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Mental health first aid to help identify community problems

Hutchinson News, The (KS) - 4/22/2014

April 21--Maybe it's a person shouting at vehicles as they pass on the roadway.

Or it's you're your neighbor who never leaves his house; maybe a woman sitting alone in a coffee shop.

Of course, it could also be you.

According to the National Alliance on Mental Health, mental illness affects one in four people and no matter their situation, Hutchinson care providers want people to know services exist that could help them.

Locally, those services may become more available in the next year as Hutchinson community members gather to learn mental health first aid.

"Not only are we teaching people how to identify mental health challenges, we're trying to equip them with resources," said Teryn Irvin, Coordinator of Prevention, Education and Outreach Horizons Mental Health Center.

A mental health first aid class set for May -- mental health awareness month -- is full. Two more, however, are scheduled later in the year. If those are well attended, Irvin said as many as 150 new people in Reno County could be certified in mental health first aid. These people, Irvin said, wouldn't necessarily serve an individual with a mental illness, but would be able to identity when a person is in the midst of a crisis and point them in the right direction.

Currently, approximately 185 Reno County professionals are trained in mental health first aid. Healthcare providers, educators and law enforcement make up many of those trained in navigating a person in the midst of a crisis. Members of law enforcement, said Nicole Devaney, a therapist at Horizon's same day care department, refer people so often that they have their own parking stalls and entrance in the back of the building.

"Literally, they come in through the back door," she said.

"We've been constantly working on our relationship with them and they're very helpful."

Often times, she said police officers or sheriff's deputies will come in and sit through the assessment. The referral could have come from a myriad of reasons, including a concern for welfare call or report of disorderly conduct. The officer is on hand should the person threaten violence or suicide or be disorderly and sometimes, Devaney said, the person responds better to the officer than case managers, as there's a large overlap between Horizon's clients and people with criminal history.

"Part of it is maybe they want to move away, but they are thrown into the same situations they were in before. We see a lot of people who are recently released from jail or prison who are wanting something different."

Services available to people include case management, therapy, tele-therapy and group therapy. Some, she said, may be prescribed medication.

While getting people help in the midst of a mental health crisis has improved, making them stay on a regimen is a completely different story. People certified in mental health first aid then, could help intervene and make a referral before a problem escalates.

Police Capt. Troy Hoover said his officers see the same people over and over again.

"It's about every five to eight years you have a new group of the folks we go out on all the time," he said. "When I was a rookie officer, I could name four or five people that we really went out on. I would say, though, that we deal with more mental health cases now than we did 25 years ago. I don't know if it's because officers are better at identifying mental health issues or maybe we just took them to jail."

For those even still going to jail, now there's access to mental health care.

Sheriff's Sgt. Levi Blumanhourst said therapists from Horizons come several times each week to hold private and group therapy sessions in each jail pod. The programs been going on less than a year, so he wasn't sure of its overall impact, but so far he said it's been a positive experience.

"The majority of them are listening and paying attention and are interested," Blumanhourst said. "I think it's helping people see that there are other options."

The majority of the time, a person with a mental illness doesn't end up in jail because of a single interaction with law enforcement. Usually, they either go to Horizon's for a mental health evaluation or, if they are threatening violence, can be placed in police protective custody and hospitalized. At that point, Hoover said, the person's admission and treatment is up to care providers.

Often times, he said they'll go and talk to the person to make sure they are safe, try to deescalate the problem and then leave. While they can't do anything at that point, Hoover said officers at least have a gauge on how bad the problem is should the person's behavior become more erratic. It's frustrating, Hoover said, because officers do all they can, but problems often persist.

"It's a band-aid that peels off in two hours and that's really the issue," Hoover said. "To me, the permanent fix is to try and find some mental health solution for this guy... They revert back to the same problem and it's always been that way."

Thanks to a philosophy switch in the 1990s that favored outpatient services over hospitalization, as well as a lack of beds, very rarely is a person sent to Larned State Hospital now because of mental health episode, Devaney said. While this means the person is likely free and able to function on their own, it also means long-term and mandatory care is hard to come by. With outpatient services, a person doesn't have to take his or her medications, show up to appointments or attend therapy if they don't want to.

"With any field, there's always room for growing," Devaney said. "That's why crisis therapy is here... we look at what has worked for you with your therapist and I feel that has been helpful for clients."

As more people become certified with Mental Health First Aid, Devaey expects the number of referrals to grow. Having more eyes and ears on the ground certainly won't hurt.

"We have an awesome crisis team that works so hard to keep people out of the hospital by increasing services on the outside," she said.

"We're just constantly having to learn together."

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