Tuesday, June 25, 2024

KCBD Investigates The Mental Health Crisis: What to do when your loved one refuses to seek help

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LUBBOCK, Texas (KCBD) – Healthcare workers in Lubbock tell the KCBD Investigates team the need for mental health resources continues to rise.

The Lubbock Police Department says officers responded to more than 2,800 calls regarding a suicidal subject from January 1, 2023 to March 31, 2024.

That averages out to about six calls a day.

Those aren’t the only mental health crisis calls that officers respond to and not everyone they encounter wants help.

Ethan Noble is Mental Health Peace Officer with the Lubbock Police Department.

Noble is on the department’s Crisis Intervention Team and said he tries to respond to as many of those mental health crisis calls as he can.

“I would say an increasing amount of calls we respond to have a mental health element,” Noble said.

The Lubbock Police Department recognized the growing need for officers to have access to mental and behavioral health experts and learn more skills in areas like de-escalation.

In 2018, LPD expanded the Mental Health Peace Officer program to include a full-time Crisis Intervention Team.

Noble said the team typically consists of two officers who are assisted by a mental or behavioral health clinician who is employed by StarCare Specialty Health System, the state’s Local Authority for mental health and intellectual disabilities in Lubbock, Lynn, Hockley, Cochran and Crosby counties.

StarCare offers a 24-hour crisis line, an outpatient clinic, a psychiatric hospital and more.

The KCBD Investigates Team rode along with Noble as he responded to an “Assist EMS” call.

“EMS is out with a subject who appears to be in crisis and that’s really all we know right now,” Noble said.

We arrived at a gas station near 19th and Avenue Q to find three police vehicles and an ambulance in the parking lot.

Noble climbed inside the ambulance where he spoke with the man suffering from a mental health crisis for a while.

When Noble returned to his vehicle, he told us the conversation with the man seemed promising at first because he volunteered to go to StarCare’s Sunrise Canyon Hospital for a mental health evaluation.

“One of our guiding principles is always the least restrictive means of care,” Noble said.

Then, Noble said another officer on scene informed him that the man had a history of leaving the hospital against medical advice because he would become frustrated with the paperwork and medical staff’s questions.

“I said, ‘What happens if you are not okay this time? What happens if you are frustrated? And this person said, ‘Well, I’ll probably go kill myself.’ At that point, even if he’s saying he wants to go, we have a history of him leaving against medical advice, not getting the help, and then he is expressing a suicidal ideation with a plan,’” Noble said.

Under the state’s Health and Safety Code, a peace officer, without a warrant, may take a person into custody if the officer believes that the person is mentally ill and because of that mental illness there is a substantial risk of serious harm to the person or to others, unless the person is immediately restrained, and the officer believes there is not sufficient time to obtain a warrant.

Noble said he feared if he did not execute a warrantless emergency detention, then the man would leave the Sunrise Canyon Hospital before he could be assessed.

Paramedics and Noble escorted the man to the hospital without any issues.

When a person enters a mental health facility on an emergency detention, the clock starts ticking.

The person must be examined by a doctor as soon as possible within 12 hours of arriving at the facility. Under an emergency detention, a person may be detained for up to 48 hours without an order of protective custody. There are exceptions if that 48-hour period ends on a Saturday, Sunday, legal holiday or before 4 p.m. on the first succeeding business day.

An emergency detention does not guarantee admission, treatment, or commitment to a mental health facility. During the evaluation, the medical personnel will decide if treatment is necessary and if the person needs to be committed.

If a doctor believes the person is still at risk of serious harm to themselves or others, then they can file an order of protective custody with Lubbock County Judge Curtis Parrish.

“Depending on the severity of the mental illness, we do have the mechanisms in place to hold them in treatment up to 90 days or even longer,” Parrish said.

Parrish said while calling 911 provides the most immediate response to someone in crisis, there is also an alternative to a peace officer’s warrantless emergency detention.

“Someone in the community, let’s say a parent of someone going through a mental health crisis, can come down here to the courthouse and do what is called an emergency detention application,” Parrish said.

The application asks if the person is a substantial risk of serious harm to himself/herself or others and asks for examples.

