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Method for individuals in mental health crisis a 'weakness in our system'

Davison County Jail Administrator Don Radel stands outside one of the jail cells individuals use when placed on a mental health hold. Often times an anti-suicide vest will be placed on the individual to ensure his or her safety. (Libby Leyden/Republic)

While progress is being made in behavioral health programs in South Dakota, "mental health holds" are a flaw in the system, according to officials.

Mental health holds refer to a night in a jail holding cell, and is often the safest option for individuals in a mental health crisis.

"It is not a desirable placement," said Assistant Vice President of Avera McKennan Hospital Steve Lindquist. "It is one fallback, kind-of placement option that nobody wants to use."

For the first 10 months of 2017, 91 individuals have been placed in Davison County Jail on a mental health hold, according to Jail Administrator Don Radel.

South Dakota is one of five states with laws allowing for correctional facilities to be used for mental health holds. When law enforcement receive a call about a person who is either suicidal, attempting physical harm or some other kind of mental health crisis, a petition is written to commit this person involuntarily.

"Jail is not the best place for these people because we are not able to typically keep them away from regular inmates," Radel said.

Once the petition is written, it is sent to attorney Douglas Papendick, who sits on the mental health board in Davison County, for approval.

Individuals are then transported to the jail by law enforcement in the back of an officer's patrol car and often are handcuffed for safety purposes, according to Mitchell Police Sgt. Joel Reinesch. A mental health counselor from Dakota Counseling will then evaluate the individual and determine if he or she needs to be transferred to one of the four inpatient behavioral facilities located in Yankton, Sioux Falls, Rapid City and Aberdeen.

"This is a weakness in our system," said Matthew Christiansen, a Mitchell psychologist at Avera Medical Group Family Medicine. Christiansen explained there can be long waits at outpatient clinics and waitlists at inpatient treatment centers.

Avera Health medical hospitals and primary care outpatient providers implement screening processes for patients to ask about mental health and depression issues. But for people in crisis who do not seek assistance voluntarily, mental health holds is the current method in place to assist with getting to eventual long-term treatment.

Radel said mental health holds typically last between 24 to 48 hours, but can depend on when a bed is available at an inpatient facility. The holding cells are similar to an inmate cell, with one twin-sized mattress and one toilet.

If necessary, individuals on mental health holds will be given an anti-suicide vest or blanket made of materials that can not be used for self-harm, Radel said. While on a mental health hold, jail staff will monitor the individual's actions and physically restrain them if necessary.

"I always would say if I won the lottery, I was going to build a better facility to better deal with these kind of situations," Reinesch said. "Sometimes it breaks your heart when a person is having a mental health issue and trying to get them help you take them to jail."