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VALLEY — A little more than 10 years ago, the state of Alabama took a giant step backward in the treatment of the mentally ill. In February 2013, many locations of psychiatric services in the state closed and as many as 300 workers were let go. An estimated 28,000 patients were affected.

It’s widely known that when people with mental health conditions go untreated, it results in unnecessary disability which leads to a low quality of life that usually includes unemployment and often times substance abuse, homelessness, inappropriate incarceration and even suicide.

In recent years Alabama has been trying to turn around this gloomy situation, and Chambers County’s been at the forefront of this. It was one of the first counties to be in Stepping Up Alabama. The Alabama Department of Mental Health is involved in this and thus far the program has achieved some really good results. Stepping Up is being implemented statewide and is making a major impact in the lives of people it touches. What makes the program impactful is that it not only provides services on the individual level but also works on the policy and systems levels to create continuing care for those with mental illness that can keep them out of jail.

Two county officials discussed what’s being done with this in last week’s meetings of two local civic clubs. Commissioner Debra Riley talked about it at a meeting of the Valley Lions Club and Probate Judge Paul Story discussed it at the Valley Lions Club.

The Stepping Up initiative us a national program with the goal of reducing the number of individuals in jail who are mentally ill. The Stepping Up program is managed on the county level to establish effective partnerships across individuals in law enforcement, local government, elected officials, mental health and healthcare providers, courts and any others needed to meet the goal.

Riley said that jail should not be the only option for someone who is suffering with mental illness. She said that most people who are there because of this can be victimized in one way or another, further worsening their plight.

Riley is part of a leadership group with the Association of County Commissioners of Alabama (ACCA) that is addressing this issue. They are working with State Mental Health Officer Kim Boswell on this. “The state’s probate judges are leading the charge on this,” she said. “They don’t like telling families there’s nothing they can do but put their family member in jail.”

Riley said the Alabama Senate recently took a major step forward with the approval of Senate Bill 240 on May 6th. If approved by the House and signed into law by Governor Kay Ivey, this legislation would provide other avenues than jail time for those who are experiencing mental illness. It would expand involuntary commitment to a mental health facility instead.

“Mental health hospitals are hopeful it will pass,” Riley said.

There’s a clear need for more mental health hospitals in Alabama. The Bryce Hospital in Tuscaloosa has served the state since 1861 and has served well. It can’t do what needs to be done by itself. “At least half of the people who need help aren’t getting it,” Riley said. “We need both short-term beds and long-term beds. It may take years to do this. You have to build a facility and staff it.”

Fortunately for those who live in the east-central Alabama region, the East Alabama Medical Center in Opelika is planning to open a psychiatric hospital on its main campus in Opelika.

While Alabama is stepping up in terms of getting the mentally ill into proper treatment, there’s also a need to step up in terms of paying mental health counselors and doctors the professional-level wages they have earned. “Mental health workers don’t make much,” Riley said. “A large percentage of them who are trained leave the state for better pay in other states. It won’t matter if we build the hospitals if we don’t pay the salaries to keep the people we need. Those who are trained in psychiatry and social work need to be paid higher wages to keep them here.”

Riley is proud that Chambers County was in the pilot group of Alabama counties to get the Stepping Up program under way. It started a couple of years ago with results being so good that more and more counties have come aboard. “All but seven are in the program right now,” she said.

Some major strides have been made in tracking and monitoring mental health patients. Law enforcement officers are among the first people to come into contact with someone having a mental health issue. They are now being trained to know the difference between a criminal act by a sane person and someone experiencing something related to mental health. A new system is being implemented to deal with this. A normal emergency is a 911 call. If there’s a mental health issue involved, a person trained in dealing with this can be contacted by dialing 988.

There are now six crisis centers in Alabama, with one of them being in the east-central region.

“We have been making progress with mental health, but we are not yet where we need to be,” Riley said. “There are still some things that need to be changed.”

Paul Story told members of the Kiwanis Club that it’s the responsibility of Alabama’s probate judges to provide mental health care for those who are 19 years of age and older. It’s the responsibility of juvenile court for those who are younger than 19. Story said that one of the more difficult duties of a probate judge is to handle involuntary commitment proceedings. Under state law, a family member can present a petition for the commitment of a fellow family member based on their having mental problems. In addition to the probate judge, East Alabama Mental Health can do this as well.

There’s a seven-day window for them to receive treatment. A hearing will then take place to determine what needs to be done for their well being. They can either be admitted to a mental facility, provided bed space is available, or released as an outpatient. In many cases, someone is having mental issues because they have gotten off their medication. Once they are back on it they can live in a home environment if a family member will keep them.

In some situations, though, no one will do that.

Story explained that some programs, such as Stepping Up, can be implemented at the jail. An individual with a mental problem can be treated after they are admitted. Their medications can be properly administered while they are there. “We contract with East Alabama Mental Health,” Story said. “Heath Care South provides the medications.”

Story added that local law enforcement officers have received crisis intervention training. “This is a wonderful thing,” he said. “It can allow for peaceful interventions.”

Crisis Intervention Training, commonly known as CIT, is often called the Memphis Model. It was developed there in 1988 and has since spread throughout the U.S. and in several foreign countries. The CIT program is a community partnership of law enforcement, mental health and addiction professionals, individuals who live with mental illness and/or addiction disorders, their families and other partners to improve community responses to mental health-related crises.

The Chambers County Sheriff’s Office and police departments in Valley, Lanett and LaFayette have two officers with CIT training on each shift.

“We work diligently to keep people out of jail. That’s not where they belong,” Story said of people with mental problems, “but there’s at least two people per week who wind up there because we don’t have the bed space for them. We need to keep dealing with this.”

Story said there’s usually several petitions each week from families seeking placement for someone with a mental problem. In many cases this would have been preventable had they stayed on their medication. In some cases, individuals don’t have the resources to get the medicine they need and self medicate with what they can find on the street. This usually worsens the original problem.

“We are not where we need to be in dealing with this problem,” Story said. “It’s something we need to keep working on.”