At times, the fine line between mental illness and criminal activity can be hard to distinguish. Helping to uphold the law is one thing. Deciphering mental illness is quite another.
Armed with knowledge as their most formidable weapon, medical personnel must take on many different hats and make these decisions routinely, determining if a patient goes to the hospital for further observation or to the slammer.
Last week, Clark County Circuit Court No. 1 Judge Dan Moore invited these front-line “heroes” to a luncheon in their honor at the courthouse. While the meeting served as a way to thank those in the mental health community for a job well done, it also allowed for court personnel and these workers to connect with each other and learn how they can better work toward their common goals.
“The reason why we started this several years ago was we saw a big need in our community for mental health professionals to kind of get on the same page with law enforcement, other legal professionals and the court system,” said Ashley Oliver, Clark Memorial Hospital’s lead therapist and community liaison.
Working collectively with law enforcement officials, those in the mental health field can help lessen the strain on the court system by diverting medically ill patients from overcrowded jails. Perceived nonviolent criminal behavior might, in some instances, be nothing more than a person with an illness going off their medication. Once prescriptions are reintroduced and families are called, patients often quickly return to their everyday, law-abiding selves.
Of course, not everyone necessarily wants help for their mental illness. In these instances, Indiana law provides a process that essentially overrules the person’s objections and holds the patient against their choice. Called an emergency detention order, a petitioner may ask the court to decide if a patient needs to be psychologically evaluated at a local medical facility.
According to Mark Pruitt, Clark Memorial Hospital’s director of behavioral health services, several criteria must be met to obtain such an edict. Above all, the person in question must be dangerous to themselves or others and need immediate restraint.
“It’s always better to let the person make the choice, but ultimately if they don’t and they’re a danger to themselves or others, we will allow an emergency detention order,” Pruitt said.
When approved, medical personnel have up to 72 hours, not including weekends, to complete their analysis. Commitment extensions, although rarely asked for, are available for either 30 or 90 days and require a separate court hearing.
Of course, medical personnel can’t do any of this without a judge’s approval. Most of the metal health cases in Clark County come before Moore. While protecting the public from threats, Moore also must weigh the constitutional protections of the patient into his decision to issue emergency detention orders. He’s been known to turn down these requests if proper justification isn’t provided.
“We are all mindful of the fact that using this procedure … we are depriving the citizen of their liberty and the first step here we’re depriving them of their liberty without a hearing,” Moore said. “We’ve got to be very careful that we do this the right way. We’ve got to be very guarded that the information we’re getting looks and sounds legitimate.”
In addition, law enforcement also has the ability to institute a 24-hour psychiatric hold on someone they deem mentally unstable. For the past two years, a 40-hour Crisis Intervention Team (CIT) program has given police officers necessary tools to make that decision easier. Each participating department has at least one CIT member available for each shift. Money provided by the Indiana Criminal Justice Institute has since run out, and other nonpublic avenues of funding the program are currently being considered.
“The training of a CIT officer is intended to let that officer know the tools to use to decide if that person goes to our jail for disorderly conduct or public intoxication or if that person goes to a hospital,” Moore said. “It’s a shame that in Clark County our funding situation is such that we couldn’t continue this police training.”
Even without the law enforcement training, plenty of medical professionals still are able to diagnosis these illnesses accurately every day. Moore called the social workers, doctors and other behavioral therapists heroes.
“Your job is the hardest part. Right there on the front line, accessing what is going on,” he said. “I can’t say enough about the heroes. I marvel at it all the time. It’s a shame that in this community there isn’t more recognition for the work you do.”