," he said, "they're worried about the safety of their loved one, but what resort have they?
"If we can, as law enforcement officers, respond to a call for service, and stabilize the call-identifying mental illness-and divert them, rather than (take them) to the jail, that's what we want to do," he said, adding that "it should be the last resort, to put them in jail."
One of the more far-reaching ideas the coalition is exploring is the creation of a special unit, which might, at first, be composed of volunteers, that would respond with-or even ahead of-sheriff's deputies when a call deals with an emotionally disturbed subject.
There is already a unit like this in Pima County, Hancock said, where trained volunteers go out with police on calls.
The jail as de facto treatment center
Mascher has already instituted a mental health unit in the Camp Verde jail.
"Even thought the jail is truly a bad environment to try to treat people...it's really not meant for that...we've tried with the help of Wexford, our correctional health company, they've accepted the challenge to step up" and devise a treatment program for what Mascher called "minor (offenders) we see a lot of recidivism in," such as the person who has stopped taking their medications and commits a minor offense.
They are housed together, which Hancock said was beneficial.
"There's a built-in support system right there," she said. "It's a much better environment for them."
Even so, "we're doing the best we can in the jail," when it comes to mental health care, "but it's still a jail," Mascher said.
Paying for care
One hurdle on the way to creating this program appears to have been cleared: who pays for the treatment once a person is released?
"Many times, services are there, but there was no way to pay for them," Mascher said.
When a person was incarcerated, the Arizona Health Care Cost Containment System (AHCCCS), which covers indigent patients, would drop them from the rolls, and when they were released, they had no way to pay for continued care.
But now, Mascher said, within 24 hours of their release, AHCCCS coverage is reinstated.
"That's huge," Hancock said, because once cut off, it was difficult to re-enroll in the system, and without "continuity of care," the same issues would arise again.
Dealing with the judicial system
Because Hancock handles all the so-called "therapeutic courts"-DUI and Drug Court, Mental Health Court, Family Treatment Court, and the competency hearings-she's in a unique position to deal with people who may have deeper problems.
"We've been able to identify and move people from Drug Court into Mental Health Court," she said, "because once they cleared the drugs and alcohol (from their body), it was more a mental health issue than it was an addiction problem."
The coalition has identified a position, called a clinical liaison, which could be of help in coordinating treatment and court appearances.
"If we can (treat) the prisoner who is here on a misdemeanor, maybe they won't come back on the felony," Hancock said.
A "Solution Center"
Larry Green, CEO of the West Yavapai Guidance Clinic, proposes a wider-ranging concept-and, possibly, the final piece of the puzzle of treatment vs. incarceration.
"My vision, for a number of years, has been to establish a community program that would be an observation-stabilization center," Green said. "It would be a support to law enforcement, it would be a support to the local hospitals.
"I call it a 'Solution Center,'" he said, and it could become a reality if proposed grant funding and agency cooperation all come together.
The people who were diverted from headed for jail by Mascher's proposed volunteer squad, for example, might be taken to the Solution Center.
It won't be fast or cheap to establish, Green said, "but I think it's a very needed program."
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