Share

Archives: KHI News Service

On January 1, 2017, the KHI News Service became part of KCUR public radio’s new initiative, the Kansas News Service. The Kansas News Service will continue to cover health policy news and broaden its scope to include education and politics. All stories produced by the former KHI News Service are archived here. Stories and photos may be republished at no cost with proper attribution and a link back to KHI.org.

KC area program shifts how police deal with people in mental health crisis

Co-responders link people with treatment rather than jails, emergency rooms

By Tammy Worth, HEARTLAND HEALTH MONITOR | March 31, 2016

KC area program shifts how police deal with people in mental health crisis
Photo by Tammy Worth/Heartland Health Monitor Megan Younger, shown here talking with Overland Park Police Officer Mike Melvin, tries to keep people with mental health issues out of jail and hospital emergency rooms.

On Megan Younger’s third day on the job, she accompanied police officers to the home of a woman whose family hadn’t heard from her in days. The woman was found in the bathtub – where she had been for three days – and had chemically burned off all of her hair.

She was psychotic and delusional, but she was otherwise healthy and her lawn was mowed, her house clean and her pets well-groomed. After talking with her for a while, Younger determined the woman wasn’t suicidal or harmful to others. She was left at home where a mobile crisis team checked on her the next day.

For Younger, this was a victory. What might have appeared like a frightening situation for many was this woman’s baseline. Taking her to the emergency room to get checked out, a typical response for officers in this situation, would have only added to her problems.

“That’s a total success because if we have someone who is really fragile, then to pull her out of house and put her in handcuffs in front of neighbors … and to have her sit and wait for hours in an ER, would only re-traumatize her,” Younger says.

Younger is a co-responder with the Overland Park police department. She’s one of a handful of co-responders across the metropolitan area – Kansas City, Kan., and Olathe are two of the other cities – working to change the way police interact with people in a mental health crisis and to get them treatment instead of cycling in and out of emergency rooms and jails.

“I go out on the scene and explain why people aren’t belligerent or hostile, but it may be their symptoms making them like that,” she says. “They may be under the influence or mentally ill.”

Tracking, calling and knocking on doors is what Younger does. When officers go on a call and find someone in the midst of a mental health crisis, Younger is a phone call away to talk them, or the client, through the issue. She calls the families when individuals with mental health conditions find themselves in custody.

Seeing things differently

She and her partner, officer Thomas Keary, investigate contacts with officers that may be mental health related. They follow up with repeat offenders awaiting their day in court to make sure they are taking their medications. She talks with her former colleagues at the Johnson County Mental Health Center to ensure people are coming in for treatment and making progress.

Photo by Tammy Worth/Heartland Health Monitor During her first year on the job in 2014, Megan Younger went on 129 site visits in Overland Park. She helped avoid 40 arrests, which would have cost nearly $61,000, according to a report. Younger now has anywhere from 70 to 90 contacts per month.

View larger photo

And if the problem is severe enough and people decline to seek treatment, she keeps records as they move in and out of the system in case they require involuntary commitment.

That was the case with an Overland Park resident who refused care even after nearly 60 “involvements” with the department over a three-month period. Finally, Younger went on a call to the man’s home and, after speaking with a family friend and doing a walk-through, was convinced his run-ins with the system were the result of a severe mental illness.

Keary has been trained to recognize people in a mental health crisis, but Younger typically sees the scene differently. For instance, Keary’s notes of the Overland Park house described it as dirty and cluttered with trash. He observed alcoholic beverage containers strewn throughout the kitchen.

Younger’s write-up showed the likelihood of more intense underlying problems. She noted the stairway, which was covered in dog hair, a floor blackened by urine saturation and air that was ripe with the scents of urine, feces and cigarette smoke.

“The toilet was coated in urine and feces and had clothes stuffed inside it to make it unusable,” she says. “The bed was saturated in urine and had no sheets. The floor was covered in dried feces and had clothes all over.”

Diverting from ER and jail

This is one distinct way co-responders contribute to the system, says Alex Holsinger, a professor of criminal justice and criminology at the University of Missouri-Kansas City who tracked co-responders’ work in Olathe and Overland Park.

“They may look to see if a person is well fed, for instance,” he says. “It’s not a parlor trick per se, but it’s something he (an officer) wouldn’t think to do. They see things that are subtle that might help avoid arrest.”

There’s a benefit to keeping people with mental health issues out of jail. They stress the system more, typically staying in jail longer and costing more than double to care for than an inmate with no mental illness.

Not only do they have greater care needs like medication and mental health care, they may require extra staff hours and intervention to ensure they don’t harm themselves or others, says Johnson County Sheriff Frank Denning.

And the nature of jail itself – confining, solitary, unpredictable and transitory – makes it difficult to fully meet the needs of inmates with mental illness, Denning says.  

“The staff that we have and the resources we have are good, but I just don’t know that they are plentiful enough,” he says.

“I may have to spend hours out there and spend time with family and a crisis team … but we don’t have to pull people out of their houses against their will to take them to the ER to be assessed.”

- Megan Younger, a co-responder with the Overland Park police department

During her first year on the job in 2014, Younger had 866 contacts and went on 129 site visits. She helped avoid 40 arrests, which would have cost nearly $61,000, according to Holsinger’s report. Younger now has anywhere from 70 to 90 contacts per month.

Although her initial aim was to keep people out of jail, Younger says she found that keeping people out of local emergency rooms was just as important.

Laura Birch, nurse manager for inpatient psychiatry at the University of Kansas Hospital, says up to 250 emergency room visits per month are attributable to someone in the midst of a mental health crisis. She says the numbers have gone down since the inception of the Johnson County co-responder program in 2011.

According to Holsinger’s data, each ER trip related to a mental health call requires two officers who are required to stay and monitor the individual until they are seen by a physician. That can last up to 12 hours. Because Younger has helped avoid 56 emergency room trips, the department has saved more than $25,000 in staffing costs. The cost saved to hospitals amounts to as much as $145,000.

“I can go on the scene as a clinician to see what is going on, and can say things are bad but they are going to be OK until tomorrow,” Younger says. “I may have to spend hours out there and spend time with family and a crisis team … but we don’t have to pull people out of their houses against their will to take them to the ER to be assessed.”

Because of the results seen in other parts of Johnson County, the Lenexa and Shawnee city councils have approved hiring one co-responder to share between them.

Wade Borchers, a captain with the Lenexa Police Department, says he expects to have the co-responder on board later this spring or early summer. He said other small cities in Johnson County are in talks with the Johnson County Mental Health Center regarding sharing a co-responder as well. If that happened, Borchers says Leawood and areas north to Merriam would be covered, except for some rural areas of the county.  

“There is value in getting to the consumer and diverting them from the jails or the state hospital,” he says. “The co-responder concept definitely is taking hold in Johnson County.”