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Handling mental patients in ER is forum topic
Mental-health groups, advocates excluded from CenterPoint meeting
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Published: August 21, 2009
For the second time in six weeks, CenterPoint Human Services is having a forum aimed at how to better handle mental patients in the emergency room.
And for the second time, it has chosen to exclude from the forum local mental-health advocates and organizations, as well as the media. It will take place from 9 a.m. to noon Monday at the Forsyth County Jail.
"This one is not open, as management-level legal matters will be discussed," said Michael Cottingham, a spokesman for CenterPoint. "We are planning to present what happens at the next board meeting, which is open to the public."
CenterPoint drew criticism from some local advocates for excluding them from a July 7 meeting that attracted about 40 officials involved in health-care, mental-health care and law enforcement, and elected officials from Davie, Forsyth and Stokes counties. The meeting was initiated by Patricia Murray, a Winston-Salem police captain.
In response to the advocates' concerns, Scott Cunningham, Winston-Salem's police chief, held a briefing with local advocates on July 29. He pledged his department's support for resolving the issues of monitoring psychiatric patients in emergency rooms.
Cunningham said that Monday's meeting will be "a continuation of discussions that various partners are having on possible options to increase the efficiency and effectiveness of the procedures, policies and practices regarding helping persons who are in crisis."
"As we continue to try to deliver the best possible service to our citizens, we are also looking at options for enhanced use of available resources," he said. "This includes clarifying the most desirable and beneficial role of law enforcement, and the amount of time law enforcement is involved in the process.
"This specific meeting will focus on the interpretations of applicable laws," he said.
CenterPoint said that Angel Gray, an assistant state attorney general, will make a presentation at the meeting. The agency requested the presentation to provide the office's opinion "on the legal obligations and responsibilities of law enforcement regarding involuntary commitment."
"With clarification of legal responsibility, it is hoped that participants can move forward to agree on protocols based on compromise."
However, Noelle Talley, a spokeswoman for the N.C. Attorney General's Office, cautioned that "a legal opinion is the state's interpretation of the law, not a binding court order."
"An attorney from our office has agreed to participate in a training session with hospital and law-enforcement personnel to talk about the law related to the transportation of the mentally ill to hospitals, and law enforcement's role in this process," Talley said.
The issue has vexed local law-enforcement, health-care and mental-health officials for years -- financially, logistically and in terms of security. Advocates say they worry that long waits are becoming more common because of a lack of beds in local and state hospitals and psychiatric facilities.
In late May, for example, the lack of beds for psychiatric patients meant that a local man who was having a mental-health crisis spent more than eight days in the emergency department of Forsyth Medical Center -- at times in handcuffs -- before being admitted to the hospital.
Many advocates are frustrated by being excluded from the meetings as well as what they perceive as a "closed-door policy" by some CenterPoint officials. The advocates help provide training to Winston-Salem police and Forsyth deputies on how to deal with a mental-health crisis.
Judy Briggs, the chief executive of Carolina Behavioral Health Alliance, said that the current situation "is a burden to our law enforcement and to our hospitals, and that better solutions should be sought."
Briggs said she is concerned that the focus on the meeting is not on "seeking solutions to shorten emergency-room stays for patients. Those most impacted, patients and families, are clearly being overlooked.
"Perhaps they don't want it to be an open forum with individuals relaying their personal stories, but why not have the agencies that represent them present as well as the press so that the community can be informed?"
According to officials of the police, sheriff's office and Wake Forest University Baptist Medical Center, their organizations have spent at least a combined $1.4 million in 2008 and thus far in 2009 on handling mental-health patients. That includes taking patients to and from local and state health-care centers and hospitals, and providing security services for involuntary commitments in emergency departments.
Advocates and mental-health officials said that the sour economy has contributed to more people with mental illnesses losing jobs and health insurance.
■ Richard Craver can be reached at 727-7376 or at rcraver@wsjournal.com.
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