April 14, 2017 | Blog Post

Falling through the cracks in our mental health system: a way out

By Kyle Helton, Spring 2017 Advocacy Fellow

The Colorado State Legislature is considering a bill, SB17-207, this year that would end the practice of holding people, who have committed no crime, in prison for 72-hour mental health holds. This practice is also referred to as M1 holds. Healthier Colorado has made this legislation a priority. In response to hearing about our recent activity around M1 holds in prisons, a former housing intake coordinator for the Colorado Coalition for the Homeless shared her experiences with Healthier Colorado staff.

The following details some of these experiences.

Tara worked with some of the most vulnerable populations.

Requirements for involvement in the program were chronic homelessness, some kind of disability, and a tri-morbidity that classified them as medically unsafe. These people would be flagged in a system used by the coalition and Tara would go find them. She would help them complete the required paperwork and get them in touch with a team that would attempt to keep them in housing so that other medical interventions could successfully piggyback on that stability.

The thing about comorbidity is that mental illness is usually involved. Suffice to say, at times, the people Tara was looking for could get a little rowdy, which would result in police being called. Police are generally well trained on how to interact with people who are experiencing a mental health crisis, but it doesn’t change the fact that they approach these crises looking through a certain lenses – they are trained to look for criminality, not to soothe and support people who are momentarily not experiencing a mental health crisis. A half day training on mental illness, unfortunately, cannot compare to a master’s or doctorate degree in a psychological field.

Simply put, police officers aren’t therapists and they shouldn’t have to be.

Tara would sometimes have the option to request a ride along therapist when she had to call the police, but at the time that she was working for the Homeless Coalition there were only two on staff at the Denver Police Department. She was also dealing with police who might not understand the consequences of their actions. Neurotypical police officers might be under the impression that taking someone to jail for a 72-hour hold might give them a chance to calm down, get some food, and be off the street for a while, but what is often forgotten is the impact of court fees, fallout from interacting with the criminal justice system, and going to jail for no reason can have on people. They also might not realize what a 72-hour hold actually entails.

You’ll be forgiven for thinking that this is a positive experience for everyone.

No hard data exists. It’s not as if the psych ward will give you a feedback survey when you check out, but anecdotes that have been shared with Healthier Colorado point to mandatory holds being invasive and alienating. Most describe three days of heavy sedation and prying questions rather than intensive case management and support.

Unfortunately, the people Tara helped had fallen through numerous cracks in our system to get to this point. The net to catch people who fall in our society is very low to the ground: you can find it on park benches and downtown stoops. This is primarily an issue of access.  A more robust mental health system would be available to people from a young age to get help when and where they needed it, rather than waiting for them to enter the criminal justice system on charges of vagrancy. It wouldn’t require wealth to be a prerequisite to mental health. And it certainly wouldn’t leave mental health to be handled by family and friends, a source of support that can dry up at any point.

The majority of the people Tara helped into housing knew that they were mentally ill, and took advantage of the therapy available to them from either a psychiatrist or a therapist. The issue, then, is not that this population by and large wants to be mentally unwell and on the street, but they are lacking support. We have a long way to go before we’ll be able to say we have a robust mental health infrastructure that doesn’t let people fall through the cracks. SB17-207, by stopping the use of jails for 72 hour holds, is a step in the right direction.

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