Imagine sitting for days in the emergency room or for weeks in jail, in need of treatment, but without any options available. People with severe and persistent mental health and/or substance use issues need treatment and we aren’t providing it. This is not an anomaly, either. It is the new normal.

Each and every day, providers, law enforcement officers and I have to tell families in this state that they have to hang on and wait until something happens because there are no available psychiatric beds at any of the mental health hospitals across the state. We are in desperate need of long-term mental health, substance use and trauma integrated care with levels of stabilization that allow for sustainable successful recovery for those who most desperately deserve it. It is time that we share the truth about our broken system so that we can come together with those who can help us change it.

I’ve worked at the Portland Police Department for 11 years, first as the mental health police liaison through Opportunity Alliance, and now as the embedded behavioral health coordinator. We’ve made a commitment to following national best practices for responding to mental and behavioral health issues. We’ve also maintained a commitment to crisis intervention training. This means all of our officers receive 40 hours of mental health, substance use, trauma and resource training courses.

Every day, when all else fails, the final answer for too many people is to call the police. Our officers utilize their training to de-escalate situations and divert people with mental health issues from jail as often as possible. But far too often they are left with impossible situations where jail and emergency rooms are the only option. And even then, those are not real solutions, since too many leave as sick as they went in because of the lack of appropriate treatment options.

Despite our commitment to creating the most effective and efficient responses to those in crisis, and exhausting all means to collaborate with our community to assist those in crisis, the limitations of the mental health and substance use systems continue to stymie us. Currently, state laws force the system to be reactive, waiting until one who is resistant to treatment becomes an imminent and substantial risk to self or others before treatment options are available. This process of waiting until one becomes so sick that they are unsafe is unacceptable. People with mental and behavioral health issues and their families should not have to suffer in silence just hoping and praying that nothing horrific happens until they can receive care. Or worse, that something bad does happen so they can finally access the treatment they deserve.

We can change this. But it will take a well-funded, collaborative approach. Our system needs more effective, efficient, compassionate and cost-effective streamlined treatment options to decrease safety risks for the individual, their families, the professionals attempting to support and intervene, the responding officers and the community at large. In 2010, we were one of six agencies nationally recognized by the Department of Justice’s Bureau of Justice Assistance and Council of State Governments for our law enforcement and mental health collaboration.

Through this effort, we’ve partnered with local hospitals, inpatient and outpatient professionals and agencies, jail staff, the Cumberland County District Attorney’s Office and various other partners. Over the next year, we plan to reconvene our partners and identify in detail the areas in need of change, while identifying and creating funding opportunities to support these changes. This process will require the support of all in the community and state, not just those directly affected personally or professionally. Ultimately, we know our community needs more psychiatric bed availability and accessibility to allow for more appropriate levels of treatment and lengths of stays. Nationally proven diversion centers that act as a one-stop shop provide crisis relief with a safe, lower level of care than the emergency room and have been shown to be more cost-effective, with better outcomes for clients. We must create paths to proactively provide treatment, especially to those who may be resistant because of the effects of symptoms of severe and persistent mental illness.

Unfortunately, those who are uninsured have even more limitations, and we have lost funding opportunities by not expanding Medicaid. Our clients need us all to fight for their rights to all aspects of treatment. People are dying every day — and officers, families and the community at large are more at risk each day we don’t fix the system.

Jo Freedman is behavioral health coordinator for the Portland Police Department.

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