In a phone interview on Tuesday, Oct. 30, Mary Gnandt, emergency services director of the Center for Mental Health, and John Gordon, executive director, responded to the issues raised by law enforcement.
"Let me start by explaining the rules we are operating under in our state," Gnandt said.
"In a rural area, the emergency service team has up to two hours to respond to a call. We do meet somebody in a secure area for a mental health evaluation, and that's either in the jail or hospital. We don't have our clinicians go directly out to homes or situations like that."
Their emergency services clinicians cover six counties.
"We are not actually mandated to be providing these services to the general public. Under our Medicaid contract, we are required to provide emergency services to our Medicaid clients. However, we feel that it's important to try to provide services to our entire communities and partners," Gnandt said.
"We respond to approximately 200 to 250 calls a month on our emergency services. And that's both phone and face-to-face in our six counties," Gordon said. "Of those calls, probably half of those people are not even our clients to begin with. So it makes it difficult, obviously. One of the reasons it is critical when we do assessments, . . . it has to be done at a secure location. I know it is frustrating for police and sheriff [officers]. We've had some conversations with different law enforcement about that, as well as the hospital when it does take us too long."
The center was unaware that Paonia and Hotchkiss law enforcement had any issue with the services they provide.
Gordon and Gnandt plan to meet with local law enforcement to see what can be worked out about their concerns. "They are under a lot of pressure too. We understand the frustration they have, and what we want to do is to figure out how we can work better together," Gordon said.
Gordon cannot imagine it would take seven hours to respond to a call for emergency services. He can imagine three hours if the one person on duty is finishing with one assessment, before going to another county to handle another party. The clinic has one person on call and one person on back up.
"The screening is to test to see if the person is a danger to himself or others, so it's not a quick in and out," Gordon said. If they are working with one patient, they try to at least call up to Delta to let the hospital or law enforcement know what is going on and why there is a delay. Gordon believes it is rare that there is a two hour delay. "But I'm not surprised that in a month or so, you might have a two or three hour delay," he said.
"A lot of times when people come in and talk about suicide, they have been drinking or taking drugs. When they get depressed they have homicidal or suicidal thoughts. State law does not allow us as mental health services to evaluate someone who is intoxicated. And that's a real frustrating thing for law enforcement and we appreciate it. But the law doesn't allow us to do it. We can only evaluate a person once they are sober or not high on drugs," Gordon said.
"When a person comes in and says, 'I'm going to kill myself,' . . . And then they sit around and may say, 'You know I thought about it and I don't want to kill myself.' Then when our staff evaluates someone — Do you feel this person could harm themselves or harm someone else? — It's a very serious thing. Because once we do the commitment that person loses their rights, and they are held by law. So we have to do a thorough assessment. Do we really feel this person is suicidal at this time. I appreciate that it's very frustrating for law enforcement. We go through this a lot. They see somebody and by the time we get there, we do not feel the person is a danger to himself or others, and we have to make that call," Gordon said.
If someone has to be committed, it is hopefully to the hospital in Grand Junction. But sometimes all hospital beds are full all over the state. In that case, the law states they can be held in jail separate from other prisoners until a bed is available. Ideally, a party would be held up to 72 hours in Grand Junction before they have to be reassessed. When they are discharged, the center tries to do an outreach to the person and encourages them to come in for therapy.
Gnandt says that no one is ever turned away because they don't have insurance. The center has a sliding fee scale and an uninsured benefit package. Someone who qualifies could see a therapist or psychiatrist for as little as $5.
"Especially somebody who has shown up on emergency services, we will absolutely see those people. Part of what we want to do as the Center for Mental Health we want to work with people in our community," Gordon said. "If we turn these people away, they're going to turn up again" with law enforcement, social services, in jails. "That becomes a burden for the entire community."
The Center for Mental Health says it will do a better job of reaching out to law enforcement. Delta County Sheriff Fred McKee is the center's board president.
"We are available. We are a community agency . . . [Don't] get caught up on the stigma of mental health. If people feel they need services, come and see us," Gordon said.