Working in near-zero temperatures to stabilize the man, they knew there would be no good outcome for another person suffering a mental breakdown in a community where emergency psychiatric care is scarce. After doctors assessed him at a hospital emergency room, he was booked into the Beltrami County jail.
“Another case of criminalizing the mentally ill,” said Sheriff Phil Hodapp. “And we have to put that man in the jail because there’s no other place for him to recover.”
Today, Hodapp finds himself among a group of judges, prosecutors, public defenders and social workers supporting a plan at the state Legislature to transform the way Minnesota treats the mentally ill on the front-end of the criminal justice system.
The bipartisan bill would create four regional “jail diversion hubs” — short-term, quick treatment centers for mentally ill adults arrested for relatively minor crimes.
The $8 million proposal, sponsored by Sen. Barb Goodwin, DFL-Columbia Heights, is modeled on a nationally recognized program in Orlando. It diverts mentally ill people to a 100-bed hub where they receive diagnosis and immediate treatment rather than languishing in jail — a drive-through facility that immediately frees law enforcement officers to return to work on major crimes.
If the bill passes, one of the 16-bed hubs is likely to be located in Bemidji, seat of one of Minnesota’s poorest counties, where daunting issues of homelessness and chronic drug abuse plague the city’s mentally ill. The Beltrami County jail can hold up to 120 inmates, and it is nearly full every day. On any day, about 80 percent of those inmates have a history of mental health problems, Hodapp said.
“If that man suffered a heart attack, he’d be in the hospital, and we’d spend tens of thousands to save his life,” Hodapp said, referring to the 300-pound man sitting in a cell, a block from his office. “But because he’s mentally ill, you can see how he’s treated and where he ended up. I hate to use the word, but I call that ‘crazy.’ ”
Paul Nistler, executive director of the Upper Mississippi Mental Health Center, is as pragmatic as he is passionate. He keeps a mileage table in his head, a map in his drawer and his frustrations mostly to himself.
“People with mental health issues need rapid access to a place that can help fix their crisis of the day — and we don’t have that here in northwestern Minnesota,” Nistler said.
One of the first, critical breakdowns occurs at Bemidji’s state-operated Community Behavioral Health Hospital, which serves mentally ill people who are court-ordered into intensive psychiatric care.
The 16-bed hospital is full most of the time, Nistler said, “but it’s rare that anyone from Beltrami County is in that facility. The state moves patients from all over based on where they can find an available bed.
“Far too often, a person with those kinds of needs in Beltrami County ends up being transported by us to North Dakota because there’s no beds here,” Nistler added.
Five years ago, the center added a mobile crisis team to its therapy operation, a 24-hour unit that serves up to 55 people a month. “It’s win-win to expand that team and also have the ‘hub’ to take the pressure off this community,” Nistler said. Right now, he said, his staff transports patients as much as 7,000 miles a month. “I call it ‘windshield time,’ ” he said. “It doesn’t make sense.”
It’s 6:45 a.m. and the homeless who are mattressed down at the Assemblies of God Crossroads Church in Bemidji are rising to face another uncertain day.
Benjamin Allen, 24, knows that ending the day in jail is a very real possibility. He fits the exact prototype of adults who would benefit from a stabilization hub.
“I’ve been bipolar all my life,” Allen said in the most matter-of-fact tone. “I’ve been institutionalized three times in Michigan. I’ve been in jail a few times, too, when I caught a charge for fighting. I’m not an angry person, I just need a break.”
Allen gets two bus tokens from a volunteer and then turns dotingly to his wife, Gail, who says she suffers from PTSD.
“How are you?” he asks in a near whisper.
“Not sure, yet,” she says. Over their toast and juice, another volunteer brings their two large baggies full of medications. “Oh, I can’t forget these,” Gail says gratefully.
Allen said they’ll most likely end up at the city’s library for the day, enduring snickers from children who know they’re homeless. “It’s like you’re getting set up for failure, and it’s just a matter of time before you will end up in jail instead of getting help.”
Gail puts on her coat, leaves her pink pajama pants on, and together they board the bus to see what the day will bring.