Mental health transports put pressure on police, hospitals

This year, the Tulsa Police Department has made changes to their transportation of individuals with mental health issues. TPD’s former system had relied on officers working overtime to transport the individuals to hospitals, many of which were outside the city of Tulsa. Now, TPD has reduced the responses to those out-of-town hospitals by scheduling the transfers during times when officers are on duty. While this new system is projected to save TPD $100,000 this year, it also may harm both inpatient and outpatient mental health care within the city of Tulsa.
Within Tulsa, inpatient health care is limited. Major facilities like Parkside, Laureate, Brookhaven Hospital, Tulsa Center for Behavioral Health and Hillcrest Medical Center have a very limited number of crisis beds available at any given time. In fact, across these five facilities, the total number of crisis beds available for adults is 224, according to the information on their websites. (15 for Parkside, 75 for Laureate, 64 for Brookhaven, 56 for Tulsa Center for Behavioral Health and 14 for Hillcrest.) Hillcrest offers an additional 72 crisis beds for children and adolescents. That is simply not enough beds. According to the Oklahoma Department for Mental Health and Substance Abuse Services, in 2016, 700,000-950,000 Oklahomans experienced a substance abuse or mental health issue that required immediate treatment.
When an individual is in a life-threatening mental health crisis, TPD is notified and, according to Oklahoma state law, TPD officers must transfer the individual to the nearest hospital that can take him or her in for treatment. With the extremely limited number of crisis beds available in Tulsa, officers were having to transfer mentally ill individuals sometimes as far away as the panhandle for inpatient treatment. According to TPD data, the number of out-of-town transports has increased 86 percent from the fiscal year 2012 to fiscal year 2016. TPD’s new transfer system is looking to reduce out-of-town transports by reducing officer response to individual cases and utilizing a more “bang-for-your-buck” approach. Instead of transporting one individual at a time, officers are now transporting multiple individuals at a time.
This will impede inpatient mental health care improvements within Tulsa for two reasons. First, hospitals within Tulsa will be less likely to have room for, say, three or four individuals at one time rather than just one individual. It becomes increasingly likely to have to rely on hospitals outside of Tulsa if there are more people being transported at once. Second, with this new system, the sense of urgency in dealing with individuals with life-threatening mental health issues is reduced. If police are having to transport these groups of individuals to out-of-town hospitals, the time it’ll take to reach these hospitals, let alone get all of the individuals processed and admitted, will only help to exacerbate the individuals’ already critical conditions. Life-threatening situations require immediate, individualized attention, not group clearings.
In addition, having those transfers scheduled for when officers are on-duty further undermines the urgency inherent in life-threatening mental health situations. If an individual is having to wait for officers to complete a scheduled shift, for example, then they are having to wait longer than if an officer is on-call and ready to go at any given time. And if that individual is unlucky enough to be the last stop in, say, a four-person group roundup, the time it’ll take to reach him or her is much longer. TPD’s response time to individuals that require inpatient care is likely to increase under this new transportation system, and as a result, the quality of inpatient care within Tulsa will suffer.
As for individuals with mental health issues that are not life-threatening (which according to TPD Major Tracie Lewis is the majority of individuals TPD encounters), the new transportation program may likely also hurt outpatient care that is suited for these individuals. One of the few 24-hour outpatient mental health care programs in Tulsa is COPES (Community Outreach Psychiatric Emergency Services), a telephone and mobile service of Family and Children’s Services. While COPES does intervene in life-threatening situations, it also is available for people with less urgent mental health care needs, helping people who suffer from panic attacks, symptoms of anxiety, depression and thought disorders. COPES works with TPD to help get those individuals to facilities that may help them with their symptoms, if need be. If officer response time to these individuals is increased, as I predict it will be under TPD’s new system, those individuals with lower-level mental health issues may not get the immediate assistance they need to keep their symptoms from reaching more life-threatening levels.
TPD’s primary objective is to keep Tulsa citizens safe, and that includes people suffering from mental illness. With this new transportation program, I believe TPD may be doing Tulsa’s mental health care system a disservice, and consequently, harming our city’s population that suffers from mental health problems.