"I had a lady call me and say, 'I called the sheriff's office because my son was threatening suicide and he was threatening me, and you guys showed up and took him to jail. I thought you were going to take him to a mental health treatment center.' Well, that is the jail, unfortunately." -Yavapai Co. Sheriff Scott Mascher in May 2014
With calls like that one in mind, Sheriff Scott Mascher has taken the lead in creating the county-wide Mental Health Criminal Justice & Community Coalition.
"There was time when we had mental health hospitals," Superior Court Judge Celé Hancock said. "Then there was a change in which people said, 'You can't imprison people for being mentally ill.'"
Hancock, who presides over the county's mental health court, said, "So now, we're trying to cobble together (a system) to serve this part of our community."
The challenge, then and now, was, how law enforcement and the justice system should deal with getting those people the help they need.
That's the reasoning behind the coalition. In a February meeting attendees included Mascher; Hancock; County Attorney Sheila Polk; Deputy County Attorney Jack Fields; Public Defender John Napper; Becky Payne, RN, the jail's health administrator; Dwight D'Evelyn and Capt. David Rhodes of the YCSO; Debra Kendall of the county's Adult Probation division; and Audrey Dorfman of the Verde Valley Mental Health Coalition.
"We're now working together as a team to work towards dealing with the mental health issues we have here on a local level," Mascher said.
'It should be the last resort, to put them in jail'
The first contact people with serious undiagnosed mental health issues is often with a police officer, who have generally had some training in the area, but not a high level of standardized, consistent training.
"Training the police is really the first (objective)," Hancock said. "They've got to get trained."
Mascher said he doesn't like having deputies arrest people who really haven't committed a major offense but need treatment.
"I can understand how a family doesn't want to call law enforcement," he said, "they're worried about the safety of their loved one, but what resort have they?
"If we can, as law enforcement officers, respond to a call for service, and stabilize the call -- identifying mental illness -- and divert them, rather than (take them) to the jail, that's what we want to do," he said, adding that "it should be the last resort, to put them in jail."
One of the more far-reaching ideas the coalition is exploring is the creation of a special unit, which might, at first, be composed of volunteers, that would respond with -- or even ahead of -- sheriff's deputies when a call deals with an emotionally disturbed subject.
There is already a unit like this in Pima County, Hancock said, where trained volunteers go out with police on calls.
The jail as de facto treatment center
Mascher has already instituted a mental health unit in the Camp Verde jail.
"Even though the jail is truly a bad environment to try to treat people ... it's really not meant for that ... we've tried with the help of Wexford, our correctional health company, they've accepted the challenge to step up" and devise a treatment program for what Mascher called "minor (offenders) we see a lot of recidivism in," such as the person who has stopped taking their medications and commits a minor offense.
They are housed together, which Hancock said was beneficial.
"There's a built-in support system right there," she said. "It's a much better environment for them."
Even so, "we're doing the best we can in the jail," when it comes to mental health care, "but it's still a jail," Mascher said.
Paying for care
One hurdle on the way to creating this program appears to have been cleared: who pays for the treatment once a person is released?
"Many times, services are there, but there was no way to pay for them," Mascher said.
When a person was incarcerated, the Arizona Health Care Cost Containment System (AHCCCS), which covers indigent patients, would drop them from the rolls, and when they were released, they had no way to pay for continued care.
But now, Mascher said, within 24 hours of their release, AHCCCS coverage is reinstated.
"That's huge," Hancock said, because once cut off, it was difficult to re-enroll in the system, and without "continuity of care," the same issues would arise again.
Dealing with the judicial system
Because Hancock handles all the so-called "therapeutic courts" -- DUI and Drug Court, Mental Health Court, Family Treatment Court, and the competency hearings -- she's in a unique position to deal with people who may have deeper problems.
"We've been able to identify and move people from Drug Court into Mental Health Court," she said, "because once they cleared the drugs and alcohol (from their body), it was more a mental health issue than it was an addiction problem."
The coalition has identified a position, called a clinical liaison, which could be of help in coordinating treatment and court appearances.
"If we can (treat) the prisoner who is here on a misdemeanor, maybe they won't come back on the felony," Hancock said.
A 'Solution Center'
Larry Green, CEO of the West Yavapai Guidance Clinic, proposes a wider-ranging concept -- and, possibly, the final piece of the puzzle of treatment vs. incarceration.
"My vision, for a number of years, has been to establish a community program that would be an observation-stabilization center," Green said. "It would be a support to law enforcement, it would be a support to the local hospitals.
"I call it a 'Solution Center,'" he said, and it could become a reality if proposed grant funding and agency cooperation all come together.
The people who were diverted from headed for jail by Mascher's proposed volunteer squad, for example, might be taken to the Solution Center.
It won't be fast or cheap to establish, Green said, "but I think it's a very needed program."
Follow Scott Orr on Twitter @AZNewsguyTerry's case was moved from Drug Court to Mental Health Court in July 2014; she also is involved in a peer support program. Terry spoke about her experience at the League of Women Voters meeting March 7.
"When I was growing up, all I knew was that I was big screw-up. I knew I had problems, but I didn't know what. I took drugs and got drunk, not to get high, but to take away my pain and confusion. It was never to get high.
"I was (court) ordered to go to therapy, take classes,all kinds of things. I'm realizing my problems are because I'm bi-polar, I have OCD, ADHD, who knows what else.
"I'm on the right medication now. There have been ups and downs with finding the right medication. It helps me pay attention.
"Being in this kind of court - there are challenges. I was ordered no contact with my girlfriend. I didn't like that, but I didn't want to go back to jail. I had to prove myself. It's a good environment to be in.
"Yesterday, I'm 10 months sober. I'm 37 years old. I started using alcohol and drugs when I was 7 years old. This is the first time in 30 years I've been clean and sober for this long.
"Judge Hancock was the first person who told me they were proud of me. She knew it was hard work."
How to interact with people with mental illness
Mental Health First Aid uses role-playing and simulations to show how to assess a mental health crisis, choose interventions, and provide help. The training also tackles risk factors and warning signs of specific illnesses such as anxiety, depression, schizophrenia, bipolar disorder and substance use disorders.
Participants in the eight-hour class will receive a booklet on Mental Health First Aid and a certificate naming them a mental health first aider.
The free class is based on an international program designed to help individuals, first responders, family members and others to understand mental illness and how to help persons suffering from various disorders. "This class is for anyone - professionals working in the field, sisters with brothers who have mental health concerns, ministers who want to be able to better relate to all members of their congregation, and more," said Laura Norman, chief development and communication officer with West Yavapai Guidance Clinic.
Training takes place in Prescott Valley on Wednesday, April 29, or Wednesday, May 27, from 8 a.m. to 5 p.m., with about a one-hour break for lunch on your own.
Private donations pay for WYGC to offer this training. For more information, call Laura Norman at 928-445-5211 x3615 or email L.Norman@wygc.org.