Half of Arkansas' crisis stabilization units have opened and diverted more than 360 people from jail to mental health care.
The original startup date for the units was November 2017, but the Pulaski and Sebastian county units began serving patients in August and March, respectively, said Kathryn Griffin, the justice reinvestment coordinator in the governor's office.
The state designated money for four counties to establish the units, places where law enforcement officers can take people who have committed low-level crimes as the result of mental health crises.
Patients go to the units voluntarily and usually stay about two days, said Barry Hyde, county judge for Pulaski County.
In its first month, Pulaski County admitted 13 people, but officials expect the numbers to increase as the unit becomes more established, unit director Lisa Evans said. Sebastian County's unit is almost at full capacity, Griffin said. Throughout the summer, Sebastian County consistently served more than 80 patients a month, unit director Joey Potts said.
Each unit has had to adapt its policies to serve its individual client base, and each 16-bed unit serves multiple surrounding counties, Griffin said.
The units in Washington and Craighead counties have yet to open.
"I think they've all gone as fast as they can go," Griffin said.
Because it's taken longer than expected to get the units off the ground, the units have used only about $689,622 of the original $5 million that state lawmakers dedicated to them and none of the additional $1.4 million that Gov. Asa Hutchinson later allotted for them, Griffin said. That money will roll over into the next fiscal year for the units.
After they use all of the money, legislators will decide whether to continue providing the counties with money for the program.
Officials hope to admit patients at the Washington County unit by January, County Judge Joseph Wood said. The county is applying to receive about $650,000 from the Endeavor Foundation to convert its Judicial Annex into the crisis stabilization unit. The state's money pays for the operation of the unit but not renovation or construction costs.
County money paid for Pulaski and Sebastian counties' units, said Hyde and David Hudson, county judge for Sebastian County.
Craighead County has not definitively determined a location for its unit but is considering erecting a building on county land near the jail, County Judge Ed Hill said. Hill expects the county to start serving patients by next summer. Craighead County will present designs for the unit to its Quorum Court in the hopes that the county will pay for the construction.
Craighead County has looked at at least three other locations besides this one, Griffin said. Washington County looked at at least four.
"It's hard to find a place where there wouldn't be resistance [from] the public," Hill said.
People don't want the unit near them, he said.
It's a stigma issue, said Kim Arnold, the executive director of the National Alliance for the Mentally Ill Arkansas.
"Because stigma is discrimination," Arnold said at an event to promote mental health awareness Oct. 7.
Arnold called mental health problems "the no-casserole" illness because people don't take families casseroles or offer support when they're struggling with mental illnesses.
"Nobody's bringing you a casserole, because they're afraid," she said.
She said people are so wrapped up in being afraid of mental illnesses that they won't talk about it or help people who deal with it.
"All we really need you to say is 'I'm so glad you're here,'" Arnold said "That's all we really need you to say. 'I'm so glad to see you.' Because I think people who live with mental illness are some of the bravest people I know. They get up every day to do it all over again."
About one in five people will have a mental illness in a given year, according to the National Alliance for the Mentally Ill website.
"So we're not talking about people that we don't know," Arnold said. "Everybody knows somebody with a mental illness. This is not 'those people.' This is us. And we need to be the compassionate people that we know we are."
Arnold said she views crisis stabilization units as a step toward providing the same kind of care for mental health problems as for other health concerns.
"We don't criminalize cancer or diabetes," she said.
Mental health care and the justice system became intertwined during the 1960s when President John F. Kennedy moved to close mental hospitals -- places that had become synonymous with neglect -- and replace them with Community Mental Health Centers.
However, the centers did not take off as Kennedy had hoped. Some states refused to allot money for them, and so after the 1960s, people with mental illnesses largely had nowhere to go.
Often those people became homeless. About a third of people who are homeless have serious, untreated mental illnesses, according to research compiled by the Treatment Advocacy Center.
Even worse, those people were often arrested for petty crimes like loitering or disturbing the peace and were sent to jails and prisons, where they easily got stuck in a cycle of repeated jail time. In Arkansas today, the odds of a person with a mental illness being in a jail or prison as opposed to being in a hospital are 3.3-to-1, according to the Treatment Advocacy Center.
Mental health experts want to change that through the crisis stabilization units.
Leon Evans, a San Antonio mental health expert, began developing a jail-diversion program in 2000, according to the Center for Health Care Services website. Arkansas county officials looked to San Antonio when they began making the move to initiate crisis stabilization units here.
Evans advised state officials on how to adapt San Antonio's model for Arkansas. Evans predicted that Arkansas' units would get more patients the longer they were in place, and that has been the case in Sebastian County, which serves more patients each month, Hudson said.
Nationally, states are turning to crisis stabilization units to keep people with mental health problems out of prisons and jail. States including Iowa, Mississippi and Tennessee now have units.
If Arkansas' first four units yield positive results, demonstrating that they help people and save the state money -- including what it would cost to build a new prison -- the plan is for legislators to approve money for four more units in southern and north-central Arkansas, Griffin said.
Griffin said she has already been talking to people in those areas to prepare for the possibility.
The state has paired the units with crisis intervention training, teaching law enforcement officials how to interact with people who are in mental health crises.
"The words I'm hearing are 'boy this should have been here a long time ago,'" Hyde said.
NW News on 10/15/2018