Shouldering the burden

BUFFALO — The number of mental-health related calls and the severity of the calls that come into Johnson County's dispatch center have increased over the past few years, but mental health services haven't increased to match, Johnson County Sheriff Rod Odenbach said.

Unmet mental health needs can sometimes lead to law enforcement involvement when they reach a crisis point. Once law enforcement is involved, Odenbach said, those agencies sometimes don't have enough resources to provide the services people may need.

Allen Thompson, executive director of the Wyoming Association of Sheriffs and Chiefs of Police, said these challenges aren't unique to Johnson County.

“Law enforcement seems to be dealing with more and more cases with less resources,” he said.

Thompson said that has led to communities getting creative when it comes to services, such as using virtual counseling services for detention inmates when there are a limited number to no providers at all in the area who can give in-person counseling.

At a Johnson County Commission meeting in July, Odenbach said that a virtual session isn't enough when inmates are in a serious crisis.

County commissioners voted unanimously to enter into a memorandum of understanding with Summit Psychological Services, a local private counseling provider.

Now the county pays $1,000 a month to Summit so that inmates at the Johnson County Detention Center, sheriff's deputies and police officers can receive in-person counseling as needed 24/7.

While the new contract provides in-person services for the detention center, there are still other needs that the detention center cannot meet without more outside services in the state.

The Wyoming Behavioral Institute in Casper is one of the few psychiatric hospitals in Wyoming, yet it often has no rooms available, Odenbach said. In cases where there are no psychiatric hospital rooms available when inmates are a threat to themselves or others as a result of a mental health crisis, the detention center has to get creative.

“A lot of times they have to be in their own block. Well, that means that we take everybody out of that one block and mix them up with the others, so it makes it cramped in the other blocks because we have one with one person in there,” he said. “This wasn't built as a medical or mental health facility. It's not run like a mental health facility.”

One of the things detention centers do in some communities is place people who are in crisis into a 72-hour emergency hold. Odenbach said that is something that can be done in Johnson County, but that's a last resort.

"That's not what we want to do,” Odenbach said. “Matter of fact, that's the last thing we want to do, but our mental health help is limited.”

Tied hands

Another challenging aspect for law enforcement when handling mental health crises is that law enforcement officers are limited in how they can intervene when responding to a call.

Buffalo Police Chief Sean Bissett said that when police are called to a house where an individual is inside threatening self-harm, it's legally risky to enter the home even with permission from the individual. If that person is alone and is only threatening himself, he isn’t breaking the law.

“Even though we go in there trying to help, if something goes bad and we use force, whether that's deadly or any kind of force, the courts are now looking at us and saying, 'Well, you guys created that exigency. They're not breaking a law. They're in their house,'" Bissett said. "So, if we make entry and create that exigency and we use force, we are now liable.”

Bissett said that, in Johnson County, dispatchers and officers will try to coax individuals outside of their homes in these situations.

It becomes especially difficult when a third party calls in with concerns that a person may harm him or herself.

“We show up to the house, we knock, we look in the windows and don't see anything? We're leaving. We don't have a right to go in that home and check,” Bissett said.

There have been situations in which officers were witnessing individuals engaged in self-harm in their homes, and the only option the officers had was to coax them out or wait for them to become unconscious.

"It's a real hard and difficult call for us because we want to do the right thing and we want to help, and now we have to think about liability first,” Bissett said.

Specialized training

As expectations on law enforcement to handle mental health crises have increased, the training they and dispatchers receive has had to adapt, Wyoming Law Enforcement Academy Director Chuck Bayne wrote in an email.

“Training has had to evolve to address the increasing calls and demands for service with diminished agency and community resources,” Bayne wrote.

The peace officer basic training course that every Wyoming law enforcement professional goes through includes training specific to handling people with mental illness.

Training includes a class taught by a Wyoming psychologist to help identify whether a person is potentially suffering from a mental health crisis, as well as potential ways to respond and resources. Students also attend a mental health first aid class from the National Council for Mental Wellbeing that helps responders identify and address the mental health needs of their peers, the community and themselves, Bayne wrote.

However, skills for mental health crisis intervention are incorporated in nearly every area of training during basic training, from diversity training to police use of force, Bayne wrote. There's more to come for the academy, as well.

"We're developing an overall wellness approach for officer stress management, teaching new officers about the importance of nutrition and physical fitness to manage stress and combat its adverse effects on health,” he wrote.

Johnson County has scheduled additional training for officers and dispatchers, Bissett said. They will have access to crisis intervention team training in September and again in spring, in addition to the Crisis Intervention Team training they have already received through the Wyoming Law Enforcement Academy and elsewhere.

CIT training teaches law enforcement officials a method of approaching individuals in a mental health crisis and directing those individuals to appropriate mental health care facilities and services, according to CIT International's website. While CIT was developed several decades ago, Thompson said, it has become popular in Wyoming over the past few years. The next step after CIT training is bringing in the community resources aspect, Thompson said.

"It's not just law enforcement involved in that; it's the community,” he said.

Bissett said that whenever law enforcement officers handle a mental health call, their next step after handling the initial crisis is informing the individual about resources available to them and funneling them into available services.

While training better equips law enforcement agencies to handle mental health crises, Bayne wrote, the responsibility to address the increasingly unmet mental health needs shouldn't rest solely on law enforcement.

“Agencies are seemingly never fully staffed, treatment and holding facilities are often full, and costs continue to rise,” Bayne wrote. “This is a community issue that requires a community response - not just leaving law enforcement to shoulder the burden.”

Bissett said the situation is becoming dire.

"It's getting to that crisis level. We do the best that we can, but we need some help,” he said.