13.3.pdf

ST. JOHNS COUNTY SHERIFF’S OFFICE ROBERT A. HARDWICK, SHERIFF Mental Illness and Social Services Diversion Effective Date: 06/30/2006 Policy 13.3 Amended Date: 11/04/2022 Reviewed Date: 05/10/2023 ACCREDITATION STANDARDS CALEA: 1.1.3, 41.2.7, 70.2.1, 70.3.1, 70.3.2 CFA: FCAC: FLA-TAC: FMJS: Discussi...

ST. JOHNS COUNTY SHERIFF’S OFFICE ROBERT A. HARDWICK, SHERIFF Mental Illness and Social Services Diversion Effective Date: 06/30/2006 Policy 13.3 Amended Date: 11/04/2022 Reviewed Date: 05/10/2023 ACCREDITATION STANDARDS CALEA: 1.1.3, 41.2.7, 70.2.1, 70.3.1, 70.3.2 CFA: FCAC: FLA-TAC: FMJS: Discussion: In the course of their duties, deputies often encounter people in need of assistance best provided by a social service agency. This policy provides the guidelines to use when dealing with subjects who have committed no criminal offense, but action needs to be taken due to alcohol or drug abuse or to mental health conditions. [1.1.3] [41.2.7] DEFINITIONS [41.2.7, a] Baker Act (Mental Health) Involuntary Admissions: [41.2.7, a, c]  A person may be taken to a receiving facility for involuntary examination if there is reason to believe they are mentally ill, they have refused treatment or is unable to determine for themselves if treatment is necessary, and because of their mental illness:  Without proper care or treatment, they are likely to suffer from neglect or refuse to care for themselves.  Such neglect or refusal poses a threat of substantial harm to their well-being and that harm may not be avoided through help of family members or friends.  Without care or treatment, they will cause serious bodily harm to themselves or others in the near future, as evidenced by recent behavior. Mental Illness - Mental illness is defined in F.S. 394.455. A range of commonly encountered mental health conditions, each with its own specific characteristics, include but are not limited to:  Schizophrenia  Bipolar disorder (manic depression)  Major depression  Schizo-effective disorder  Panic disorder  Obsessive-compulsive personality disorder  Borderline personality disorder  Anxiety disorders and phobias Voluntary Admissions:  Any person showing evidence of mental illness who is suitable for treatment and provides informed consent for admission.  Release may be requested at any time by voluntary patient, guardian, or attorney. Mental Illness and Social Services Diversion 13.3 Page 1 of 8 GENERAL.1 The American with Disabilities Act (ADA) entitles people with mental illnesses or disabilities to the same services and protection law enforcement agencies make available to others. They may not be excluded or otherwise provided with lesser services or protection than is provided to others. [41.2.7, a, b].2 F.S. 394 Florida Mental Health Act addresses the taking of a person into protective custody under the Baker Act. This is not considered an arrest. [41.2.7, a].3 Any mental health record received by a law enforcement agency or correctional agency shall be treated as a non-public record..4 Mental illnesses are the result of physical abnormalities in the brain which can cause extreme disturbances in thinking, feeling, and relating to others or the environment. These symptoms can cause those affected great anxiety, an inability to correctly assess the world around them, and extreme fear, often thinking people intend to harm them. [41.2.7, a].5 Medical conditions such as epilepsy, developmental disability, Alzheimer’s disease, hearing impairment, and diabetes may cause confusion and disorientation in an individual. These conditions are not considered mental illnesses. [41.2.7, a] DEALING WITH PERSONS SUSPECTED OF SUFFERING FROM MENTAL ILLNESS [41.2.7, a, c].6 Deputies should obtain as much personal data from the subject, family members or others present as possible, such as:  If the person will voluntarily submit to an evaluation  Whether the person is violent  If the person needs medical attention  Name of next of kin  Name of doctor currently treating person  Current medications.7 Deputies should:  Secure the scene while maintaining a high level of officer safety  Verify subject is not wanted  Stay calm and don’t overreact. Be helpful and professional.  Indicate you are trying to understand and help  Speak simply and briefly and move slowly  Remove distractions, upsetting influences, and disruptive people from the scene.  Understand you may not have a rational discussion  Recognize the person may be overwhelmed by sensations, thoughts, frightening beliefs, sounds, hallucinations, or even the environment  Be aware your appearance may frighten the person  Reassure the person you do not intend to harm them  Recognize and acknowledge the person’s delusional or hallucinatory experience is real to them  Announce your actions before initiating them  Avoid direct, continuous eye contact  If possible, avoid touching the person Mental Illness and Social Services Diversion 13.3 Page 2 of 8.8 Deputies should not:  Move suddenly, give orders rapidly, or shout.  Force a discussion  Crowd the person or move into their “buffer zone” of comfort.  Express anger, impatience, or irritation  Assume a person who does not respond cannot hear. Mental illness does not cause deafness  Use inflammatory language, such as “wacko” “psycho” or “loony.”  