Transcript A Sheriff’s perspective on the current mental health

“A SHERIFF’S PERSPECTIVE ON THE
CURRENT MENTAL HEALTH SYSTEM
IN NORTH CAROLINA”
SHERIFF SAM PAGE
ROCKINGHAM COUNTY, N.C.
2015 NAMI Conference in Raleigh, N.C.
Mental Health Reform:
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
1840s – DORETHEA DIX crusaded for years for
State supported Psychiatric Hospitals for the
treatment of persons suffering from mental illness.

She was opposed to just throwing the mentally ill
into local jails and prisons with no real treatment.
SOURCE: N.C. Center for Public Policy Research, Mebane Rash 2012 article
Mental Health Reform:
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
1900s – Change in thoughts on IN-PATIENT vs.
OUT-PATIENT care for the mentally ill.

1999 – U.S. Supreme Court, Olmstead Decision,
that basically said persons with mental illness need
to be treated in the least restrictive sittings.
SOURCE: N.C. Center for Public Policy Research, Mebane Rash 2012 article
Mental Health Reform:
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
2001 – N.C. passed Mental Health Reform Legislation

2001 to 2011 – Observed approximately 46% increase
in community based treatment. County Mental Health
programs became managed by Local Management
Entities (L.M.E.s)
SOURCE: N.C. Center for Public Policy Research, Mebane Rash 2012 article
Mental Health Reform:
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
When the call for help comes…
what will YOU do?

Reidsville Police 9-1-1 audio recording
(background)
Mental Health Reform:
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
So… what changed my thoughts on
interactions between Law Enforcement
and the Mentally Ill?
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VIDEO – Kenneth Terry,
2004 (Background)
Crisis Intervention Training (C.I.T.):
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After releasing the vehicle back to Mr.
Terry’s family, they place it in their front
yard with a large sign on it…
 “THE ROCKINGHAM COUNTY SHERIFF’S
DEPARTMENT HAS A LICENSE TO KILL
THE MENTALLY ILL”

Crisis Intervention Training (C.I.T.):
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
Following the fatal shooting in the
graveyard in 2004, I began assessing
what we as law enforcement officers can
do better to reduce the chances of
someone dying during these encounters
while maintaining the safety of the
officer and the community.
Crisis Intervention Training (C.I.T.):
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
After all, Deputies
interact with
individuals suffering
from Mental Illness
EVERYDAY…
Crisis Intervention Training (C.I.T.):
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
It was then that I discovered CRISIS
INTERVENTION TRAINING (C.I.T.) offered
through NAMI and attended a
presentation on the program in
Statesville, N.C.
Crisis Intervention Training (C.I.T.):
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Afterwards, we met with our local NAMI
representatives and formed a Mental
Health Committee.
 Grant was obtained to cover training
costs of offering C.I.T. to Deputies and
local officers.

Crisis Intervention Training (C.I.T.):
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
Key stakeholders came together and
within a year, we had developed a plan
and M.O.A. for training and put that plan
for enhanced Mental Health Services
from all of our stakeholders into action.
What was the Expected Outcome?:
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To reduce the wait time for officers
during Involuntary Commitment Process
so that these officers can return to their
street assignments as quickly as possible.
 To reduce the chances of a deadly
encounter/ending while interacting with
a Mentally Ill person.

What was the Expected Outcome?:
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
To provide Law Enforcement Officers
with the tools and skillset to de-escalate
a situation involving a Mentally Ill
individual, so we can get that person in
crisis the help needed, thus being able to
return them to their home setting
quicker.
What was the Expected Outcome?:
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
Most of our officers at the Rockingham
Co. Sheriff’s Office and throughout all
agencies in the county are trained in the
40 hour C.I.T. course thanks to NAMI and
our Rockingham County Mental Health
Committee.
CRISIS INTERVENTION TRAINING FOR OFFICERS:
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What was the Expected Outcome?:
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We MUST continue to train our
Telecommunicators, Jail staff, Hostage
Negotiators, and other First Responders
in C.I.T.
 Now, 6 hours of C.I.T. is also being taught
as part of the B.L.E.T. curriculum

Costs Associated with IVC Process?:
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For Rockingham County Sheriff’s Office
and FIVE local Police Agencies:
2012-2014 Man hours involved = $136,483
2014 Transportation man hour cost of 722
patients = $34,300
Jail Mental Health Issues:
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
Nowadays, we are seeing more and
more persons entering our local jail
systems with Mental Health issues.
Jail Mental Health Issues:
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
Our Jail and Medical Staffs are working
harder to better screen arriving inmates
to get help to those in need and reduce
the chances of suicide in the jail.
Jail Mental Health Issues:
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
50% of jail suicides occur within the first
24 hours of incarceration.
Jail Mental Health Issues:
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Arresting Officer’s role in suicide
prevention.
 Local LME is also working with Law
Enforcement in community based suicide
prevention& awareness by way of the
faith community.

Jail Mental Health Issues:
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
Many jail suicides (attempted or
successful) are committed by persons
NOT being held on serious charges.
Problems with Mental Health Reform:
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
After 2001, movement to reduce inpatient beds by turning over Mental
Health services to L.M.E.s. Currently, our
L.M.E. is trying to establish a 24 hours
crisis center. (MUCH THANKS)
Returning War Veteran Issues:
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P.T.S.D.
 T.B.I.
 Depression
 Alcohol & drug abuse issues

Problems with Mental Health Reform:
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Shortages of State in-patient beds.
 Increased wait times at local hospitals.
 Suicide rates seem to be increasing.
 Reduced local and State budgets.
 Increased population to be served.

What We Have Seen:
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14 hours standoff w/heavily armed
Marine Veteran.
 PTSD suicide/attempted murder on
Christmas Eve.
 Madison area IVC – VIDEO
(Background)

What We Have Seen:
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14 hours standoff w/heavily armed
Marine Veteran.
 PTSD suicide/attempted murder on
Christmas Eve.
 Madison area IVC – VIDEO
(Background)

Training Officers in Less Lethal Force:
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Training for all Sworn Deputies & Detention
Officers.
 Training for S.R.T. members in deployment
and after care for patient.
 “Suicide by Cop”.
 SAFETY FIRST!
(Community, Officer & person in crisis!)

Mental Health Care in the Future:
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Budgets and funding always a big issue
tied to Mental Health Care in N.C.
 Organizations such as NAMI, as well as
Advocates such as yourselves, are the
most important component in the future
of Mental Health!

Mental Health Care in the Future:
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Continue to train LEOs, Detention
Officers & First Responders in C.I.T.
 We have learned back home in my
county that you can’t always wait on
State and Federal Govt. to solve our local
problems. STEP UP AND GET INVOLVED!

Mental Health Care in the Future:
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Form Community Partnerships to
combine available resources.
 REMEMBER – Don’t give up & continue
to help those in our communities in need
that can’t help themselves in crisis
situations.

Mental Health Care in the Future:
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
According to an article from MEBANE
RASH on the future of the Mental Health
System, we must SET A STRATEGY,
IMPLEMENT IT, and STAY THE COURSE
long enough to evaluate it… I think this
makes a lot of sense.
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Thinking outside the box:
DVD VIDEO
(Background – Sheriff Page
as Reporter)
QUESTIONS:
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THANK YOU!
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SHERIFF SAM PAGE
Rockingham County, N.C.
(336) 634-3239
[email protected]
TWITTER: @rockcosheriff