Pinellas Sheriff's Office tackles mental health one conversation at a time

LEALMAN

Dusk was bleeding into night, so the couple turned on their porch light to keep talking with the deputy at the foot of the steps.

Days before, Erna Lopez and Benjamin Moreno said their son, Benjamin Jr., had been taken to a mental health facility under the Baker Act when neighbors felt threatened by the 27-year-old waving knives and yelling in the street. It was another nerve-racking encounter with law enforcement sparked by their son's schizophrenia and bipolar disorder.

But the conversation with the deputy on that warm night in February — that was different. There was a social worker with him, gently prodding to learn more about the family situation.

"We want to get him the proper help instead of just a strict law enforcement response," said La'Tonya Oats, a caseworker with Directions for Living.

"A lot of times, law enforcement officers that come out only have the option to Baker Act or arrest," said Pinellas County sheriff's Deputy Keith Jackson. "There's no middle ground."

But now there is, they explained, with the formation of the Sheriff's Office mental health unit, made up of two deputies and two social workers who respond to and follow up on mental health-related calls full time. The unit was designed to take pressure off a system that saw about 3,000 Baker Act cases last year in the agency's jurisdiction alone and direct people to resources that will possibly lead to a more permanent solution.

The unit has conducted about 435 followup calls and visits since it began late last year, filling what Sheriff Bob Gualtieri said is a crucial need to help people avoid repeated contact with law enforcement. Typically under the Baker Act, a law allowing for the involuntary commitment of people believed to be a danger to themselves or others, individuals are released after 72 hours, leaving them vulnerable to repeating the cycle. Nine people were taken into custody six or more times last year, according to Sheriff's Office data.

"The people who are tasked with being the first responder of last resort are the people who are least qualified," Gualtieri said. "We're on the hamster wheel to nowhere."

• • •

The unit, which targets the Lealman area between St. Petersburg and Pinellas Park, was funded by a roughly $635,200 federal grant, said Sgt. Kelly Bush, who heads the unit. The University of South Florida will examine data over a four-year period to gauge progress.

In practice, it's modeled in part after agencies with similar programs, including the San Antonio Police Department in Texas. Like the Sheriff's Office, the department started crisis intervention training years ago for officers to learn how to de-escalate tense situations where mental illness or substance abuse are often factors.

But in 2008, the department assigned two officers to handle mental health calls full time.

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"Their (the officers') takeaway was that the department needs basically its own mental health apparatus … to coordinate with all the other sources out there and the hospitals and any entity that deals with mental health," said Sgt. John Cooley, who leads the San Antonio unit.

It has since grown to 10 officers who have several duties beyond calls and followup, including teaching crisis intervention training courses, coordinating with mental health organizations and helping counsel colleagues in crisis.

Cooley pointed to several successes: Officers in the unit have used force only four times since its inception, and some chronic users of the system are popping up less and less, although, Cooley said, they're often replaced with new ones.

But while coordination between law enforcement and health care providers has improved, the system is overwhelmed in a state that consistently ranks near the bottom in mental health funding.

The same goes for Florida, where per capita spending on mental health agencies hovers between $30 and $40, according to the National Association of State Mental Health Program Directors Research Institute. Maine spent about $345 when it took the top spot in 2013. Ohio, in the middle of the pack at 24, spent about $100.

More individuals with mental illness are being diverted from jail into hospitals and the county's five mental health providers since the implementation of crisis intervention training in 1999, a shift that, while positive for mental health advocates, has strained the care system, said Judy Turnbaugh, president of the National Alliance on Mental Illness Pinellas County.

She anticipates the mental health unit will cut down on repeat cases and catch people who fall through the cracks after they're discharged, she said. But it doesn't tackle the root cause.

"You have to address what's causing all of these Baker Acts, what's causing all these people to have mental health issues," she said. "It's been difficult without the increase in (state) funding."

Turnbaugh said she sees trends in how mental illness can go from manageable to an emergency. Symptoms that develop in someone's late teens or early 20s are brushed aside as teenage hormones. Or a person may be in denial because of the stigma that comes with mental illness.

For Jackson, the deputy, it's personal. He patrols the streets and sees his brother.

• • •

It started with his mother, diagnosed with bipolar disorder, depression, paranoia, schizophrenia and posttraumatic stress disorder, Jackson, 35, said. When he was 10, she had a breakdown. The police came.

Then, he watched his older brother cope with bipolar disorder and depression. At 16, he went to military school. At 17, he moved out and started using crack cocaine and alcohol instead of his medications.

Jackson went on to become a police officer in Kansas City. Colleagues would run into his brother on calls and reach out to Jackson, who, frustrated, would tell them to lock him up if he was breaking the law.

Crisis intervention training helped him start to empathize, he said. So did an experience that almost left his brother dead.

After overdosing on crack, his brother was shoved out of a car into the blistering summer sun. It took half an hour for anyone to call 911, enough time for him to develop third-degree burns and a brain so damaged he now operates at a sixth-grade level.

"I carry that a little bit to try to motivate myself to take some extra time out," Jackson said, "and realize what it is in my position that I can offer to help someone not have a sad story."

Soon after meeting with Lopez and Moreno, Jackson and Oats went to see their son at Personal Enrichment Through Mental Health Services Florida, a nonprofit behavioral health organization with a campus in Pinellas Park.

This was the first time Moreno Jr., unemployed and uninsured, had gotten treatment for his illness, he said, sitting across from them at a table in the small cafeteria. He wasn't hearing voices anymore with medication and a routine, he told them.

Jackson and Oats explained who they were, what they were trying to do. Before they left, Jackson asked if it would be okay for them to check in soon with him and his parents.

"Oh yeah," Moreno Jr. said.

Contact Kathryn Varn at (727) 893-8913 or kvarn@tampabay.com. Follow @kathrynvarn.