Assessment teams factoring into Rhode Island, ME health care

Patients with mental health issues too often end up in emergency rooms with nowhere else to go. ERs in Maine reported approximately 16 patients per 1,000 had mental health issues between 2011 and 2014, according to the latest statistics.

“We know people are waiting in ERs from seven to 14 days for a bed rather than getting immediate care,” said Jenna Mehnert, MSW, executive director of NAMI Maine. “ERs should be ERs, not mental health institutions.”

The state is working on an alternative option to ease the burden. In February, a bill was proposed that would offer four mental health assessment centers to divert mental health patients from emergency rooms.

Cost, location, and number of beds are still to be determined and the bill itself is in limbo. Disability Rights Maine, an advocacy group for the state’s disabled, opposes any brick and mortar building, citing it as an “institution” and therefore inherently bad for mentally ill patients.

Other organizations like Maine’s Hospital Association, the Mental Health Association, and law enforcement all support the bill.

Chief Justice Leigh Saufley is among the advocates. In her State of the Judiciary address this year, she said there is a need for more mental health and addiction treatment, safe and sober housing, data collection, case managers, and facilities for youth in crisis.

She posed the challenge that the judicial branch was “ready whenever you are.” Health care providers are ready but feel stymied that the legislation hasn’t gone anywhere.

“There’s cutting edge medical care. But nobody competes to have cutting edge mental health resources,” Mehnert said. “At NAMI, we don’t run acute care centers. We are the advocates. And, we’re frustrated because there are just not the resources for a step between the ER and jail or a psychiatric hospital.”

Rhode Island has a different approach to assessment teams. Its focus is on school threats.

Too often when a school shooting takes place, people talk about the warning signs and how many were ignored before an event. That was the case after the Parkland school shooting in 2018, which made a big impact on Rhode Island officials.

The state is now trying to guard against missing those warning signs. As Capt. Derek Borek, director of training at the Rhode Island State Police Department and chairman of the School Safety Committee, says, mental health plays a big role in preventing a tragedy.

“It’s why we want to get social workers and school psychologists involved,” he explained. “If you look at the incidents of school shootings, it all comes back to mental illness. There were signs they didn’t relay to the proper authorities.”

Each public school in Rhode Island is required to do an “all hazards threat assessment” to look at how it handles a crisis to better protect the students. Assessment teams will address potential threats to school security with past and current students, parents, and employees.

Following specific guidelines, they will identify potential problems and make recommendations to social workers, school staff, and superintendents so they can respond accordingly.

Rhode Island is currently the only state in the region to have a state-wide School Safety Committee. It’s comprised of state police and Rhode Island’s Department of Education, Association of School Superintendents, Police Chiefs’ Association, Emergency Management Agency, and other state and local organizations poised to provide training and resources to each school district.

“We’ve asked every school to have an emergency action plan,” said Borek. “We want to ensure a baseline of security in each school.”

Borek has worked closely with Rep. Nicholas Mattiello in support of this initiative. At the end of April, House lawmakers unanimously passed legislation to form these assessment teams for every school. Last year’s policy proposal officially solidified the School Safety Committee and required all school districts to come up with a safety plan every three years.