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Mental health holds continue to climb for Davison Co.

Daily Republic - 4/4/2019

April 04-- Apr. 4--By every measure, Davison County authorities are dealing with more mental health calls and evaluations, and those figures were presented starkly this week in a meeting with the county's commissioners.

Davison County law enforcement has had at least 240 total mental health evaluation requests in each of the last three years, including a high of more than 260 evaluations last year. The year 2018 was also a three-year high for holds stemming from those evaluations by a qualified medical health professional, with more than 90 mental holds issued.

Davison County Sheriff Steve Brink and Jail Administrator Don Radel said the demand for mental health services in their respective divisions is not subsiding. South Dakota is one of five states that allows involuntary mental health holds in jails for up to 24 hours, in part because the state has few medical facilities equipped to handle individuals for in-patient behavioral health matters.

"It shows how things are going up. And we know it's continuing to go up," Brink told the Davison County Commission during its meeting on Tuesday in Mitchell.

Of the evaluations done by a medical professional, the rate of involuntary commitments done in the last two years has climbed by 60 percent from about 50 in 2016 to 80 in 2018. Evaluations by qualified medical health professionals have increased in total from about 70 in 2016 to nearly 120 in 2018.

In total, Radel said the Davison County Jail had 119 mental holds issued last year. That can include people who come to Davison County with an evident mental problem, are processed and then are transported to another facility. A hold can also be placed when someone is intoxicated or under the influence of drugs and wish to hurt themselves. That also leads to an evaluation, which must be completed once the person is sober before they can be released.

The jail had 107 mental holds in 2016 and had holds in 2017.

"It fluctuates each year," Radel said.

The county jail often takes on the role of sorting out who needs to be where, Brink said.

"Sometimes, we don't have to do all of the evaluating. Some of it gets done at the hospital, but we end up transporting those people," he said. "We have to find out who's going to get them, where they're going to go, who is going to go ..."

Radel estimated that mental health holds, between the medical clearance examinations, staff time and transportation, cost an estimated $51,238.96 in 2018. More than half of that cost -- $27,676.96 -- comes from medical expenses attributed to mental health patients, although Medicare rates reimburse some of those costs.

Davison County Commissioner John Claggett was among the commission members trying to calculate the labor commitment that jail staff dedicates to mental health matters.

"If you even say it's 20 hours, that's 2,400 hours that we didn't really deal with like this years ago," Claggett said, multiplying the time by the nearly 120 holds the jail had last year.

The figures come from requests made by the Mitchell Police Department, the Davison County Sheriff and jail departments or other agencies that might route their mental health requests through the Davison County jail.

"We try to get them in and out as fast as we can," Brink said of 24-hour holds in jail. "We work it and work it as hard as we can to find somewhere for them to go, unless we absolutely can't find a place, and then we hold them overnight. We don't like to do that. It's not where they belong. We try to get them in and out and where they need to be."

Commission Chairwoman Brenda Bode said the current mental health system in South Dakota has forced Davison County into its current situation.

"They've cut off the facilities," she said. "And that's why it does take all of this time. They've just decided that jail has become the new mental health facility."

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