County board having to take look at system for care of mentally ill

The Union County Board of Supervisors is once again having to decide the question of how to handle mentally ill residents.

They learned Monday that a system that they thought has been working well for nearly three years may be discontinued due to lack of sufficient funding.

For many years, when someone believed another to be mentally ill to the degree of being a danger to himself, herself or others, he would file a commitment request.

As soon as a chancery judge signed the order, the person would be taken into custody by law enforcement officers. The person would be evaluated by doctors, given a hearing before a judge and, if deemed necessary, ordered sent to the state hospital for treatment.

But the state hospital often had no available beds due to overcrowding and lack of budget so a patient might have to wait weeks in the custody of the county. Occasionally, a patient could be taken to an area crisis intervention center such as was available in Batesville if a bed was available there, but those have been discontinued.

The only alternative was to house patients in the county jail, which was not equipped to deal with the mentally ill who have committed no crime, and had neither appropriately trained staff nor procedures in place.

About three years ago, that changed.

Region IV Mental Health established a sort of transitional catchment facility in Tupelo near the North Mississippi State Hospital and contracted with 12 area counties to temporarily house those who have been committed.

Before, the county here had to pick up patients, house and care for them, transport them for evaluation in Tupelo, transport them to a hearing and provide them with an attorney and, eventually transport them to the hospital. All the expense – and liability – during that time was Union County’s.

With the change, officers would still have to pick up patients, but then they would take them directly to Tupelo to Region IV, after which they could essentially forget them.

Region IV took care of them, provided an attorney, set up hearings by video conference and handled everything else.

For are these services and taking on the liability, Union County paid Region IV about $44,000 a year.

When this was first proposed, supervisors were reluctant to spend the money, but quickly figured out that for Union County to meet the legal requirements to house patients here would cost many times that, and Union County would still have liability for the patients.

Monday, Chancery Clerk Annette Hickey reported that Region IV officials are considering closing the Tupelo facility. It was started as something of an experiment and, while it works well, they say they need more money to continue it.

Hickey said they are asking Union County officials to double the amount they have been paying, to $88,000, and they have said they believe they need the participation of 20 counties, not just 12.

Hickey said clerks are trying to negotiate a lower price, but so far without success. Region IV has said they will take no action toward closing until Sept. 1 so local officials may continue to negotiate or look for alternatives, such as contracting with a county that has a certified facility or a hospital like Tri-Lakes in Batesville.

Hickey said her office processes 30 or more commitments a year. That would put the new cost at nearly $3,000 per patient. Questionable commitment requests have been a problem in the past, she said, when one family member might get angry with another and file the commitment for spite, but since anyone filing has to pay a fee of well over $100, frivolous filings have almost ceased.

If county officials put patients in jail here they risk a lawsuit. If they want to have the jail certified, they will have to make modifications to part of it, specially train the staff, have full-time medical staff and meet other requirements. Additionally, they will still have liability for anything that happens to a patient.

If they agree to pay the $88,000, all they will have to do is provide transport once and will be free of liability otherwise.

Hickey said she would get more information on the various options and report to the board.