24-hour crisis center designed to divert people from jail, hospitals

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by Jordan Green

Forsyth County officials are working on a plan to divert people with mental health and substance abuse challenges from the local jail. A new 24-hour crisis center to be operated by the regional mental health authority could provide an alternative to help offenders get treatment.

A new, 24-hour crisis center expected to open in Winston-Salem next January could divert people experiencing mental health and substance abuse challenges from the Forsyth County jail and local emergency departments.

The Highland Avenue Crisis and Recovery Center, a 43,000-square-foot building under construction across the street from the Behavioral Health Plaza, will include round-the-clock urgent care and evaluation, a 16-bed facility for up to seven days, a primary-care clinic jointly operated by Baptist Hospital and Novant Health, and a wellness center. The crisis center will be operated by CenterPoint Human Services, the regional mental health authority, on property leased by Forsyth County.

“This is an outpatient facility allowing folks to stay up to 23 hours,” said Dr. Chad Stephens, the medical director at CenterPoint. “They can be triaged if they run out of medication. Once they’re stabilized and back on their medication, if they have safety issues, for instance if someone comes in suicidal and needs to be transported to a hospital under an involuntary order, they can do that. I’m really excited about that. It can be more of a recovery setting.”

Forsyth County officials have expressed hope that the crisis center could divert people with mental health and substance abuse challenges from the jail, in addition to local emergency departments.

“Let’s get people help and keep them out of the jail,” said Don Martin, vice-chair of the Forsyth County Commission. “It reduces the jail population. It’s less expensive and it gets people the help they need, so from my perspective that’s a win-win-win.”

The county commission approved a resolution in April to support an initiative to reduce the number of people with mental illnesses in the jail and to study ways to minimize the contact that people with mental illness and co-occurring substance use disorders have with the justice system, while helping them get treatment.

The resolution states that “county jails spend two to three times more on adults with mental illnesses that require interventions compared to those without these treatment needs” and that “without the appropriate treatment and services, people with mental illnesses continue to cycle through the criminal justice system, often resulting in tragic outcomes for these individuals and their families.”

Commissioner Gloria Whisenhunt brought the initiative to Forsyth County through her involvement with the National Association of Counties, which sponsored the Stepping Up Initiative. Forsyth County allocated $50,000 to hire a contractor to help implement the initiative. Doris Paez, a psychologist and statistician, came on with the county in November to fill the part-time position.

Paez is heading up an effort with a consortium of law enforcement, court and mental-health professionals to identify what types of people are going through the jail, what resources are in place to help them and how the system could be tweaked to divert more people into treatment. The consortium will be looking at five potential intercepts for diverting people from jail: first responders, initial detention, long-term detention, the courts and release.

Paez hosted an orientation for first-responder agencies, including the Winston-Salem Police Department and Forsyth County Sheriff’s Office, on Jan. 15. She said some law-enforcement officers have already received a Crisis Intervention Team certification through CenterPoint to identify potential offenders who could benefit from mental health services and substance abuse treatment.

“Often times, that’s the problem — that’s the reason why these folks end up in a jail: There’s nowhere else to take them except emergency rooms,” Whisenhunt said. “They’re released. It might be something as simple as sleeping on a park bench. Then they’re arrested and taken to jail. We’re hopeful it will help that population.”

Whether diversion would be available to people with pending criminal charges remains unclear. Reporting by Triad City Beat brought to light the tragic case of Jen McCormack, a 31-year-old pregnant woman who was booked in the Forsyth County jail on multiple felony charges of prescription drug fraud committed to support her addiction to hydrocodone. McCormack experienced a heart attack after two weeks in jail and later died at Baptist Hospital.

“You would bypass the jail and go right into court and be arraigned, and after that you would be staying at home,” Commissioner Martin said. “If she were taken to the Highland Avenue facility, then you haven’t been booked and you haven’t entered the criminal process. Any criminal activity issue is deferred until that whole process is adjudicated. If you fail to show up, then you would be taken into custody.”

But Dr. Stephens, the medical director at CenterPoint, cautioned against the expectation that diversion would necessarily be available to someone who has already been criminally charged.

“Once they’re in police custody, I’m not sure how much latitude the police have at that time,” he said. “One of the questions we are still working on is, what if someone’s picked up for possession?

“If someone has been charged but they don’t have to go to jail at that time, this would be a fantastic opportunity to be hooked up with services,” he added.

An ad-hoc committee comprised of Paez, Assistant County Manager Ronda Tatum, Commissioner Whisenhunt, Chief Deputy Sheriff Brad Stanley, Chief District Judge Lisa Menefee, Judge Camille Banks-Payne and Amber Humble of CenterPoint has been meeting from time to time to iron out details.

“We’re at the very early stages of these conversations,” Paez said. “What do we know about these populations? What are the mental health issues? What kind of offenders are we talking about? Trespassing or felonies?”