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Program allows those with mental health issues to receive treatment in Rogers County

Claremore Daily Progress - 2/26/2018

Feb. 26--Among the discussions generated from the recent shooting at a Florida school is the subject availability -- or lack thereof -- of resources for persons suspected of suffering from mental health issues.

While there may be few simple answers to the complex issues surrounding mental issues, in the Rogers County court system, a program exists to assist those with mental health issues to receive treatment.

"We've got a program -- a relatively newer one -- to assist the mentally ill before something unfortunate happens -- assisted outpatient treatment, or AOT," said Judge Pazzo. "This program -- funded through the Oklahoma Department of Mental Health and Substance Abuse Services --us gives us the tools to intervene and offer a person treatment -- to give them help before their situation escalates."

Assisted outpatient treatment was enabled following the passage of House Bill 1697, or The Mark Castello Act.

Passed on Nov. 1 2016, the Mark Castello Act allows courts to order certain individuals with mental disorders to comply with treatment while living in the community.

Further, it allows the courts to commit the mental health system to providing the treatment, i.e. assisted outpatient treatment.

"With AOT, we receive a referral from a member of the community, then the D.A.'s office will review that referral then we -- that is the D.A. and the Grand Lake Mental Health coordinator -- to determine if the referral is a good candidate for intensive outpatient treatment," explained Alicia Beard, special programs coordinator, Grand Lake Mental Health Center, Inc. "If they're accepted, we continue to take them through the program, they complete group and individual therapy, intensive case management, and medication management services -- the goal of the program obviously is to get these people the help they need."

Referral sources may include a family member, close friend, councilor, police officer or someone familiar with an individual believe to be in need of mental health services.

"Most of our referrals come from those working in law enforcement," Judge Pazzo said. "Oftentimes, in a small community like Claremore or the surrounding towns, the police or sheriff's officers will get called out to a scene several times where a person may have committed no crime, nor threatened themselves or others -- this prevents them from being detained or arrested on criminal charges, but if the officer suspects them to be in need of some kind of mental health services, they (the law officer) refers them to us."

Assessments on referrals may be made by a one-on-one interview by a mental health specialist or through testimonies of persons familiar with the individual, after which, should they be determined to meet the criteria for the program, a petition is sent to the District Attorney's office.

Grand Lake assists in the preparation of the petition, which requests that the individual be ordered to participate in the AOT program.

"Referrals prompt us to examine a person's behavioral patterns -- if they have behaviors which suggest they're at increased risk for incarceration, or in-patient hospitalization because of suspected mental health issues, we -- and the courts -- try to intervene before it gets to that point," said Josh Cantwell, clinical director of special programs, Grand Lake Mental Health Center.

"After the petition is filed, the individual is eventually served and they're brought to court," Judge Pazzo said. "Sometimes, people are resistant to this -- maybe because they're not going to counseling or taking their medications, they're just not taking care of themselves and their issues, but that's really an indicator that they need help."

"If they're willing to participate in (mental health) treatment, there's really no need for assisted outpatient treatment," Cantwell said, "but if they're resistant to engage in outpatient mental health treatment on their own, that's tells us they're probably in need of it, all the more."

Upon their initial court appearance, the referred party is presented with the petition in the presence of the D.A. and Grand Lake Mental Health representatives.

"One thing I make sure to do when presenting the petition to someone is to firstly explain what it is, and then to reassure them that it's not a criminal proceeding -- they're not in trouble, they haven't broken any laws, it's a civil commitment issue," he said. "Once they understand they're not in any kind of trouble with the law, that seems to put their minds at ease, so then I'll tell them about he program and why it exists. More than anything, I let them know that the state believes they're a person suffering from a kind of mental illness and that they would benefit from treatment -- simply put, AOT is a process to offer them help."

Following the presentation of the petition, the individual is told they have a right to an attorney -- either one of their own or one of two contracted attorneys -- Tim and Linda Wantland --who accept the appointments through the Oklahoma Indigent Defense System.

Should the person object to participating in the program, a hearing is later held with evidence presented by the state as to why it's believe the person is in need of assisted outpatient treatment.

"So far, we've had no contentions (for treatment) in Rogers County -- everyone who's been referred has consented," Judge Pazzo said. "We've got seven active files right now. Maybe about half of those cases, we had a little resistance in the beginning, but after they consulted with their attorneys, they changed their minds and agreed to participating willingly in the program."

Once in the program, participants receive treatment from Grand Lake Mental Health Center, with review hearings held every 90 days.

Program participation is one year, although it may be extended if the state finds it would benefit the participant.

Although the AOT program has only been in Rogers County for slightly over a year, both Judge Pazzo and those with Grand Lake Mental Health feel it has already shown itself to be "very successful."

"Initially, there were several schools of thought as to how the program was going to play out, but we've seen some very significant outcomes," Cantwell said. "In the beginning, we were hopefully, but we just didn't know what our success rate would be. I for one have been very pleased with the outcomes we've had -- program participants have been fully engaged and gotten the treatment which might not have been available to them without this program."

Judge Pazzo said he's hopeful that letting the public know about the existence and availability of assisted outpatient treatment in Rogers County will help those who need treatment to receive the help they need.

"So many people who wind up in jail -- not just in Rogers County -- are those who have been traumatized as children and have never dealt with things that have just snowballed into larger issues," Judge Pazzo said. "They need counseling, they need help, and with the AOT program, they're can receive the help they need."

"The crux of this is, assisted outpatient treatment allows us to increase our outreach and engagement efforts to the public," Cantwell said. "The access to our services is always there -- the barrier has just been for people to take advantage of those services. Once a civil commitment is in place, we're able to do much more assertive outreach with the help of CIT (Crisis Intervention Team) trained law enforcement officers and Judge Pazzo -- so we have this three-pronged approach of motivating people to get treatment. We've not had that before -- you can't just 'cold call' someone who's not asking for help. This -- AOT -- gives us the ability to go to them and to offer them help."

To refer someone you feel would benefit from mental health treatment through the assisted outpatient treatment program, contact Grand Lake Mental Health at 918-342-0770. Grand Lake Mental Health's' 24-hour Crisis Line is 1-800-722-3611.


(c)2018 the Claremore Daily Progress (Claremore, Okla.)

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