Hays police chief: 'We've criminalized mental illness'
By CRISTINA JANNEY
Hays Post
A waiting list at Larned State Hospital has created what officials are calling a mental health crisis in western Kansas.
People have waited 14 hours and more in police conference rooms, days in hospital ERs and up to a week in jail cells before being transported to Larned for treatment.
Walt Hill, director of High Plains Mental Health, which is the community mental health center for 20 counties in northwest Kansas, said the waits are a burden on local resources and traumatic for the patients involved.
“If I’m here in Hays, and I have a heart attack, they’re going to have me at HaysMed and have me in a cath lab or surgery within a couple of hours," he said. "If I’m having a brain attack, which is a psychiatric crises, waiting five, six, seven days, just doesn’t make any sense. We aren’t treating people equally.”
Patients in law enforcement custody
The patients that are on the wait list are usually under a court commitment order and have been deemed a danger to themselves or others.
This often means patients have to be in police custody in order to make sure they are safe from themselves or safe from hurting others. However, patients who are ill and have no criminal charges can't be legally housed in the jail.
Hays Police Chief Don Scheibler said the police department has had a patient who waited 14 hours in the department's interview room before they could be transferred. An officer had to be with that person that entire time for the person's safety.
"The only thing they have done is they're sick," Scheibler said. "They have a mental illness."
Patients who have a criminal charge can be held in the jail.
However, Ellis County Sheriff Scott Braun said this is not the ideal place for these patients either — some of which have had to wait a week for transfer to Larned.
In cases in which a person is suicidal, detainees with mental illness are placed in cells by themselves. They are denied anything that they might use to hurt themselves, including blankets and pillows. They are placed in smocks and fed from a rubber bowl, Braun said.
'We're not professionals'
Although numbers of contacts with residents with mental illness are decreasing. There was a spike in law enforcement contacts during the pandemic, according to local law enforcement. The jail has seen as many of half of its detainees on psychiatric medication in the last two years, Braun said.
"We are not professionals," Ellis County Sheriff Scott Braun said. "We have to rely on those experts, and they are at Larned State and High Plains Mental Health. We need to get them in their hands.
"The system is obviously broken," Braun said.
Frustrations run high for both offices and the patients when patients who have mental illness are being supervised by law enforcement.
"We're doing the best we can. In reality, it's very stressful for everybody, and all too often that leads to an escalation. Now we have criminal charges, and we just criminalized mental illness," Scheibler said.
"If we just had the resources, we won't be in this situation. It's terrible, we shouldn't treat anyone like that in terms of the patient."
Waiting in the ER
Now the departments are taking patients to HaysMed to wait, often in the emergency room.
"Now the burden's on the medical center," Scheibler said. "We have people out there for days on the waiting list. If the person is cooperative and not resistant, just ill, we don't have to stay out there.
"But if they are violent or still in crisis — they're a danger to other people — sometimes that requires us to put a law enforcement officer [at the hospital.]"
Since the first of the year, HaysMed has averaged 25 mental health patients a month who were brought to the emergency department, Tammie Williams, HaysMed director of Emergency Nursing Services, said.
The time spent in the emergency department differs for each patient, she said. It depends on many factors, including the complexity of the case, how quickly medical and mental health assessments can be performed, the availability of openings at an appropriate mental health facility, if needed, and how quickly travel accommodations can be made.
Only two patients in the last three months were housed over 24 hours waiting for final arrangements, she said.
"The main consequence these patients face is waiting for the proper procedures to be completed to determine how and where they will be treated,"Williams said. "Other than the medical assessment, all other steps are dependent on outside entities. And again, the lack of mental health resources is a major deterrent"
Law enforcement off the streets
Braun and Scheibler both said they have limited manpower. If an officer has to be stationed with a person who has mental illness, that means that is one less person that is available for patrol or the department has to pay an officer overtime.
When Larned is full, some patients are transferred to open beds in hospitals as far away as Kansas City. These transfers can take up two officers and are also a drain on the department, Braun said.
