County's new program could help those with mental health difficulties

There are four major goals universal to all “Stepping Up” initiatives, including Law Enforcement Diversion, Screening and Identification, Connection to Services, and Community Supervision. Desired outcomes include reducing the number of people booked in jail with behavioral health disorders, reducing the length of time people with mental illness stay in jail, increasing connections to community-based services and support, and reducing the number of people returning to jail.

A large contingent of Alamance County elected officials, county employees, and local citizens made their way to San Antonio, Texas earlier this fall. The group received information about a diversionary program that could save the county time, money, and resources in dealing with mental health challenges among local residents.

The proposed program in Alamance County is being called the “Stepping Up” initiative.

“It was a wonderful trip. We learned a lot,” County Commissioner Bob Byrd said of the visit to San Antonio. “Sometimes you never know what’s possible until you see it. And what we saw there (in Texas) kind of opened up my view as to what’s possible in Alamance County. We all went down and learned a lot.”

“We went out there and looked at this. I’m telling you - I left there very excited, and I’m still very excited with what they’re doing out there, and how they’re addressing these issues,” Alamance County Sheriff Terry Johnson added. “I could talk about it all night long. Because that’s how exciting it was. The one thing that got me was they were able to communicate with these people, and stop many of these people from being frequent fliers into the county jail, over and over, costing taxpayers money.”

There are four major goals universal to all “Stepping Up” initiatives, including Law Enforcement Diversion, Screening and Identification, Connection to Services, and Community Supervision.

Desired outcomes include reducing the number of people booked in jail with behavioral health disorders, reducing the length of time people with mental illness stay in jail, increasing connections to community-based services and support, and reducing the number of people returning to jail.

Johnson broke down for the Alamance County Commissioners at its November 20 meeting some of the financials involved for Alamance County in dealing with mental health cases.

According to the Sheriff, this year in Alamance County, there have been approximately 450 calls that were coded “mental health issues.”

“Many of those wound up in jail, costing the taxpayers,” Johnson said. “Whereas if they’d had the proper treatment, and proper medication and follow-up, they would be productive citizens out here in society.”

Alamance County Deputy Chief Tim Britt told the tale of one local resident who has spent more than two years of his life incarcerated in the Alamance County jail in Graham for non-violent offenses related to his mental health condition.

“I’ll give you quick one case study,” Britt said. “We had one gentleman in our community. He has been incarcerated 26 times. All nuisance. All non-violent. He’d get off his meds and go into Burlington. I need help. Start acting out. Someone would call the police. Limited options, so they take him to jail. He would spent about 30 days per time in our jail. This gentleman has spent almost 800 days in the Alamance County jail. Alamance County has spent $77,000 incarcerating this one man. You know what his problem was? He was sick. He needed some meds.”

According to the county’s research, approximately 12 to 15 percent of inmates that are screened at the Alamance County jail have mental health issues.

“It is costing us over a million dollars - $1.2 million dollars - to our jail system. That is about 12 percent of the jail budget,” county official Susan Osborne said.

County estimates indicate that mental health issues generate approximately 3,300 emergency room visits per year in Alamance County - a number the figure believes is actually low.

“As a law enforcement officer for 46 years, we’ve only ever had three choices as an officer in dealing with individuals with mental health issues. One is to put these individuals in jail. Which does no good to the individual, or society,” Johnson added. “The second thing is take them to a hospital emergency room, where our officers will sit with them sometimes for two or three days, before they can find a bed. Because the state and federal government has basically turned their backs on these people. The third is to go Monday through Friday, from 9 to 5, to a crisis center. Which is not always feasible.”

“This is no longer acceptable, in my opinion, for us in Alamance County. We have a chance to change history here in dealing with mentally ill individuals. We have to confront this problem. It is costing society, and our government, hundreds of thousands of dollars every year. Not only in Alamance County, but other places.”

Johnson, as well as other local officials, implored the County Commissioners to support a plan to bring a 24-hour-a-day, seven-days-a-week Diversion Center to Alamance County, where mentally-challenged individuals could get much-needed assistance.

