Newsletter - Bartlett Regional Hospital

Caring for the Mentally Ill
A highly functional system
Most of us will experience depression or anxiety to one degree or another at some point
in our lives. With prolonged feelings of sadness or hopelessness, such conditions become,
by medical definition, mental illness. Fearful of being labeled “crazy,” all too often people
suffering from depression and anxiety disorders are reluctant to seek help when they need
it most. When fearful that such a state could lead to self-harm, friends and family have
reason to take pro-active steps for their loved one.
A
strongly built man stalks down
the middle of a South Franklin
Street sidewalk flailing his arms
while carrying on a loud and vigorous
argument—with himself. Tourists step
aside to let him pass.
Two police officers, responding to calls
from concerned merchants, make contact
with the man and begin a dialogue.
Their immediate concern is whether he
is a threat to others or, much more likely,
a threat to himself.
“This can be a very challenging environment
for police officers,” says Lt.
Kris Sell of the Juneau Police Department.
“People who come to our attention
because of this sort of behavior are
rarely criminal, but they can be alarming
to their families or the people around
them. The question we have to answer
is does this person meet the standard for
‘emergency detention for evaluation’?”
For an adult to be committed for psychiatric
care, he or she must meet certain
criteria. In the above scenario, if police
officers determine the man’s behavior
suggests he is a danger to himself or
other people, or is incapable of caring
for himself, the next stop will be the
Bartlett Regional Hospital Emergency
Department.
Lt. Sell says that Juneau police officers
do their best to avoid the use of force.
“But we have to respond to the person’s
behavior. He controls the situation.”
Typically, such a person is well known to
the police. “Often our officers have built
a rapport with such people,” she says.
“Most cooperate when we tell them they
have to go to the hospital, but sometimes
we have to physically restrain them. We
hate doing this. We did not get into this
job to constrain the mentally ill.”
Once at the Emergency Department,
the officer will often stand by, not as an
enforcer, explains Sell, “but keeping the
person company so that they are not
alone in a cubical.”
When a patient presents mental issues,
the Emergency Department will place
a call to the Juneau Alliance for Mental
Health, Inc. (JAMHI, commonly
referred to as “jammi”). One of the clinicians
on call might be Lee Burgess, who
supervises the JAMHI mental health clinicians—eight
professionals who work
either as clinic staff or on contract. A
clinician is on call 24/7 to respond to
mental health emergencies.
“When we see the patient in the ER,”
Burgess explains, “we triage to determine
whether the person meets the criteria
for admission.” A clinician decides
if the patient poses a threat to himself
or others or has a grave disability, which
is defined as being unable to meet one’s
basic needs.
One challenge for the ER medical staff
and the clinician is to evaluate accurately
whether a person who is talking
aggressively about suicide or harming
others is serious. Maybe the person
is very intoxicated, or has been abusing
drugs, has a medical condition like
a traumatic brain injury or dementia.
“Sometimes they simply do not have the
capacity to harm anyone or their intent
to harm themselves is not credible,” says
Burgess. “Before we can make a determination,
sometimes we have to wait
until they detox.”
Continued, next page
3 — Fall 2011