Coroner's report spotlights mentally ill in EBR

BATON ROUGE, LA (WAFB) - The East Baton Rouge Coroner says there's a problem among the living that needs immediate attention. Looking at Dr. Beau Clark's annual report, it's clear EBR continues to face a mental health crisis.

Besides the investigation of death, the EBR Coroner's Office is also charged with the committal of the mentally ill, meaning it's on the front lines of this growing problem. In its report for 2013 the office shows Orders of Protective Custody have risen steadily over the last four years, and Emergency Certificates to have someone committed jumped from 4,362 in 2012 to 5,277 in 2013. In 2011 there were 4,316.

Dr. Clark says some of it can be attributed to a normal rise in population, especially post-Katrina, but there's no doubt the issue is getting worse. The question is how much worse?

"You hear a lot of people talk about it, they say 'Well we have a mental health problem.' But nobody's really ever been able to quantify it, because there's no database. Once there's a database we can say 'Our problem is bad by 100 patients or our problem is bad by 10,000 patients,'" Clark said.

He's now working with the Department of Health and Hospitals to develop an automated system to track those protective orders, emergency certificates and judicial commitments.

At least part of the problem can be traced back to the old Earl K. Long hospital. When the Mental Health Emergency Room Extension closed its doors in April of 2013 it never found a new home, leaving hundreds of patients looking for alternative treatment options.

"They were seeing about 156 people [per month] in a very defined crisis at that point, so every month now we have 156 more people coming to our local ERs that have in the past had a specialized emergency department," said Capital Area Human Services District Exec. Director Dr. Jan Kasofsky.

She said prior to EKL's closure many predicted those mental health patients would be seamlessly absorbed into other facilities, but many of her office's clients are ending up in jail rather than getting the treatment they need.

"Our jails were never built to be mental health hospitals, and they don't have the resources to do that. It's got to be a new day," Kasofsky said. "We're really struggling with how do we get a stabilization unit back up and running, because that's clearly what we need."

Dr. Clark agrees.

"There are cities in this state that are smaller than us that have these kind of stabilization units. It's very important that we probably consider that as a community," he said. "Rapid stabilization works. It keeps people out of acute beds, and gets them better faster, and that's what you want. You want people to be in an outpatient setting."

Dr. Kasofsky is working with the healthcare sector and local leaders to come up with a solution, but in the meantime her office is doing what they can to make a difference. Her office routinely takes police departments through Crisis Intervention Team Training, and there's also talk of a Mental Health Court to evaluate mentally ill patients going through the courts system.

"We have a wonderful warden, the sheriff the police chief, the DA, we have judges that have been involved really looking to see what is the system we need in Baton Rouge to address the need," Kasofsky said. "I have been calling agencies across the country to ask how to handle this - the type of questions you're asking me. And everyone has to come to the same conclusion: You need a stabilization unit in the community."