Vance deputies to try new approach in mental cases


The Vance County Sheriff’s Office transported 1,085 mental patients from Jan. 1, 2004, to May 12 this year, almost double the number handled by deputies in Granville, Franklin and Warren counties combined. Now the Sheriff’s Office and the Five County Mental Health Authority are launching a pilot program to address that problem.

The Vance County Board of Commissioners unanimously approved a budget amendment July 11 to use $57,643 in state grant money funneled through the mental health agency to launch the Rural Crisis Intervention Team (CIT) Initiative.

“We’re trying to improve on the system,” Vance Sheriff R. Thomas Breedlove said in an interview last week. He said the state’s mental health reform, enacted in 2001, has put an extra burden on law enforcement by reducing the services that the local mental health authority provides directly, and the mental health agency is stepping up to help.

According to a proposal prepared by Dr. Al Mooney of Five County Mental Health, the money will be used to hire a $30,000-per-year crisis intervention officer, train that officer and eight other sheriff’s deputies through Vance-Granville Community College and a Wake County program to handle mental health crises, provide incentives for those deputies, and supply the team. Five of the deputies will be designated as basic CIT officers and will be paid an extra $825 per year each, and three will be senior CIT officers and will earn an extra $1,225 per year.

“Our goal is to set a standard of excellence for our officers with respect to treatment of individuals with mental illness,” reads a draft of the proposal dated June 20. “This is done by establishing individual responsibility for each event and overall accountability for the results of encounters with mental health consumers. Officers will be provided with the best quality training available, they will be part of a specialized team which can respond to a crisis at any time and they will work with the community to resolve each situation in a manner that shows concern for the citizen’s well being.”

The proposal also spells out the problem: “Law Enforcement often responds to calls precipitated by aberrant behavior precipitated by consumers suffering from mental health conditions. The resources available to law enforcement officers are frequently inadequate to immediately address the needs of individuals in need of behavioral interventions.”

For Breedlove, the problem is a simple matter of manpower.

Each incident involving a possible mental illness — from a family breaking down over long-term financial pressures to a single person damaged by years of drug abuse — takes deputies off the streets for hours as they first deal with the trouble, then bring the patient in for an evaluation that takes up to 10 hours, usually at Maria Parham Medical Center, and finally drive that person to a mental facility. The facility could be as close as John Umstead Hospital in Butner or as far away as Jacksonville for a juvenile. Even Asheville has been the destination.

Breedlove cited one case in which a single patient kept two deputies occupied for 17 1/2 hours. “That takes a lot out of our day,” the sheriff said.

Those two deputies represent half the standard patrol shift for the Sheriff’s Office. And Breedlove said he frequently has only three deputies patrolling because of vacations and sick time.

Breedlove said it’s not unusual for his deputies to handle two mental patients at one time, leaving the county vulnerable to crime.

Even when a mental case doesn’t originate with an emergency call to the Sheriff’s Office, there’s a drain on the office’s resources. If a person is brought into Maria Parham and doctors determine that he needs to be committed, deputies get the call.

The sheriff asked Vance Emergency Operations Director Brian Short to look into the number of mental patient transports from the county, and Short reported back that deputies transported mental patients to facilities 1,085 over 16 1/2 months, or 2.3 patients per day, seven days per week. Breedlove said those figures included many people who needed transportation two or three times per six months.

For comparison, the sheriff checked with Warren County and was told, “We have lots of them”: 62 patients over the same 16 1/2 months.

Franklin County said it transported 382 mental patients in that time.

Granville County told the sheriff, “We had quite a few”: 189.

That means the three North Carolina counties bordering Vance combined to handle 633 mental patients, or 58 percent of the Vance total, even though those counties have almost triple the population, 124,000 to 44,000.

Those figures are slightly misleading because patients from other counties, particularly Warren County, often wind up at Maria Parham for evaluation, and there they become the responsibility of the Vance Sheriff’s Office. One Vance deputy said you can listen to the police scanner and hear the Warren ambulances notifying Maria Parham that they’re inbound with mental patients.

In a first step toward dealing with the mental patient problem, Breedlove addressed those non-Vance patients. Under state law, Breedlove may bill the sheriffs in other counties for the transportation of mental patients who live in those counties.

This spring, Breedlove started to do just that, and he said Warren County Sheriff Johnny Williams responded to the first bill by agreeing to have his deputies pick up Warren mental patients from Maria Parham.

But the Vance problem runs deeper than a few Warren patients being shifted from one Sheriff’s Office to another. The CIT initiative targets the bigger issues through an approach that could produce long-term reductions in the number of drives Vance deputies have to make out of the county.

The idea is to get mental patients the proper help the first time so that deputies don’t have to deal with the same patients repeatedly. “Results of such efforts improve morale of officers, improve the outcome of mental health consumers, and reduce the incarceration of individuals who are not primarily engaged in criminal activity,” Mooney’s proposal reads. “These efforts also enhance safety for the consumer, the officer, and the public.”

The program follows a model established by Memphis, Tenn., (see this 2000 report from the Seattle Post-Intelligencer or, for a in-depth article, try the June 2004 issue of Psychiatric Times) and being implemented in Wake County (see this June report from The Independent Weekly). The Vance program will try to prove that the CIT approach can work in a rural setting, and Five County Mental Health plans to expand the program throughout its service area if the trial succeeds.

A task force representing law enforcement, the mental health agency and Vance-Granville Community College is being formed to oversee the program. The proposed members are Shirley Dasher, representing the users of mental health services; Breedlove; Mooney, Five County Mental Health’s clinical director; Henderson police Capt. Charles Crumpler; Robert Kurtz, North Carolina Department of Health and Human Services; Susan Thompson, an assistant district attorney and member of the Five County Mental Health board; Tony Pendergrass, who heads the law enforcement training program at Vance-Granville; Glenn Field and Christina Jackson from Five County Mental Health’s administrative team; Bob Rhoden, a Five County Mental Health consultant; and Gina Dement, who handles community outreach for Five County.

The CIT liaison officer — the job that will consume the bulk of the $57,000 grant budget — will be the point person for the Sheriff’s Office and the CIT task force.

“It’s going to take a special person,” Breedlove said.

The liaison officer will answer mental health calls whenever possible, serve as an authority to guide other deputies handling such calls, connect the Sheriff’s Office to the mental health system, work with the task force to develop ways to expand the CIT system to Granville, Warren, Franklin and Halifax counties, and help develop CIT training activities. The liaison officer will assist in investigations involving mental patients, testify in legal proceedings, document the CIT trial, represent law enforcement in spreading the CIT gospel and patrol whenever the sheriff asks him to.

The liaison officer must be a sworn deputy, have two years’ law enforcement experience, and complete a special CIT curriculum within six months of being hired.

The project’s timetable calls for the liaison officer to be hired by Aug. 15 and to begin training in Memphis or Wake by Sept. 15. The crisis intervention system would launch by the end of October, and eight other deputies would complete a lower level of CIT training sometime in the spring.

The CIT task force intends to make initial assessments of the program next summer based on such statistics as the number of arrests for mental health problems, the number of CIT dispatches resulting in arrests and hospital admissions, and the number of days people with mental illness spend in jail. A more subjective measure will be the improvement in attitude of the law officers.

Breedlove is optimistic that the program will result in his deputies spending less time dealing with mental patients. If nothing else, the liaison officer will often free other deputies to return to patrol duty.

The program is costing the county treasury no money because Five County Mental Health is supplying the funds. If the grant ends, however, the liaison position will too, County Manager Jerry Ayscue and Commissioner Danny Wright said when the commissioners passed the budget amendment last week.