Care for mental health patients often falls to law enforcement in Idaho
Moscow police respond to a call of someone acting strangely — wrapping themselves in tin foil, for example.
When they arrive, it’s clear they are law enforcement with their marked cars, uniforms and holstered weapons. But in many cases, a crime hasn’t been committed, and officers are responding to provide assistance in a crisis and avert a tragedy.
Paul Kwiatkowski, Police Lieutenant
“The thing is, they’re not a criminal,” Kwiatkowski said. “They’re a patient. They’re in crisis, they might be hearing voices or be in a state of paranoia, and it’s scary for them. We have to put them in handcuffs in the back of the car for our safety and theirs. They’re suffering from this illness, but they didn’t do anything wrong, and now they feel like they did.”
Officers look for three things in a mental health crisis: Is the person an imminent danger to themself? Are they an imminent danger to others? Or are they gravely disabled, meaning they cannot currently take care of their daily needs?
Kwiatkowski said if the answer to any of these questions is “Yes,” the person is taken into custody.
Once taken into custody, patients are transported to Gritman Medical Center, where they undergo a psychiatric evaluation. If patients are deemed by a doctor to be in a state of crisis — in other words, they haven’t recovered from their paranoia during the trip to the hospital — officers write a probable cause affidavit to hold patients for 24-72 hours in a hospital for evaluation and care.
According to Gritman spokesman Eric Hollenbeck, the hospital hopes to add mental health and psychiatric services through a partnership in a new building they plan to construct at the corner of Jackson and South Main Streets.
But as of now, Gritman does not offer psychiatric services other than an emergency evaluation. As a result, the hospital is prohibited by law from housing mental health patients for the 24-72 hour period following the initial evaluation.
So, patients are placed back in the hands of Moscow police officers, who are responsible for transporting them to St. Joseph’s Regional Medical Center in Lewiston, or if St. Joseph’s is full, to Kootenai Medical Center in Coeur d’Alene.
Officers are also responsible for returning to retrieve patients at the end of their holding period.
For a department that may only have three officers on duty at certain times, such responsibilities can place a substantial burden on the officers and the community.
Kwiatkowski said sometimes the patients must be held in the emergency room at Gritman until more officers come on duty and the patient can be transported without leaving the department understaffed.
“In a lot of cases, especially if it’s a female patient and we have no female officers on duty, we send two officers for our protection as well as the patient’s,” Kwiatkowski said. “If we have to take them to Coeur d’Alene, that’s four hours those officers aren’t in Moscow, patrolling neighborhoods and responding to other calls.”
Because of the increase in calls, Kwiatkowski said officers have had to transport more patients to Coeur d’Alene.
“The Department of Health and Welfare is strapped for cash and the Lewiston psych ward only has so many beds and same with Kootenai hospital,” Kwiatkowski said. “I don’t think there has been a time we’ve had to turn someone back to the streets, but it’s a possibility if the problem gets worse.”
Once a patient has been held for up to 72 hours and received a second psychiatric evaluation, a Moscow officer must pick them up from whichever psychiatric ward they’re being held in and return them to Moscow so they can appear in front of a judge.
If, after a second psychiatric evaluation, doctors feel the patient is not ready to return home, they’ll make their case before a judge. At this point, the judge decides if they should be committed to the state hospital in Orofino. The average stay at the state hospital is 45 days, but could be up to 180.
Kwiatkowski said the woman who lived in her car would often be committed to the state hospital in the winter when a judge would determine she was gravely disabled.
“In the summer, when she lived in her car, it was warm so the judge would say she wasn’t gravely disabled,” Kwiatkowski said. “But in the winter when it gets so cold, they’d send her to the state hospital. This went on for several years. Now she lives in Coeur d’Alene, and I’ve heard she’s doing well.”
Kwiatkowski said there is concern for officers and patients when handling mental health crises. He said there has never been an issue of a situation being handled incorrectly because the department tries to send officers to as much mental health training as possible, but because they are not trained medical professionals, there is still a concern they won’t know what to do in a given situation.
“It’s a sad situation,” Kwiatkowski said. “Mental health crosses all lines of society, from the wealthy to the homeless. It can happen to anyone. We do our best, but I don’t think we can continue treating mental health patients as criminals. Something needs to change at the state level.”
Kaitlyn Krasselt can be reached at [email protected] or on Twitter @kaitlynkrasselt