Local law enforcement struggling to find treatment for mentally ill after state policy changes

Oct. 29--Jon Garlick's job as mental health officer for Calhoun County appears fairly straightforward: Respond to calls of residents experiencing mental health issues, then get them treatment before they hurt themselves or others.

Lately that job has become more difficult, Garlick said.

Fewer residents experiencing mental health issues are receiving treatment because of two state policy changes enacted this summer, local law enforcement and mental health officials say. Coupled with the state closing nearly all its psychiatric hospitals in recent years, the changes mean more mentally ill residents are being left in jail or on their own without proper care, officials say.

"With these two rules, they have shut down anything I can do as a mental health officer," Garlick said.

Mickey Turner, executive director of Highland Health Systems, formerly Calhoun-Cleburne Mental Health in Anniston, said the Alabama Department of Mental Health enacted the policy changes in July.

Under the changes, residents must first be medically stable before they can be committed to a designated mental health facility -- meaning mentally ill patients can't have an ongoing health issue such as high blood pressure. Also under the policy change, a mentally ill patient can't be submitted to a designated mental health facility without first having a court hearing, Garlick said.

Previously, residents experiencing an emergency mental issue could be admitted to a designated mental health facility temporarily until a probate court hearing could be held and they could be properly committed after a psychological evaluation.

"I'd love to take individuals experiencing a crisis and when we first started we did," Turner said. But the Department of Mental Health in July decided that mental health facilities can only take committed patients

"It was thought that if we take both, we'd run the risk of filling up with non-committed and not have enough room for committed patients," Turner said.

Garlick said he also had the option of submitting mentally ill patients to Regional Medical Center's emergency room until a hearing could be held, but that's no longer the case.

"They recognized they're not a designated mental health facility, so they stopped that," Garlick said of RMC.

Garlick said that without these options, residents in mental health crisis are being taken to the county jail if they're committing any kind of crime. If not, the other alternatives are to try to convince them to admit themselves to emergency rooms on their own or take them to their families, if they have any, Garlick said.

Designated mental health facilities have been the mental health department's answer to the closing of its psychiatric hospitals in recent years. The smaller facilities, spread around the state, are designed to save the state money and provide more localized mental health care. Highland Health Systems opened its own 16-bed facility in Alexandria more than a year ago.

Since 2012, the state has closed Searcy Hospital in Mount Vernon, Greil Montgomery Psychiatric Hospital and North Alabama Regional Hospital in Decatur. Only the Tuscaloosa-based facilities Bryce Hospital, Mary Starke Harper Geriatric Psychiatry Center and the Taylor Hardin Secure Medical Facility for the criminally mentally ill remain.

Calhoun County Sheriff Larry Amerson said he's not in favor of the state closing its larger mental health hospitals and using the smaller facilities.

"If they can't take local people who are in crisis, then it's defeating the purpose in our point of view," Amerson said of the facilities. "Now we have these folks that if they act up, they wind up in jail and that's not fixing anything."

James Perdue, commissioner for the Alabama Department of Mental Health since July, said he was unaware of the recent policy changes. Perdue said though that he agreed in part with Amerson's concerns about the state not providing enough care for mentally ill patients.

"I do think we have enough beds, but if you have to travel two to three hours to a facility, then that's too far," Perdue said. "There's still a lot of work to do."

Turner said he thinks the state should have more beds available for the mentally ill. Turner noted that Highland's 16-bed facility also periodically takes committed patients from other surrounding counties.

"I don't think there's enough beds," Turner said. "We don't take people who are having a psychiatric crisis ... there needs to be more space for these individuals."

Money for more beds is limited, though. Turner said Highlands has received flat funding from the state since 2009.

Perdue agreed that money for mental health in the state is tight.

The Alabama Legislature allocated $106 million for mental health in its 2016 budget, up less than $1 million from 2015.

"Anything that needs changing and fixing is going to take time, money and community involvement," Perdue said.

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