The News Courier in Athens, Alabama

August 1, 2013

Officials talk state of mental health care

By Karen Middleton

— Tuesday night, about 50 local people found out how the Mental Health Center of North Central Alabama is doing more with less.

Athens State University and The News Courier sponsored a mental health forum at the college, at which mental health service providers, law enforcement and Probate Judge Charles Woodroof explained their respective roles in dealing with those with serious mental illnesses.

Lisa Coleman, clinical director of the MHCNCA, gave an overview of how the center treats clients in Limestone, Morgan and Lawrence counties in the face of Medicaid cuts in mental health funding.

“One out of four people nationwide are estimated to be afflicted with some kind of mental illness, and one of 17 suffer from serious mental illness,” said Coleman.

Serious illness includes those with debilitating mental disorders, such as schizophrenia, paranoid schizophrenia, bipolar disorder 1, or severe clinical depression that does not respond to medications. These are clients that are considered to be a possible threat to themselves or others.

Coleman said while 27 percent of the centers’ clientele are on state contracts for medical assistance, the centers are not state supported. The shifting of mental health care from state hospitals to community-based care is a movement that started 50 years ago.

“The Community Mental Health Act of 1963 was one of the last pieces of legislation that President Kennedy signed into law before he was assassinated,” said Coleman. “When I started in this job 22 years ago, the state had 5,000 beds for mentally ill patients, and now that is down to 500. The state has 26 community centers that serve 100,000 people.”

While mental illness falls under three categories: mental illness, developmental disabled and substance abuse, MHCNCA is certified to serve only the mentally ill and those struggling with substance abuse.

Clients must seek help through the Limestone, Morgan and Lawrence centers strictly on a voluntary basis.

“No one can make them,” she said. “Informed consent can only be signed by the client.”

The Limestone center served 556 people in June.

“Of our clients in Limestone County, 866 are adults and 490 are children,” said Coleman. “We have on the average of 50 children a day coming into the center for services.”

Law enforcement officers Lt. Guy Simmons of the Sheriff’s Department and Capt. Anthony Pressnell of the Athens Police Department spoke of being called by family members when a mentally ill relative becomes unruly and threatening. Both Simmons and Pressnell said they cannot make a determination of mental illness, but only prevent them from harming themselves.

When they are unable to talk a person down from the crisis, they call in licensed counselor Jerry Wilhoite, the community mental health officer. Wilhoite’s position was established in December 2004 to assist law enforcement and families in determining when a person should be confined for his or her own safety or that of others.

Officers cannot jail someone for mental health issues, but Wilhoite can order a two-day hold on the person at Decatur General West. During that 48 hours, family members may petition the Probate Judge’s Office for committal.

Woodroof said committal is an involved process in which a person has to have been previously determined to be mentally ill and there must be a well-documented case of whether he or she is a physical threat to himself or herself or others.

Woodroof may order committal to North Alabama Regional Hospital in Decatur for up to 150 days, but he said the usual stay is from two weeks to four weeks.