Argue with delusional or hallucinatory statements, or mislead the person to think you feel or think the same way BAKER ACT [41.2.7, b] Processes which Initiate Involuntary Examination.9 If a person meets the criteria for involuntary examination, the process may be initiated by any one of the following means:  A court may enter an exparte order stating a person appears to meet the criteria for involuntary examination and directing the deputy to take the person into custody and deliver them to a treatment facility.  A physician, clinical psychologist, psychiatric nurse, mental health counselor, marriage and family therapist or clinical social worker may execute a certificate stating they have examined a person within the preceding forty-eight (48) hours and finds the person appears to meet the criteria for involuntary examination and stating the observations upon which conclusion is based. The deputy shall take the person named in the certificate to the appropriate receiving facility for involuntary examination. Transportation notes shall be documented in the assigned CAD call.  A deputy may take a person who appears to meet the criteria into custody and execute a written report (BA-52) detailing the circumstances under which the person was taken into custody and the report shall be made a part of the patient’s clinical record..10 Once the decision to Baker Act has been made the person must be taken to either:  A Baker Act Receiving Facility  If medical clearance / evaluation or treatment is needed, to the closest hospital for medical clearance..11 The following include, but are not limited to, cases that may need medical clearance / evaluation or treatment:  Overdoses  Bodily Trauma  Self-injury (cut wrist, etc.)  Acute medical problems  Extremely agitated person at risk of harming themselves or others while enroute to a Baker Act facility  Others as determined  Physicians at the ER may exercise the clinical decision of relieving a person from a Baker Act Mental Illness and Social Services Diversion 13.3 Page 3 of 8.12 Florida law requires a person held under the Baker Act be taken to the nearest receiving facility. Flagler Hospital is the only approved adult Baker Act receiving facility in St Johns County. River Point Behavioral Health, Jacksonville, and Halifax Health Center, Daytona, are approved juvenile Baker Act receiving facilities..13 Under no circumstances shall a wanted person be transported to the hospital or receiving facility, unless medical clearance is required.  Any and all persons transported to any receiving facility must be checked through FCIC / NCIC to see if they are wanted.  If they are wanted, or are under arrest for a criminal act, and after medical clearance has been obtained they shall be transported to the Detention Center, if necessary. Juvenile Procedures.14 The Mental Health Crisis Team (MCT) is available during and after normal business hours to evaluate juveniles who may meet baker act criteria. The MCT can be contacted via Communications..15 If a juvenile is in need of medical clearance, they are to be taken to the nearest emergency room where they will be cleared prior to being transported to the receiving facility as determined by their staff..16 In the event the patient is violent, the admitting deputy will remain with the patient until the situation is under control..17 Note: Transportation form is needed if Rescue transports for the agency due to medical emergency. Reporting Procedure: [41.2.7, b].18 All BA-52 forms will be left at the Receiving Facility. Do not make a copy. Records will no longer accept or retain BA-52 forms or any other medical paperwork..19 The call will be coded out B-Bravo 2011 Baker Act, an Offense number will be stamped, included in the narrative should be, the circumstances supporting the decision to complete a Baker Act and the receiving facility in which the subject was transported..20 If a report is turned in, do not attach or forward a copy of the BA-52 form or any other medical paperwork. Mental Illness and Social Services Diversion 13.3 Page 4 of 8 WHEN TO ARREST AND TRANSPORT TO THE DETENTION CENTER OR NOT ARREST AND TRANSPORT TO A TREATMENT FACILITY.21 When any law enforcement officer has custody of a person based on either noncriminal or minor criminal behavior that meets the statutory guidelines for involuntary examination under this part, the law enforcement officer shall transport the person to the nearest receiving facility for examination..22 When any law enforcement officer has arrested a person for a felony and it appears the person meets the statutory guidelines for involuntary examination or placement under this part, such person shall first be processed in the same manner as any other criminal suspect. The law enforcement agency shall thereafter immediately notify the nearest public receiving facility, which shall be responsible for promptly arranging for the examination and treatment of the person. A receiving facility is not required to admit a person charged with a crime for which the facility determines and documents that it is unable to provide adequate security, but shall provide mental health examination and treatment to the person where they are held. For further information, see FS 394.462. TRANSPORTATION [41.2.7, c] [70.2.1] [70.3.1] [70.3.2] Law Enforcement Responsibility.23 Law enforcement is responsible to transport involuntary admissions to the nearest receiving facility but may decline to transport to a receiving facility if the law enforcement deputy believes the person has an emergency medical condition. If such condition is present, the individual should be taken to the nearest hospital regardless of whether it is a receiving facility or not. Once the person