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What will solve Harrison County's 'biggest crisis?' Local, state officials look for a fix

Sun Herald - 7/21/2021

Jul. 21—Of the 338 people involuntarily committed for mental health treatment in Harrison County in 2020, 136 had been committed at least once before, and one person had gone through the process 16 times.

That statistic was shared at a Tuesday morning meeting between the county Board of Supervisors and four top officials from the Mississippi Department of Mental Health.

The immediate purpose of the meeting was to discuss the county's challenges finding treatment beds for people who are committed, forcing them to spend up to 10 days in local emergency rooms while waiting for a bed to open up at the local Crisis Stabilization Unit (CSU), operated by Pine Belt Mental Health, or at another state-funded facility.

But that problem is interwoven with Mississippi's many other mental health care challenges. With poor access to care, people struggle to get treatment before their illness worsens to the point that a family member feels commitment is their only option.

"I think one of the main keys to some of the issues that y'all are facing is diversion — how to prevent that person from entering the court system in the first place," Wendy Bailey, the new head of the state department of mental health, said to supervisors. "In order to do that, you need a good, strong system."

She described a few long-term ways the state could potentially help Harrison County:

— Provide grant funding to create a diversion center where people could go for treatment to avoid hospitalization or commitment. (Pine Belt has already received $1.2 million from the state.)

— Establish another crisis stabilization unit of up to 16 beds to serve the region.

— Help connect families considering the commitment process with alternative services so their loved one can avoid commitment.

— Provide grant funding for more crisis intervention training officers.

This week, supervisors also approved an increase to the Harrison County Sheriff's Department budget. With $386,000 in funding this year and $265,000 annually after that, Sheriff Troy Peterson will launch a five-person unit solely devoted to transporting people experiencing mental health crises.

Part of their job will be transporting people who have been committed to a CSU bed elsewhere in the state if Pine Belt is full.

Peterson said he is not aware of any other sheriff's department in the state that operates such a unit. All officers on the unit will go through training in crisis intervention.

MS required to expand community mental health programs

Bailey said the state is working to expand locally based treatment programs. Harrison County is currently served by a Programs of Assertive Community Treatment (PACT) Team, a mobile group that provides individual care to people who may have gone without services in the past.

Statewide in fiscal year 2020, the teams served 535 Mississippians, while more than 300 people were committed in Harrison County alone.

Two other "intensive community services" programs she discussed do not currently operate in Harrison County.

Williams' meeting with the Board of Supervisors came as her department is under great pressure to enhance mental health care at the community level. Last week, a federal judge ordered the appointment of an independent monitor to evaluate the department's progress toward providing care outside hospitals.

In 2019, the judge ruled Mississippi had violated the Americans with Disabilities Act by unnecessarily hospitalizing people with mental health problems instead of providing treatment in their communities.

What is commitment?

The commitment process is meant to give families a way to help their loved ones experiencing a serious mental health crisis get care if they're refusing to seek treatment voluntarily.

Harrison County Chancery Clerk John McAdams oversees the process and is responsible for finding beds for people going through the process, both before the hearing that determines whether they'll be committed, and after the hearing if they are committed.

In recent months, staffing issues at Pine Belt Mental Health, which runs the region's Crisis Stabilization Unit where people who are committed can get care, have reduced the number of beds available from 16 to 12.

Mona Gauthier, executive director of Pine Belt, said she hopes the facility will be operating at full capacity again within the next few weeks.

When there are no beds at a mental health care facility, McAdams has had to send people to emergency rooms instead. ER staff keep patients safe, but aren't equipped to begin treating mental health issues.

The CSU at Pine Belt serves not only Harrison County but also Hancock and Stone counties.

Last month, McAdams addressed the board of supervisors and pleaded for help.

"We're putting pressure on the emergency rooms," he said. "And not only that, our obligation for treatment is not being fulfilled."

Along with increasing funding for Peterson to create a new transportation unit, the board is hoping to sign a contract with two local private hospitals, Oceans Behavioral Health and Gulfport Behavioral Health, which have facilities to care for someone in psychiatric crisis.

That way, when no CSU bed is available, the county can send patients to one of the private facilities for treatment until a bed becomes available.

Board attorney Tim Holleman said those negotiations are ongoing over how much money the county will pay the hospitals for each day a patient is in treatment.

'It is a puzzle'

At Tuesday's meeting, the department shared graphics showing it had cut funding for institutional care by $71 million while increasing funding for community services by nearly $89 million over the last decade.

The state argued in court last week that it had made sufficient progress in expanding community-based care since it was sued by the Department of Justice in 2016.

But U.S. District Judge Carlton Reeves ruled that an independent monitor was needed to evaluate the state's services and verify its data. It is not clear yet whether the department will appeal and attempt to block the monitor's appointment.

At Tuesday's meeting, Bailey said she was committed to working with local stakeholders to address Harrison County's mental health challenges.

"It is a puzzle, and you find the pieces, and you have to try to put the puzzle together, and it's not a quick thing," she said.

Supervisor Rebecca Powers called mental health the "biggest crisis" Harrison County faces. She said she was impressed that Bailey and three other department leaders had driven down from Jackson to meet with supervisors.

Expanded treatment options designed to avert hospitalization in Harrison County sounded promising, she said.

She pointed out that poor access to mental health care exacerbated other problems, like child welfare, crime and addiction. And because Mississippi has not expanded Medicaid, many low-income people with mental health problems between ages 18 to 65 lack healthcare.

Unable to afford treatment, they're "floating in the wind," Powers said.

"They're the ones who are going to end up in our hospitals, jails, and morgues," she said.


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