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Mental health holds put strain on resources

Moscow-Pullman Daily News - 2/10/2018

Feb. 10--Mental health is an undercurrent of society much of the public doesn't want to confront or see in their everyday lives.

A break in mental health often makes the community uncomfortable and unsure how to handle the situation, but mental health crises are just a part of the every day job for law enforcement and hospital staff.

Officers most often handle mental health calls in one of three ways. In the best case scenario, the crisis was fleeting and officers are able to determine the person will be OK if he or she is connected with the proper resources to seek help in the future.

Moscow Police Department Chief James Fry said when officers determine a person cannot be left alone, an attempt will be made to place the individual on a voluntary hold, which is when a person agrees to go to the hospital and seek treatment on his or her own. A person placed on a voluntary hold can leave the hospital at any time.

The third option is much more involved. Idaho law requires law enforcement to place a subject on an involuntary hold if an officer believes the person is a danger to themselves or others and is refusing to go to the hospital willingly. Involuntary holds can also be used for people who have committed a crime during their mental break and require medical attention before being transported to jail.

In either case, officers are required to watch the subject around the clock until a bed at a hospital with a behavioral health unit can be secured. This means there is one less officer available for patrol, forcing other officers to split a heavier call load, Latah County Sheriff Richie Skiles said. State law also requires a designated examiner to

determine during the first 24 hours of a mental health break if the patient needs to be committed. A second examiner, either a psychiatrist or psychologist, must then preform an additional exam within 72 hours to confirm the initial recommendation.

Because Gritman Medical Center does not have a behavioral health wing, or a psychiatrist or psychologist on staff, it is not equipped to handle long-term mental health treatments, which means all patients placed on long-term commitments must be transferred to either St. Joseph Regional Medical Center in Lewiston or Kootenia Health in Coeur d'Alene.

While rare, when a bed is not open in Lewiston or Coeur d'Alene, officers have had to transport patients to Boise, Fry said.

"That is not very optimal for anybody, especially the person who is sitting in the back of those (police) cars," Fry said. "They're not comfortable -- it's not what we want for people."

Skiles said he held a patient on an eight-day hold during the week of Jan. 17 as they waited for a psychiatric bed to become available.

Skiles said mental health holds seem to come in waves, and Fry pointed out the police often deal with the same people again and again.

"We might have a couple a week or we might go one or two weeks without any," Skiles said.

Crystal Schluter, the director of Care Management at Gritman, said the hospital provided four of its eight emergency room beds for mental health holds during the week of Jan. 17, severely limiting the amount of space and resources available for other patients.

Nicole Wheaton, the director of Emergency Services at Gritman, said having an officer standing next to a room in the ER also affects other patients.

"It piques other's curiosity, and some aren't as comfortable around law enforcement," she said.

Schluter said she is often concerned for the patients being held on involuntary holds who are not facing criminal charges.

"It makes them feel like they did something wrong," she said.

Schluter said suicide attempts are the most common reasons people are booked on mental health holds, but more and more often Gritman is seeing patients with paranoid schizophrenia.

Fry said his officers usually rotate in four-hour shifts, but shifts can be as long as eight hours. If the departments cannot sacrifice a patrol officer for that long, others are often asked to come in on their day off, which cuts into the department's overtime budget and gives officers one less day to recuperate before their next shift.

Skiles said he is working to contract with two security companies out of Lewiston and Coeur d'Alene to take over some of the mental health holds, which would relive some of the stress on his staff.

"It would give me more resources to draw from," Skiles said.

Schluter said Gritman has looked at constructing a behavioral health wing so patients would not need to be transported elsewhere and officers would not be required to be present at all times, but the amount of funding and staffing is too extreme at this point. Schluter said finding a licensed psychiatrist or psychologist willing to live and work in Latah County has been difficult as well.

Fry said despite the drain it puts on the departments and hospital staff, the bottom line is it is a critical and necessary job.

"We care for the people," Skiles said. "They are one of the vulnerable groups in our community, just like our elderly and our kids."

Katie Short can be reached at (208) 883-4633 or by email to


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