When a dispatcher receives a call of a person in crisis, it’s not always clear exactly what’s going on, but the incident usually falls into one of three categories: disturbance, mental, or suicidal subject.

In the past year, Hermiston has seen a spike for some of those types of calls. Hermiston Police Chief Jason Edmiston said from 2017 to 2018, calls for suicidal subjects have increased 36 percent, going from 90 in 2017 to 122 in 2018. Mental health calls decreased slightly, and disturbance calls saw a minor increase as well.

Pendleton’s numbers were static, with 122 suicidal subject calls in 2017, and 121 in 2018.

The number of suicidal subject calls doesn’t translate directly to the number of people that attempt or complete suicide.

“It is important to note that the numbers provided are reflective of how the dispatcher/call taker entered the call for service or activity at the time of the report,” Pendleton Police Chief Stuart Roberts wrote in an email to the Herald. “In most instances, the subject(s) of such calls are in some stage of crisis; however, there are a fraction of said calls that are the result of someone else’s perception as well (i.e. I believe my friend may be suicidal due to a social media posting...).”

Edmiston said it’s hard to pin down what’s caused the increase in Hermiston.

“It’s concerning, and interesting,” he said. “Back in 2008, as the economy was tanking, we expected an increase in domestics, and we did see some of that.”

But now, he said, he doesn’t see the same reason for a spike in mental health calls.

“If unemployment is low as it’s reported to be, the only thing I can point my finger to is substance abuse,” he said.

He said those numbers don’t tell the whole story, nor do they encompass the entirety of mental health calls the department receives.

“If it comes in as a disturbance, we don’t track it as a mental call,” he said. “But a lot of disturbances could be mental health-related as well.”

Agency responses

In Umatilla County, helping people in crisis requires a multi-agency approach. The first responders are usually law enforcement and Umatilla County Fire District paramedics. When law enforcement authorities receive a call for a disturbance or a mental health subject, they may be able to de-escalate it themselves, either by separating parties or talking to the person until they’ve calmed down. If they begin making statements or behave in a way that could harm themselves or others, responders will call Lifeways, the mental health authority in Umatilla County.

“It’s not punitive,” said Hermiston Police Capt. Travis Eynon. “Sometimes it’s for their own safety.”

Just last week, he said, they received reports of a woman dancing in the middle of Southwest 11th Street, who refused mental health assistance.

“It’s not illegal to suffer from a mental illness,” he said. But because she was putting herself and others in danger, he said, they arrested her and released her soon after.

Operations Chief Jim Forquer said there are two primary ways the Umatilla County Fire District is involved in mental health conversations in Umatilla County.

“Probably the most critical are the 911 calls,” he said. “Those time-critical, life-safety issues, and there’s usually a dual response from EMS and law enforcement.”

He said he’s seen a direct connection between those crisis calls and substance abuse.

But the Fire District also runs the Community Paramedic program, which provides preventive care and screenings to people to prevent unnecessary or return visits to the hospital. Forquer said that program has expanded to include mental health resources.

The Community Paramedic program provides screenings for various health issues, including substance abuse and alcohol screenings, and helps connect people to the appropriate health or mental health resources.

“Some folks, because of mental health or substance abuse issues, part of their care cycle is calling 911, getting transported — and in some cases that may not be necessary,” Forquer said. “This kind of loops the program back to the preventative side.”

Mental health services

Law enforcement often calls Lifeways to assist with a mental health issue or suicidal subject. But last January, several agencies were concerned about the lack of response or delayed response time from Lifeways, prompting a review and revision of their operations, which included hiring an outside consultant to help them make changes.

Since then, Edmiston and Roberts said things have improved with the agency.

“Certainly the system is not perfect,” Eynon said. “But I think things have changed significantly for the better.”

He said overall, Lifeways’ response time to crises has decreased, and credited Lifeways’ Umatilla County Executive Director Micaela Cathey with embracing the challenge, and building connections with local law enforcement and other stakeholders.

“As communication and awareness raises around this subject, all the different agencies get better at identifying what types of calls these are,” said Liz Johnson, a public relations officer for Lifeways. “Part of that is just our ability to diagnose — our assessments are getting more refined.”

Johnson said when Lifeways crisis management staff arrive at a scene, their initial goal is to de-escalate the situation, but they also emphasize the follow-up contact with a patient.

“We’ve really tried to focus on developing our continuum of care,” she said.

Eynon said many of the issues they encounter are systemic, and outside the control of any one agency.

“Behavioral health will be a growing problem,” he said. “It’s very difficult in the state of Oregon to force someone into treatment. They have to kind of go along voluntarily until they prove to be a danger to themselves or others.”

Roberts concurred.

“Lifeways is still a work in progress ... they are better,” he wrote in an email. “That said, not all mental health service delivery challenges rest solely with Lifeways, because the State of Oregon leaves a lot to be desired when it comes to the law, and funding viable resources for rural regions.”

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