Resources help people in crisis

As the Georgia Bureau of Investigations looks into a DeKalb County Police officer’s recent shooting death of an unarmed, naked, bipolar man, the county already has resources to help law enforcement officers deal with people in crisis.

DeKalb Crisis Center handles “a lot of different situations” including “situations where the person has come voluntarily here,” said Margaret Shelby the center director. “They are aware that they need help and they just come on their own or a family member has brought them.

“We also handle situations where the person has been brought involuntarily,” Shelby said. “In other words, there is a legal mechanism to bring them here for an evaluation. Any law enforcement officer has the capacity to do that, to pick someone up and, on the basis of their [belief] that the person looks like they might need evaluation for a mental illness, they can bring them here.

Shelby said a patient may be at a local hospital’s emergency room “and they are in need of further psychiatric treatment or substance abuse treatment for their crisis and then we would accept the referral from the hospital.”

The center has six temporary observation beds for people “we’re not sure how long it’s going to take to get stabilized but ideally they might be somebody that stays with us a few hours and then we feel like they’re stable enough…[to] be discharged,” she said.

There are 36 other beds for longer stays of up to 30 days. The average stay at the center is seven days. In the past year, the crisis center performed 3,200 evaluations and admitted 1,700 people.

“That’s a lot of people,” Shelby said.

Another resource in the county is the mobile crisis unit which teams a registered nurse with a police officer to respond crises involving mental health, substance abuse, suicides, domestic violence and events. The unit, initiated in 1994, handles approximately 200 calls per month from E911, the DeKalb County crisis line, Georgia Crisis & Access Line and referrals from various private providers and clinics.

According to Vicki Jacobs, a registered nurse with the mobile crisis unit, the unit runs every day from 1 to 9 p.m. covering the entire county.

“The majority of our calls come through the 911 system,” Jacobs said. “We are 911 responders. If it’s dangerous they will always give us back up.”

Other calls come from the DeKalb County crisis line, Georgia Crisis & Access Line and referrals from private providers and clinics.
The unit sees five to seven people a day, Jacobs said.

When the mobile crisis unit is not on an active call, the unit follows up “with anybody who has a mental health contact with a police officer,” Jacobs said, such as “somebody who’s off their medication, not sleeping, may be delusional or paranoid, family has become afraid of them—maybe they’re making threats, [or] carrying a knife everywhere they go.

“It’s probably not going to be enough to get them a mental health appointment,” said Jacobs, who has worked with the unit for 20 years. “So we go out and talk to them and try to get them to go with us for some mental health intervention.”

Without the center, “probably all of the hospital emergency rooms in DeKalb County would be much fuller than they are,” Shelby said. “They are already full but if there were no crisis center then there would be lots and lots of folks that [go there]. Were there no crisis center, folks would end up going somewhere and most often…they generally will go to a hospital.”

Police officers would be impacted because “they bring a lot of folks here,” Shelby said. “One of the important factors is…when they bring someone here, [we] can handle that in a fairly expedited manner. We don’t ask them to stay a long time. That’s a benefit to the police.

”If we were not doing this center you would have that many more hours of police time that would go into taking people to other emergency rooms,” Shelby said.

”The other resource that would feel the pinch,” Shelby said, “would be the state hospital. If you don’t have a means to pay for your care…that’s where you would end up.”

Without the crisis center and mobile crisis unit, most of the patients seen by the center would go to jail, Jacobs said.

“Part of what we try to do is keep mentally ill people from going to jail…on minor offenses,” Jacobs said.

“Jail is very limited in what [it provides],” Shelby said. “We see a lot of folks who have been to jail and who were taking medication and for a variety of reasons that doesn’t get followed through very well. Jails are limited in their budgets with what they can afford to do. That can be a real problem. Plus it’s a problem for the jail to deal with [mental patients]. They don’t fit in well with the normal population.”