Fairfield Municipal Court Judge Joyce Campbell, who runs a special mental health court, said there has seen a sharp uptick in the number of people suffering from serious mental illness, such as bipolar disorder, schizophrenia and depression, coming through her courtroom. But Campbell said she doesn’t think there are necessarily more mentally ill people in the county.
“I just think we’re better at recognizing the symptoms,” she said. “There is less stigma attached to being diagnosed with a mental illness, so I think people are more forthright; they are more willing to acknowledge and divulge that they are struggling with mental health issues.”
Butler County commissioners and the Mental Health Board have placed a 0.5-mill levy renewal on the Nov. 4 ballot that would not increase taxes on residents. The owner of a $100,000 home would continue to pay $7.30 annually.
Mental health officials have said they need the renewal if they are to continue meeting the increasing needs of the county’s mentally ill. The board has been able to survive increased demand and state budget cuts by using about $11 million in fund reserves from a 2006 tax levy, but even if that levy is renewed next month, those reserves would run out by June 2019.
“We’re one of the few boards in the state to be able to maintain the level of services, even all through this Great Recession and the increased demand,” said Marion Rhodus, the director of finance.
When the county commissioners agreed to place the levy renewal on the ballot, they acknowledged mental illness is a pervasive problem in the county and passing the levy is essential, given the drop in state and federal funding.
“It’s pretty obvious it’s not working well; it’s not working good enough. We’re not ahead of the curve with the problem,” Commissioner Don Dixon said. “It takes too long to get into mental health services. Some people fall through the cracks. Look at our jail; our jail is probably made up of 1,000 prisoners a day, maybe 1,200. I’m going to guess that 90-some percent of that falls into that mental health category.”
Chief Anthony Dwyer, of the Butler County Sheriff’s Office, said Dixon is spot-on with his observations about the jail. He said while the numbers of mentally ill people on the outside are rising, the numbers inside the Butler County Jail can’t go much higher.
Dwyer said he considers substance abuse a form of mental illness, so just about every jail inmate has a malady.
“People in jail have always statistically had a high rate of mental health problems,” he said. “In my jail, it’s not going to go up much because it really can’t; it’s almost everybody. I’m not saying it is everybody, but it is a large, large population in the jail.”
The mental health board contracts with Transitional Living, Inc. (TLI) to provide mental health services at the jail. Executive Director Scott Rasmus said a few years ago, before TLI came on board, that the only services provided were suicide assessments and medication monitoring. The number of inmates treated hovered just under 200 per month.
Since TLI took over in 2012, they have added a person and included mental health screenings, doubling the number of inmates served to an average of 485 per month in fiscal year 2014 and 512 per month since July.
Butler County at the forefront
Kathy Becker, CEO of Transitional Living, said she has been working in the mental health system for 34 years, and the criminal justice system in Butler County and mental health providers have made great strides. She said police who come in contact with people who might need help — as long as no crime has been committed — are given help. And the courts are also on board with getting people help earlier rather than after their case has been adjudicated.
“Criminal justice was trying to talk to us but we were like, ‘If they’re arrested, they’re not ours.’ I am just so pleased that things have changed so dramatically, that the criminal justice system and mental health stand together to help people,” Becker said. “People who live in Butler County I think sometimes don’t know how much more progressive Butler County is in trying to find steps throughout the process to help people.”
Common Pleas Judge Michael Sage opened the first-ever felony mental health court in the country in 1999. He said there were people in the drug court program who just couldn’t seem to stay clean, so they dug a little deeper and found out they were also suffering underlying mental issues, hence the introduction of the SAMI court. To be eligible for the intensive treatment court, a person must have been convicted of a felony, have a serious mental illness and also substance abuse issues.
Since 2007, there have been 373 participants in the SAMI court program. Sage said the SAMI court is not, however, the only court that deals with mental health issues. Up until five years ago, he said, criminal offenders weren’t screened for signs of mental illness. Today, it’s done all the time.
“It has made us much more effective trying to deal with people who are offenders and trying to rehabilitate them…,” Sage said. “That was never done five years ago; now we do it, and those people who need help, we get them help. We don’t wait six months until after their case has been decided. We are trying to address it as quickly and as early as we can, because we don’t want to see the behavior repeated.”
Probate Court Judge Randy Rogers is also blazing trails in the realm of civil commitments. The state has recognized that Rogers’ broad interpretation of the civil commitment law — allowing courts to commit someone with a severe mental illness for treatment against their will, even if they don’t pose and imminent threat to themselves or anyone else — is correct.
“Butler County Probate Court has consistently interpreted the term in the old law, ‘subject to hospitalization by court order,’ to include all types of less restrictive settings consistent with the person’s treatment plan…,” Rogers said.
Former Supreme Court Justice Evelyn Lundberg Stratton said Rogers and his court are a role model for the rest of the state.
“I always commended him for being progressive and using the statute as I thought it was written and putting in a program that I thought was very successful and had some wonderful outcomes,” she said. “We have used him as our model in trying to make some changes that would make the statutory authority clear for judges.”
Rogers worked recently with Sen. Bill Coley, R-Liberty Twp., to clarify the law that enables judges to order help for people with mental illnesses.
“We did a lot of stuff that he was doing that was in a real gray area of the law,” Coley said. “We made it black and white that he could do it.”
Future efforts
Judge Campbell said the influx of people seeking mental health help is also largely due to the number of military personnel returning home.
“I have kids coming back from Afghanistan and Iran and Iraq, and they’ve got PTSD (post-traumatic stress disorder), and they’re dealing with other things, and then, unfortunately because of that, they’re getting mixed up in drugs,” she said.
Fred Southard, president of the Butler County Veterans Service Commission, has teamed up with Kimball Stricklin, CEO of Butler Behavioral Health Services, to see if they can get grants to offer mental health services — above and beyond what is available through the Veterans Administration — to county veterans.
“Mental health is a real issue in this country not just for veterans but for non-veterans also. It’s an issue that really needs to be addressed. We can’t just keep sweeping over it and pushing the dirt under the rug,” Southard said. “ As far as the veterans service commission, if I am able to, and I can find two other votes on the commission, I would really like to pursue what we can do as a governmental agency to help vets get the care they need.”
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