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required by DHS contracts with CMHC in Arkansas) conduct prompt screening for mental illness 24/7 and find persons in crisis emergency care. We can’t afford continued disparity or failures in delivery of these services. Te DHS and CMHS have included county representatives on a task force on behavioral services in an effort to institute these urgencies. Below are some of the areas that counties participate and should have trained staff. However, if the system for delivery of care for the mentally ill continues to rank 50th, the public health and public safety of our citizens will rank accordingly. Diversion and Training:
Persons that present a danger to
themselves or danger to others often have not committed a crime but are in crisis or show signs of severe mental illness. Local law enforcement needs prompt screening (within two hours) by the CMHC staff or other medical providers and their professional direction over the patient into appropriate acute, emergency, residen- tial, inpatient or outpatient treatment. Te AAC, the ASA and AACRMF contract counsel, Mike Rainwater and staff have been proactive in preaching diversion and training. During the 2011 and 2012 AAC conferences, the National Institute for Jail Operations (NIJO) instruc- tors worked with our sheriffs and jail administrators on how to avoid their local jails by default becoming storage facilities for the mentally ill. Te Criminal Justice Insti- tute (“CJI”), the Arkansas Law Enforcement Training Academy (“ALETA”), the Arkansas Sheriffs Association (“ASA”) and the Chiefs of Police Association (“COPA”) need to assure that police officers, jailers and dispatch- ers are trained in diversion protocol and mental health first aid. Civil Commitments: In essence, our laws have long sought the
ing crisis will require a higher level of commitment and follow through. Law enforcement and detention offices will need to work closely with their CMHC director and staff to assure persons in need of care in our jails and our communities have 24/7 access to ap- propriate care and facilities.
“P ”
proper treatment of the mentally ill (and to avoid misdirection into the criminal justice system when no actual crime has been committed). Tese proceedings are not criminal proceedings but under pro- bate jurisdiction of the courts (A.C.A. 20-47-102) and authorizes law enforcement officers or any person to give information to the circuit court acting as probate court for involuntary admission for treatment of a person with mental illness (A.C.A. 20-47-101 and 103) or voluntary admissions (A.C.A 20-47-204). Te petition seeks to show that the person poses a clear and present danger to himself or herself or others (A.C.A. 20-47-207) and filed by the prosecuting attorney, regardless of the petitioners’ financial status (A.C.A. 20-47-208). A.C.A. 20-47-210 allows for immediate con-
COUNTY LINES, WINTER 2014
roviding care for the mentally ill in Arkan- sas amidst a state created jail overcrowd-
finement for persons presenting requisite danger and allows for “any interested citizen to take the person to a hospital or receiving facility.” A petition under A.C.A. 20-47-207 shall be filed in cir- cuit court within 72 hours of detention excluding weekends and holidays. A.C.A. 20-47-214 provides that if the burden is met, the court shall issue an order authorizing the hospital, receiving facility or program to detain the person for treatment for a maximum of forty-five (45) days and for the least restrictive appropriate setting. Despite proposed cuts in funding, the CMHC will need to con- tinue to provide screening, 24/7 mobile response, emergency care and direction to appropriate care (hospital beds, inpatient or out- patient care, crisis unit or residential treatment beds). Sheriffs and jail administrators need to know the phone number and e-mail of their CMHC director and staff (along with DHS and State Hospital officials). We have a trauma system for medical services, but deliv- ery of care for the mentally ill is a morass in need of or- ganization and protocols. Te next round of CMHC contracts will need clarity and execution of oversight. Forensic
Evaluations:
CMHC contracts assure that all forensic evaluations shall be completed in the time- frame directed by court or- der and that the site of eval- uation shall be determined through mutual agreement with the sheriff’s depart- ment, the committing court and the CMHC. DHS has indicated implementation of this will help expedite foren-
sic evaluations and reduce the historically adverse impacts on lo- cal governments and the justice system. Rep. John Edwards, with the support of a broad coalition, sponsored legislation on mental evaluations of criminal defendants, Act 506 of 2013, which should help expedite and reduce the number of mental evaluations. Jail administrators should work closely with CMHC and the DHS of- ficials to assure that the expectations under the contracts between the DHS and the CMHC are met. Conclusion: Providing care for the mentally ill in Arkansas
amidst a state created jail overcrowding crisis will require a higher level of commitment and follow through. Law enforcement and detention offices will need to work closely with their CMHC di- rector and staff to assure persons in need of care in our jails and our communities have 24/7 access to appropriate care and facilities. I am certain that the late legislator and visionary Jodie Mahony would see that caring for “the least among us” is not only the moral thing to do, it’s a public health and safety imperative.
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