is delivered to the hospital for emergency medical treatment and placed in the hospital’s care, the law enforcement deputy’s responsibility is over..24 Law enforcement has no responsibility to transport for voluntary admission to a mental health facility. The transportation of a person for a voluntary admission is at the discretion of the deputy..25 When transporting a mentally ill person, the selection of restraints and mode of transportation will be governed by the degree of violence exhibited by the individual. Keep in mind, a mentally ill person can become violent without provocation..26 The deputy shall search the person for weapons or other contraband..27 For the protection of the deputy and patient, the subject will be restrained in the vehicle..28 The deputy should use the least restrictive mode of transportation and restraints available and strive to maintain the individual’s personal dignity..29 In no case will an individual who is in custody under the provisions of the Baker Act be transported with a criminal suspect..30 If the subject is violent, consideration should be given to transporting via ambulance..31 See also policies 71.1 Transportation by Law Enforcement, 71.2 Transportation of Inmates, 74.2 Service of Civil Process. Mental Illness and Social Services Diversion 13.3 Page 5 of 8 MENTALLY ILL PERSONS REQUIRING EMERGENCY OR IMMEDIATE MEDICAL TREATMENT [70.3.1].32 An ambulance will be requested to access mentally ill persons in need of emergency or immediate medical treatment. PROTECTIVE CUSTODY (PC) [41.2.7, c] Protective Custody (Alcohol Related).33 If the subject has committed no criminal offense, and the subject is incapacitated and refuses treatment:  The subject may be detained and forcibly taken to a treatment center for their protection (unreasonable force may not be used).  The subject may be held in the County Detention Center (space available) for up to seventy-two (72) hours. Protective Custody Juvenile.34 Juvenile Baker Act receiving facilities and DJJ will not take a juvenile for Protective Custody. The responding deputy should attempt to contact the parent or guardian. The detention facility may take a juvenile for up to six (6) hours if parent or guardian cannot be located. Intoxicated without Injury.35 Upon arrival at the Detention Center, the subject must be cleared by medical personnel.  If necessary, based upon medical assessment, the subject will be transported to the emergency room by a deputy.  Note: If the subject has not been turned over to the Detention Center, the Patrol deputy will transport. If the subject has been turned over to Detention Center, a Corrections deputy will transport.  A deputy will remain with the subject until the subject has been cleared by Emergency Medical Personnel for transport to the Detention Center under the Protective Custody.  In the event the attending physician declines to sign the appropriate forms, it will be the deputy’s responsibility to submit an affidavit describing the circumstances.  Once the person is returned and accepted, processing will take place in accordance with the normal procedures appropriate to the individual’s circumstances..36 The detaining officer will fill out the Substance Abuse Referral Request (SJSO-490) and turn in to the Detention Center. Mental Illness and Social Services Diversion 13.3 Page 6 of 8 Intoxication with Injuries.37 If minor injuries, then the procedures outlined in Intoxication without injury will apply..38 If the injuries are of a serious nature, the Emergency Medical Physician will make the determination to either admit to the hospital or treat and release. [41.2.7, c].39 The hospital rules and regulations concerning such admissions will prevail..40 Corrections personnel will ensure the detaining deputy has appropriately completed the Substance Abuse Referral Request (SJSO-490). Corrections contracted medical personnel will review the subject after admittance..41 All contacts made must be documented on the referral form(s)..42 On a daily basis, the onsite contracted medical provider for the St. Johns County Detention Center will do an assessment on any protective custody subject(s) to determine the release or inpatient / outpatient treatment. DIVERSION PROGRAMS [41.2.7].43 The agency participates in diversion programs through the following agencies:  Department of Juvenile Justice (DJJ)  Local County Criminal Justice Affiliations  State Attorney’s Office  State Department of Corrections, Probation and Parole.44 Diversion programs include, but are not limited to the following:  Check Diversion Program  Churches  County Welfare Agencies  Juvenile Civil Citation Program  Pre-Trial Intervention  Salvation Army  Victim / Witness Programs.45 Agency employees involved in cases in which defendants are considered for diversion should help make recommendations. Such help may include, but not be limited to, furnishing background information and offering opinions on the defendant’s suitability for diversion. Mental Illness and Social Services Diversion 13.3 Page 7 of 8 TRAINING.46 Training for mental health issues shall be conducted in a formal training program to entry level Communications, Law Enforcement, and Corrections employees. [41.2.7, d].47 Annual refresher training will be conducted for affected personnel. [41.2.7, e].48 Prior to refresher training, the lesson plan shall be reviewed and updated as needed. ____________________ Robert A. Hardwick Sheriff Mental Illness and Social Services Diversion 13.3 Page 8 of 8