Southwestern Michigan College criminal justice classes benefited from mental health training Woodlands Behavioral Healthcare Network provided law enforcement April 14 in the Student Activity Center theatre on SMC’s Dowagiac campus.
Students absorbed a comprehensive overview of the public mental health system President John Kennedy established in 1963 by Woodlands CEO Kathy Emans, common psychiatric conditions and who qualifies for inpatient care by Woodlands’ Mary Munson, the Probate Court petitioning process by Judge Susan Dobrich and law enforcement protocols by Dowagiac Public Safety Director Steven Grinnewald and Cass County Sheriff’s Capt. Tom Jacobs.
Last year Woodlands screened 275 individuals, hospitalizing 93 and admitting 21 to crisis residential care. This year Woodlands has screened 91, with 34 hospitalized and seven admitted to crisis residential care costing $430 daily.
Emans introduced the Cassopolis agency’s three daytime crisis clinicians, who must possess master’s degrees in psychology, social work or counseling and be licensed in Michigan to perform crisis services.
Clinicians perform comprehensive assessments, including gathering a full account of what precipitated crises and contact with law enforcement or the emergency room; a full assessment of suicide risk; a full assessment of risk of harm to others; individual wishes and desires for help, or parents if a minor child; a mental status exam; a substance use screen; and a complete mental illness and trauma history.
Involuntary inpatient care requires a petition and clinical certification with factual evidence of risk of harm to self or others.
Woodlands contracts with 18 psychiatric facilities with varying admissions policies.
“Woodlands is committed to assuring we communicate with law enforcement to gather their expert thoughts regarding the individual/circumstances and to communicating our disposition and the reason,” Emans said.
“We value strongly our relationship with law enforcement and our courts,” Munson said.
Individual officers sometimes feel frustrated, Grinnewald said.
“We are trained to recognize risk — not psychiatric issues. Woodlands makes good decisions, works hard and cares about people.”
Munson said substance use disorders is diagnosed most frequently, followed by borderline personality disorders, traumatic brain injury, major depressive disorder, anti-social personality disorder, schizophrenia, bipolar disorder, intellectual/developmental disorder (mental retardation; autism) and co-occurring disorders —combining any of the previous with substance use or any of the previous in combination with one another.
Blows to the head that disrupt brain function happen to 1.7 million Americans annually, with males almost twice as susceptible as females. Highest risk groups are 0-4 years old, 15-19 and over 65.
Since it is a legal process, Woodlands must assure individuals are able to cooperate in clear, coherent, cooperative evaluations.
Absent the need to be hospitalized, inpatient units will not accept until blood-alcohol levels fall below .08.
Individuals under the influence present completely differently sober.
“We see them on the front end when they’re having an episode,” Grinnewald said.
Alcohol use figures in 35 percent of suicides.
The number of clients receiving publicly-funded services for alcohol and other drug abuse increased 25 percent since 1997.
Authority to take someone into protective custody comes from Mental Health Code laws and can be done legally by a law enforcement officer when a person is mentally unable to reach that decision on their own.
Voluntary hospitalization is sometimes an advantage to both sides, as the right to purchase a firearm or concealed weapons permit would be compromised by involuntary commitment.
Emans traced the evolution of community mental health from a fee-for-service model (1966-83) to managed care by 2001.
Woodlands is part of Southwest Michigan Behavioral Health, an eight-county region of Barry, Berrien, Branch, Cass, Calhoun, Kalamazoo, St. Joseph and Van Buren which holds Medicaid dollars. Medicaid, created in 1965, is the largest mental health services payer.
Access to state facilities, such as Kalamazoo Psychiatric Hospital, has been drastically reduced.
“It’s kind of a dire situation,” Grinnewald said.
“Prisons are now our largest psychiatric facilities,” Emans said.
Funding reductions require priority to state-mandated programs and services amid growing concern about public safety.