“We have no other choice but to bring them to the jail,” the Sheriff said. “Whereas if we had a Diversion Center, we could take them to that center, and they would be evaluated there. And they would be put on a program that could help them succeed in society.”

“We have about 48 inmates a day (processed at the Alamance County jail). If you take $67 - and that’s about the average cost just to feed and look after the inmate, not counting medications - you’re looking at $3,216 a day, costing the taxpayers of this county. You figure that times 365 (days of the year). That is a gigantic savings. And that money can be put back into our Diversion Center to help us operate.”

According to Alamance County Manager Bryan Hagood, a Diversion Center service currently exists in Alamance County through RHA near Holly Hill Mall. The county is funding that through its MOE (maintenance of effort) funds.

“It’s an alternate location for law enforcement and EMS to take folks to other than jail, or taking them to the emergency department to languish for weeks,” Hagood said. “These are non-violent folks. The Diversion Center is a building that’s 24 hours a day. It’s able to take custody of folks from law enforcement and EMS. But we’re only paying for it for about half a day. We’re paying for it from 8:00 a.m. to 5:00 p.m.. They have to find places for folks to go by 8:00 p.m. at night. And it’s only five days a week. So part of our goal is to find a building that this could take place in, and ways to free up some of our money to help pay for this.”

The maintenance of effort funds, which are required under general statutes, could contribute to a new Diversion Center in Alamance County. If the county can find the right building, as well as the right financial structure, combining MOE funds with grants and private donations, a permanent, around-the-clock operation could be formulated.

“These MOE funds, these are funds that are required to spend on mental health services. So we’re already spending our own money on this. Our hope would be if we relocated the Diversion Center to a county building, there would not be any rent.”

One of the properties that has been talked about as a possible site for a new Diversion Center is the former Everly Services Building on Martin Street in Burlington.

“It’s the former mental health building, so it’s already identified with mental health services,” Hagood said of the 11,000 square feet facility that sits on the LINK bus line - a key factor for any mental health services building. “What we’d like to be able to do is find some outside funding, maybe through some grants, to take this building and use it as a possible Diversion Center. And use some of the MOE savings to be able to fund its operations longer - maybe more hours per day, or more days per week.”

“We went to the Diversion Center (in San Antonio),” District Attorney Nadolski added. “It’s really the cooperation amongst all these entities. They work together - law enforcement, department of social services, mental health providers, medical providers. The court system. The judges. And it just amazed me that you had this cooperation among these groups.”

With Alamance County already spending millions dealing with its mentally-challenged population, the “Stepping Up” initiative is a process to improve efficiency across a variety of platforms.

“What we’re really talking about is efficiencies,” Deputy Chief Britt stated. “These monies, we’re already spending. The folks that we’re looking at that would be divertible are not people that are hurting folks. They’re not people out here committing serious crimes. Most of them are nuisance-type offenses. They’re in crisis. So they act out. They’re off their meds. No help. So they’re out here in public, doing a public nuisance. They’re trespassing.”

“After seeing what they do in San Antonio, I’m really excited. Most importantly, I’m hopeful. There’s no question it will save money. There’s no question that it’s the right thing to do. Because we are defined by what we do for those who are most in need,” Nadolski added.

“We are the ideal for this project,” Sheriff Johnson said. “Because of our collaboration with the group that went out there. Our commitment to this project. And we have the necessary elements and agencies involved that are needed to make this project totally successful. And I firmly believe that.”

“It’s not about building another program. It’s not about finding another bucket to throw a bunch of money in,” Britt added. “We’re already spending this money. It’s about some efficiencies. It’s about seeing if we can do something in finding a different path. We’re tying up our ambulance service. We’re tying up our deputies. It’s the right thing to do. We’ve got people that are hurting that need help. And they don’t belong in jail. We have got folks in our county doing a life sentence, thirty days at a time, because they are sick.”

While the Alamance County Commissioners didn’t take any specific action on the “Stepping Up” initiative at its November 20 session, the elected officials will continue to monitor the progress of the organization, and may consider moving forward with finding a permanent location for a Diversion Center if the right opportunity presents itself.