Police and Daymark seek solution to involuntary commitment issue

Whitney WeaverStaff

October 7, 2012

The duties and responsibilities of a law enforcement officer are familiar to most of us, patrolling, protection and investigation, but what about waiting?

Over the last several months, Ashe County Sheriff’s Deputies have spent days, and sometimes, weeks waiting with a mental health patient, who is also waiting for a secure facility where they can get help.

The county, said ACSO Captain Carolyn Gentry, has seen an “astronomical increase” in the number of involuntary commitments over the summer months, some of them waiting “two and three weeks at a time” for placement.

“(It has become) a horrible problem for the hospital and for law enforcement officers, and it’s not very humane treatment for the person with mental illness,” Gentry said. “It’s a serious issue.”

If someone in a mental health crisis, known to law enforcement officials as a “respondent,” lives within the city limits of Jefferson or West Jefferson, that town’s respective police department is responsible to pick up the respondent and transport them to Ashe Memorial Hospital

However, that is where their departments’ responsibility ends.

Once a doctor signs paperwork to transfer the individual to a mental health facility, the sheriff’s department is responsible for them until they are admitted to a 24-hour facility, said Gentry.

This issue concerns both financial and safety aspects, said Gentry.

While officers are with respondents in the emergency department, they are “not on patrol, not responding to burglar alarms or B&Es,” said Gentry. If an emergency situation arises, off-duty officers are likely to be called in to work overtime, she said.

Involuntary commitments include cases of both mental illness and substance abuse, said Gentry.

Many respondents falling into the latter category receive treatment, are released, and end up needing to be hospitalized again.

National data compiled by the National Alliance on Mental Illness suggests that 33 percent of mentally ill persons also have substance abuse problems.

With many repeat cases, one might compare these instances with the classic tale of the boy who cried wolf, but when the issue is life or death, law enforcement and mental health officials do not take any chances. Gentry said that each crisis call is taken at “face value,” and every threat to someone’s own life or another’s must be taken seriously.

Daymark Recovery Services, approaching its one-year anniversary as Ashe County’s primary mental health care resource, faces the challenges presented by involuntary commitments daily.

Paige Stephens, Daymark’s unit director for Ashe and Alleghany counties, provided statistics on the number of involuntary commitments from Nov. 1, 2011 to Sept. 30, 2012. Out of 245 total crisis contacts during this period, mental health professionals were able to divert 143 individuals from commitment, and stabilize them on an outpatient basis.

The remaining 102 met criteria for involuntary commitment and could not establish solid safety plans. Stephens said that involuntary commitment is a “last resort” for those who are in immediate danger.

Since November, the numbers of involuntary commitments each month were as follows: Nov. – 7, Dec. – 5, Jan. – 11, Feb. – 9, Mar. – 9, April – 12, May – 9, June – 11, July – 15, Aug. – 5, Sept. – 9.

When asked her opinion why the increase had occurred, Stephens cited the county’s high suicide rate as a factor.

According to, using the most recent data from the CDC, the Ashe County suicide rate is the highest in the state, with 26 self-inflicted deaths per 100,000. This figure is much higher than the state (12.37/100,000) and national (11.79/100,000) rates.

In searching for the source of this problem, police and mental health officials agree that it comes down to state mental health resources. A 2008 report from the National Alliance on Mental Illness indicated that North Carolina has “a severe shortage” of available beds in mental health facilities, leaving 69 percent of the state’s seriously mentally ill population seeking treatment in local emergency departments.

Gentry said law enforcement along with hospital and mental health representatives will begin organizational meetings at the end of the month to establish a Crisis Intervention Team comprised of individuals from the different agencies and institute a procedure to better handle these issues.