Little Rock site to focus on mental crises

Center will open this month to offer treatment, not jail

Pulaski County's freshly painted crisis stabilization center will treat mentally ill patients starting mid-July, becoming the second of four such centers to open in Arkansas.

On Friday outside the center, the county's chief executive, Barry Hyde, and state Rep. Clarke Tucker maneuvered a pair of oversized scissors to cut a ceremonial ribbon. Tucker sponsored legislation that prompted the facilities, and Hyde's administration laid the groundwork for Pulaski County's unit.

Located at 3001 W. Roosevelt Road in Little Rock, the center will treat people who encounter trained police officers while enduring a mental health crisis.

Prevailing research shows that people with schizophrenia, bipolar disorder and major depression are often arrested because their symptoms can manifest as yelling, threatening or other combative behavior. Or, if they don't go to jail, they rack up costly emergency room visits.

When someone undergoes a psychotic episode, it's not criminal, said Dr. Lisa Evans, a clinical psychologist and the center's program director. Punishing a person for their symptoms is "like [criminally] charging someone with cancer who throws up on the street," she said.

Yet many of the "high utilizers" who cycle through Pulaski County's 1,210-bed jail have a mental illness, Evans said.

When the center opens on or around July 19, Evans said, it will be staffed with University of Arkansas for Medical Sciences nurses, psychiatric technicians, social workers and other medical professionals.

Patients will be taken there not just from Pulaski County, but from Grant, Perry, Saline, Jefferson and Lonoke counties and the cities of Little Rock, North Little Rock, Sherwood, Jacksonville and Maumelle. Those entities have agreed to pay a per-day stipend for each person treated at the center.

To qualify, a patient must be an adult who volunteered for treatment. At the center, patients aren't expected to stay longer than three to four days. They'll receive meals, counseling, health assessments and medication, if necessary, and will be connected to a larger network of treatment providers.

Inside the Pulaski County unit, two juvenile jail pods were transformed into a separate facility with 13 single-bed patient rooms and three larger rooms to hold 16 beds total. Last year, the Pulaski County Quorum Court appropriated $1 million to pay for the remodeling.

There's office space, bathrooms, a nursing station, a medication room and an intake room. The walls are painted in calm colors -- eggshell and whispering pine -- and the floor is covered in light gray tile.

"I just didn't know if we could get it to not look like a jail," Evans said. "And we did."

On Friday, Tucker observed the renovations while a tide of people approached him to offer a handshake and congratulations.

Act 423 of 2017, a sweeping bill that authorized the centers, grew out of a behavioral health task force Tucker co-chaired. At the first few meetings, "there weren't a lot of people there," he said. "Just the true believers."

"It's really exciting to see an idea from three years ago, walking into the room and seeing it in reality," he said.

At Friday's ceremony, Gov. Asa Hutchinson talked briefly about meeting a man who had been treated at Sebastian County's center, which opened earlier this year.

Hutchinson said he spoke with a Vietnam War veteran with bipolar disorder. A SWAT team was called to the man's home because of his potential for violence, the governor said.

But instead of staying locked up, the man was taken to the crisis center.

"He got back on his medication, received the interim treatment that he needed, and then he was eventually released and got to be interviewed by the governor of the state of Arkansas," Hutchinson said. "And so that, to me, is a success story."

The centers' success won't just be measured in anecdotes. Treatment providers must submit detailed data to the state to be reimbursed for the care they provide. When Act 423 was signed into law, Hutchinson committed about $1.6 million to each unit from that year's budget.

"We want this to be successful so that we can go back and say, 'Our money has been justified,'" the governor said.

Though Sebastian County's unit is operational and Pulaski County's will soon open, units in Washington and Craighead counties have lagged.

Joseph Wood, county judge of Washington County, said the county has found a suitable location in a Fayetteville building that houses a courtroom. Officials sent out bids for service providers Thursday, Wood said. If all goes to plan, the unit should open in mid-October, he said.

"We do have some work to do," Wood said, "but it won't be like building a brand-new structure."

That tricky task is underway in Craighead County. Ed Hill, the county judge, said that over the past several months, the county had a few good leads on possible locations, but the public has consistently objected.

"Everybody thinks it's a good idea," he said. "But they don't really want it in their neighborhood."

Now, the plan is to build a new facility, likely on property near the county jail, Hill said. It'll be more expensive, he said, but he hopes it won't incite public outcry.

Addressing Friday's crowd, Evans acknowledged that there have been "some skeptics circling around this project." Coordinating the mental health community with the criminal justice and law enforcement communities is a challenge, she said.

Still, the prolonged effort will be worth it, Evans said. Before now, potential patients would have been directed to the jail or an emergency room, where they don't get sufficient help.

"When they come to our door instead," Evans said, "we will have succeeded."

Metro on 07/07/2018

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