Hays is lucky in that it has both mental health and the hospital here in Hays to assist with these patients, the law enforcement officials said. Smaller western Kansas communities are further away from resources and have fewer personnel to deal with these crises, Scheibler said.
Waits traumatize<br>
Hill said delaying treatment can mean poorer outcomes for patients.
“The longer you wait for treatment, the longer it takes to get better,” he said. “Often they are waiting in facilities, which aren’t designed for psychiatric care.
“If you’ve ever been in a hospital ER, there’s lots happening. They’re chaotic or they’re waiting in regular medical units, both adults and kids,” Hill said.
Hill said he feared the waits will discourage people from seeking treatment.
“Any time you have a physical or mental health crisis, there’s some trauma involved,” he said. “The longer it takes to get that addressed, the longer that drags out and the frustration ... I think it’s very traumatic for people to have to wait.
“My guess is that it would make people very reluctant to seek treatment again to have to go through that trauma,” he said.
Regina Anderson, director of the High Plains Independence, a consumer run organization in Hays, agreed with Hill.
"When you are already in a mental health crisis, and then you get traumatized because you didn't get services, that's like a double whammy," Anderson said.
"The next time you get in crisis, you're not going to reach out like you did before because you're just going to say, 'They're just going to make me sit in the hospital or sit in a police room. They're not going to talk to me or help me.' ... then we lose another person to suicide."
Why the wait times
The delays have been an issue since May 2020 when Larned decreased the number of open beds from 90 to 70. A combination of COVID and lack of staffing was cited for the reduction, Hill said.
Larned serves a catchment of 59 counties that includes all of western Kansas and as far east as Newton and Hutchinson.
The Hays Post attempted to contact the Kansas Department of Aging and Disability Services, who oversees Larned; however, calls were not returned.
Hill said he doesn't want wait times to become the new normal.
“What I believe happens is that we begin to ignore people in crisis,” Hill said, “because it becomes so complicated and difficult and delayed that natural human inclination is that you just stop seeing it."
Fixing a broken system
Hill said an immediate remedy would be to open up the full 90 beds for which Larned is licensed. He said even more beds may be needed to meet the state's needs.
The state has also increased wages at Larned to try to deal with its staffing problem, but more may need to be done to increase staff recruitment and retention at the facility.
Schiebler and Bruan said the sate has also discussed opening regional crisis centers. Schiebler said this would be a return to what was the norm in the 1990s when local hospitals like Hadley Hospital in Hays had mental health units.
"The hospital is where we should deal with those severe cases," Scheibler said, "but we should be able to deal with that at a local level. It shouldn't be a long drawn-out affair. ...
"The longer they are with law enforcement, the more likely that something bad is going to happen. ...
"Every year we have challenges in law enforcement people who are in mental health crisis get injured or killed by law enforcement because we're being asked to do things we're not really qualified and trained to do."
In the last several decades, most of the nonprofit and private hospitals in the state have closed. Even if private hospitals were available, Anderson said many of those individuals who are on the wait list for the state hospital have no insurance and no money to pay for the care.
COVID relief money is being used to try to address mental health issues. However, both law enforcement officers expressed concerns if funding will continue when the COVID funds run out.
"This is a society thing," Scheibler said. "We didn't get here overnight, and we're not going to get out of it overnight. There's got to be a continued focus"
Local efforts to deal with the crisis
In the mean time, Scheibler said local law enforcement officials are doing what they can to deal with the issue locally.
"In 2017, we decided to start trying to control the things that we could control," Scheibler said, "and that was better educating our people on how to handle these calls for service. We knew that they were going to continue to be a problem. We knew that they were going to be drawn out.
"All our employees get mental health first-aid training, and we try to get 20 percent of our staff to get crisis intervention training. We're really trying to prepare our people to deal with folks in crisis."
The Sheriff's Department and Hays Police Department are both using the Columbia Suicide Rating Scale, which helps officers determine how in danger a person truly is.
"We were trying to send 21-, 22-year-old kids out to do an assessment on a mental health person," Scheibler said. "Now were giving them as many tools as we can to keep not only the officer safe, but the consumer safe. I think we've done some good work in that area."