The application also asks if the risk of harm is imminent unless the person is immediately restrained.

As we interviewed Parrish about the emergency detention process, he received an application from a Lubbock family concerned about their loved one who had a history of mental illness.

“He is presenting himself as being violent to his family,” Parrish said as he read through the application.

Parrish signed off on the warrant.

“Hopefully, Sunrise Canyon can get him back on medication, get him stable, and get him back out to living in our community again,” Parrish said.

Peace officers aren’t the only individuals who provide transportation to a mental health facility after a warrant is served.

State law allows for a certified mental health officer, the facility administrator of the designated mental health facility, a representative of the local mental health authority, a qualified transportation service provider, a sheriff or constable, and a relative or other responsible person who has a proper interest in the patient’s welfare may take a patient to a facility with a court order.

According to StarCare, EMS drops off about 326 people a year who suffer from a mental health crisis while law enforcement drops off, on average, 615 people a year.

StarCare’s Director of Diversion Programs, Bobby Carter, said last fiscal year, they served about 2,200 adults and 800 children, and they are on track to serve about 3,000 people again this year.

“We’ve got one hallway with six consult rooms and there are some times when every single one of those consult rooms are full and we’ve got people overflowing into the lobby to be seen,” Carter said.

Carter said the majority of people who visit Sunrise Canyon Hospital do so voluntarily.

According to the Lubbock Police Department, in 2023, 804 calls ended with the person volunteering to go with police officers to a mental health facility.

That same year, officers recorded 304 emergency detentions while the Lubbock County Sheriff’s Office said deputies served 22 mental health warrants.

Carter said there is a misconception that if someone suffers a mental health crisis and refuses help, they can be admitted to the hospital involuntarily.

“Just like police officers, we are held to certain standards of the law,” Carter said.

Carter said if someone is suicidal or homicidal, they typically meet the state’s criteria to be committed.

“The difficulty comes when you see someone who having significant symptomology associated with a mental health diagnosis such as schizophrenia or schizoaffective disorder. Yes, they are hearing voices, that is part of the diagnosis. Yes, they are seeing things, that is part of their diagnosis. That does not constitute a reason for involuntary hospitalization,” Carter said.

When it comes to involuntary admission, Carter advises people take note of the person’s ability to perform daily tasks.

“One big thing is failure to thrive. Are they not eating? Are they not drinking? It has to be very, very specific on what is going on with them before their rights can be taken away,” Carter said.

If someone is on medication and refuses to take it, Carter said that is not grounds to admit someone involuntarily.

“There is no law out there that forces someone to take their medications,” Carter said.

Carter said if someone refuses help and does not meet the criteria for involuntary admission today, it does not mean they won’t meet it tomorrow, so continue to call.

Noble said he got into this field to help people and he hopes community members will take him up on his offer.

StarCare’s Mobile Crisis Outreach Team provides intervention and assessment 24/7 to people suffering from a mental health crisis.

Carter said they will conduct a 24-hour follow-up with anyone they encounter.

To contact the 24/7 Crisis Help Line, call 806-740-1414.

If you would like to schedule an appointment with StarCare, call 806-740-1421.

Click here to learn more about the services StarCare offers.

The National Alliance on Mental Illness (NAMI) also has a trained crisis counselor available to offer crisis support via text message. Text NAMI to 741-741.

The NAMI HelpLine can be reached Monday through Friday 8 a.m. to 8 p.m. This is a free, nationwide peer-support services that provides information, resource referrals and support to those living with a mental health condition, their family members and caregivers, mental health providers and the public.

Click here to learn more about NAMI’s support groups, resources and more.

The Lubbock Suicide Hotline is 806-765-5393.

You can text or call 988 to reach a nationwide suicide and crisis lifeline that provides 24/7 free and confidential support, prevention and crisis resources. Learn more about the 988 Lifeline here.

The Children’s Crisis Line is 806-252-2748.

The Veterans Crisis Line is 1-800-273-8255, then press “1″. This will connect you to responders with the Department of Veterans Affairs.

Oceans Behavioral Hospital, while private, also takes involuntary commitments.

To learn more about the services Oceans offers, click here.

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