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Editorial: County needs to put the ‘system’ in mental health

If John Hyde had lived in Tucson, five people, including two police officers, might be alive today. Homeless camper James Boyd might not have been killed by police gunfire in the Sandia foothills.

That’s because the southern Arizona city has a comprehensive system for helping people in crisis, especially those with mental health issues like Hyde and Boyd.

Bernalillo County doesn’t. But soon to be armed with $20 million in dedicated annual gross-receipts tax revenues, the county is gearing up to tackle what is a growing national problem of mentally ill people who need help that doesn’t end in violence.

Albuquerque business, health care and community leaders recently got a firsthand look at what Pima County did to dramatically improve its mental health system. The trip, which included presentations by some of the people who made it work, was organized by the Greater Albuquerque Chamber of Commerce.

Tucson delivers services in what could be viewed as a one-stop shopping center. People can go to its crisis response center and get immediate help, evaluation and referrals for follow-up services, some of them on the same campus. The center, which serves about 1,000 adults and up to 300 children a month, also has operators trained to direct callers to people and agencies for help. It’s annual operating budget is about, yes, $20 million.

But what happens before people with mental illness go into the center, and what happens after they leave, is just as important. It’s the system. Having an expensive center where people can be stabilized, then released to fend for themselves, won’t fix the problem.

Tucson has a specialized group of police officers who handle mental health calls and have the necessary training to do so. And those officers can take people to the center instead of jail or an emergency room. In minutes, they can be back at work rather than laboriously booking someone into jail.

The unit also has specially trained officers to serve court orders on mentally ill residents, respond to mental health crises and monitor people who might become dangerous.

Although the Albuquerque Police Department was first in the nation to have a designated crisis intervention unit, it’s only staffed with two detectives. And while about 90 percent of field officers have had crisis intervention training, Lt. Glenn St. Onge says APD could do more if there were better communitywide systems and more crisis intervention officers. The U.S. Department of Justice wants the city to have 12 officers in its mental health unit.

In Bernalillo County, people with mental issues essentially are on their own in figuring out how to navigate available services and providers. Many end up at the Bernalillo County Metropolitan Detention Center or back on the street after a visit to the ER.

That’s in great part because the county doesn’t really have a grip on what programs it now offers or funds, or how much it spends on them. When Journal UpFront columnist Winthrop Quigley asked, he learned there is no such list. No one had any idea. Public Information Director Tia Bland had to scour documents and call agencies. She ultimately identified more than 50 programs operated by different nonprofits, companies and public agencies for a total of more than $8.3 million spent over the past couple of fiscal years.

The upshot of that? Confusion. For example, the county contributes to six different housing programs, but there is no system for getting someone into a program. That doesn’t work for anyone.

There are other differences between Arizona and New Mexico that factor into the picture. Arizona gets about three times more in Medicaid dollars than New Mexico. It also outspends New Mexico on mental health services – $209.44 per capita per year compared to $131.44 here. And the median personal household income is 11 percent higher in Arizona.

In addition, Arizona has a law allowing police to arrest a mentally ill person in possession of a firearm if he or she is barred under current federal law from having one. In New Mexico, local police have to ask federal agents to make an arrest.

Arizona also has a version of Kendra’s Law that authorizes courts to order some mentally ill people to accept outpatient treatment. New Mexico doesn’t, and such a measure was once again rejected in the recent legislative session. Lawmakers should consider providing these valuable tools, unless they prefer to see more of the tragic events of recent years unfold.

New Mexico, Bernalillo County and Albuquerque should learn from Tucson’s system – because it works – and try to replicate a local version instead of just expanding the current unworkable system of triage. When a University of New Mexico survey finds that of an estimated 151,000 county residents requiring mental health treatment in 2013 only 98,000 were served by local providers, there is clearly an unmet need.

The debate over the mental health tax centered on the fact that the principle of the commission majority was to tax first, plan second. And that’s the road we’re on.

Plopping down a $20 million crisis center alone won’t change that. Now that Bernalillo County taxpayers have created a funding stream, the county needs to find a way to ensure that money is spent on best and proven practices.

It took Tucson 30 years to get its system in place.

The families and victims of John Hyde and James Boyd would say we don’t have that much time.

This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.