The city of Waco and McLennan County are giving $160,000 to Prosper Waco’s Behavioral Health Leadership Team in an effort to ease a bottleneck slowing mental health treatment and regularly tying up police resources.
Both governments agreed to provide $80,000 to pay for a physician to be stationed at Heart of Texas MHMR’s crisis treatment center. The doctor would treat patients experiencing a mental health crisis who also need treatment for a physical condition before they can receive mental health care. The team estimates the $160,000 position would be responsible for saving $1.3 million a year, treating an additional 730 people per year at the crisis center who police otherwise would take to emergency rooms, often spending hours simply waiting with the patient.
The physician would treat minor medical needs and help differentiate between physical and mental symptoms, said Dr. Jackson Griggs, a Behavioral Health Leadership Team member and CEO of the Waco Family Health Center. For example, a severe infection could cause auditory hallucinations, he said.
“The role of the medical provider would be to confirm their symptoms aren’t from a medical cause,” Griggs said. “Medical and mental health conditions are frequently comorbid. The hope is that the physician can address minor medical issues in order to prevent emergency room use at one of the hospitals.”
Waco Police Chief Ryan Holt said law enforcement is often the means by which someone experiencing a mental health crisis gets help, a pattern that developed after decades of federal cuts to mental health treatment.
“What they’ve done is pushed it and made it a local problem by reducing funding to such levels that a lot of folks just don’t have access to service,” Holt said. “I’ve always believed you don’t want police to be your main entrance into the mental health system.”
When law enforcement responds to a call about someone in mental health crisis who poses a danger to themselves or others, officers may take them to the MHMR crisis treatment center.
“Anecdotally, I’ve been saying we answer about three suicide-in-progress calls a day every day of the year,” Holt said. “At least one of those ends up in what’s called an emergency detention order.”
That applies to people who are a danger to themselves or others who are taken into civil custody and taken to a mental health facility for evaluation. However, those patients may also be suffering from a physical condition like high blood pressure, diabetes, illness, injury or substance abuse. In those cases, officers take the person in crisis to an emergency room to get medical clearance before they can be seen by a mental health professional.
Holt said the current arrangement leads to patients waiting hours for medical help, and the officer who responded to the call must stay with the patient.
“We don’t cut in line. We don’t get special treatment. We go sit because they’re busy,” Holt said. “You may have police officers who sit for hours and hours and hours, and then we go get a psychological evaluation which can take more hours.”
The Waco Police Department responded to 973 suicide-in-progress calls last year, 404 of which led to emergency detention orders.
Officers spent an average of 5.72 hours on all crisis calls last year, which includes the suicide-in-progress calls, Holt said. The longest call took 27 hours to resolve.
“That’s pretty regular. Back in 2010 our maximum was 63 hours,” he said. “We have been making progress in reducing the number of emergency detention orders.”
The number had been steadily decreasing until 2016, when it increased to over 400 emergency detention orders.
“There’s no reason to believe things are going to slow down,” Holt said.