Mobile unit takes mental health services on the road

The scruffy-looking man was defensive and loud. He was having trouble completing responses to questions. He was delusional, thinking that a U.S. senator had given him permission to live in a vacant downtown building.

Two Baton Rouge police officers found the homeless man and quickly realized he needed help — not jail.

Enter a mental health crisis mobile team from the Capital Area Human Services District.

“We were able to quickly ascertain he was experiencing psychotic symptoms directly tied to his not taking his medicine. He needed to go see a doctor. We asked him very politely if he was agreeable to go with us to our (outpatient) clinic,” said crisis team supervisor Marianne Hebert.

“He was.”

The man was seen by a clinic psychiatrist, stabilized and a group home placement found where he could have a place to live while getting help so he could function in the community.

The mobile unit is a component of the Capital Area Human Services District, which serves nearly 12,000 people annually in mental health crisis in a seven-parish area that includes East and West Baton Rouge, East and West Feliciana, Ascension, Iberville and Pointe Coupee parishes.

The Capital Area mobile response crisis team developed in the wake of Hurricane Katrina, bringing mental health services directly to trailer communities that became home for evacuees. It has morphed into a unit equipped to respond to mental health crisis situations at schools, in homes and on the streets. Trained nurses, psychiatric aides, social workers and counselors are called in to try to defuse incidents, assess needs and line up treatment.

“There are many people out there in the community having an increase in mental health symptoms really because of marginal living situations,” said Hebert.

The crisis team is an integral part of a Capital Area network that also includes walk-in out-patient mental health clinics for children and adults, social workers at 22 schools, case management coordinating treatment plans and community services.

District personnel also train law enforcement officers.

Baton Rouge Police Chief Carl Dabadie said police officers routinely face calls involving people in mental health distress. It’s important for officers to be able to recognize the symptoms “and the things we can do,” he said.

“When they stop taking their medicine, they become agitated and violent. When their family can’t deal with them, they call us. They don’t call us until it gets really bad,” Dabadie said.

Cadets go through a basic eight-hour course. But some officers have also gone through a 40-hour course that “really gets into the nuts and bolts,” Dabadie said. Dabadie said he plans on sending more officers through the 40-hour program.

The number of people considered a danger to themselves or others and those deemed “gravely disabled” because of mental problems has escalated. In the Capital Area’s largest clinic, alone, the numbers have grown from 12 cases in 2004 to 136 cases last year. It hit a high of 149 cases in 2010.

The clients are among the mentally ill ending up in hospital emergency rooms or in an inpatient psychiatric hospital if a bed is available.

“We are seeing more people with more serious mental illness,” said Jan Kasofsky, executive director of Capital Area. “It’s a population in crisis.”

Kasofsky said work is underway to establish a crisis receiving center capable of diverting those with mental issues away from hospital emergency rooms.

Capital Area’s outpatient clinics operate on a walk-in basis in an effort to see as many people in need as possible, Kasofsky said.

“There are not that many (private) psychiatrists and definitely not those who take Medicare, Medicaid and certainly not indigent,” Kasofsky said. It also takes three or four months to get an appointment in the private sector, she said.

Hebert said the crisis team is seeing its share of increased demand as well. Back in 2010 when she started keeping data, the crisis team responded to about 125 emergencies in the field. In the current calendar year, the number has risen to 400 of which about 175 people are being seen on an on-going basis by team members.

“You never know what you are going to encounter,” said Hebert.