COTTAGE GROVE SENTINEL February 11, 2015
9A
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Continued from page 1A
tional state. A few years ago,
hospital staff recognized the
need for a place to care for those
who came to the Emergency
Room in a state of mental cri-
sis, and the room fi nds use with
“reasonable frequency,” accord-
ing to Dr. Paul Kranitz, director
of the emergency department
here and a key component of
a coordinated effort toward
greater mental health in Cottage
Grove.
I
t’s an effort that takes the
work of many to deal with
issues that vary with each indi-
vidual, and the safe room often
brings the agencies that typi-
cally respond to mental health
crises in the community — the
emergency department, emer-
gency responders, counselors
with South Lane Mental Health
and the offi cers of the Cottage
Grove Police Department —
into physical proximity to each
other.
Mental health issues can be
as varied as the population they
affect, and treatment of those
issues can also vary widely. As
such, not all of the patients who
fi nd themselves in the hospital’s
safe room are aware of the situa-
tion that has brought them there,
but Kranitz said many do in fact
recognize their illness. The ER
sees between zero and a half-
dozen such cases each week, he
said.
“We see patients in crisis,
and a lot of them recognize that
they’re not well,” he said. “Peo-
ple often walk themselves in,
and they’re often accompanied
by members of their family.”
At the hospital, the problems
a patient is having manifest
themselves in many ways.
“Patients can be thinking
about hurting themselves or
others,” Kranitz said. “They can
be hearing voices, can be sad or
anxious. There are myriad pre-
sentations, and they’re unique
to each patient. But most want
to be taken care of, to have their
mental health improved, and
they’re often very appreciative
when that happens.”
Here in the Emergency Room,
Kranitz and staff are trained to
deal with crises involving the
human body, and mental health
issues are approached from the
same angle.
“We’re talking about an organ
of the human body, the brain,”
he said. “It’s no different than
a patient who has had a heart
attack that you would put on a
heart monitor.”
With most external stimuli
and dangerous instruments re-
moved, the safe room fosters
safer conditions for the patient,
Kranitz said, but also for the
staff members that care for him
or her. Treatments administered
in the ER can range from simple
conversations to medications to
counseling; some patients will
be admitted to the hospital, and
some will require a longer pe-
riod of treatment in a facility to
return to more normal function.
S
ometimes, events lead-
ing up to such an Emer-
gency Room visit have brought
an individual into contact with
local law enforcement, though
Kranitz said it certainly doesn’t
happen in the majority of cas-
es. Still, Commander Scott
Shepherd said that the Cottage
Grove Police Department has
witnessed more mental health
crises recently, and the log of
activities for the Cottage Grove
Police Department typically
includes several responses to
mental health issues each week.
“We’ve seen more people in
crisis in the last six months or
so,” Shepherd said. “Whether
it’s because of illness or lack
of treatment or choices an indi-
vidual will make to self-medi-
cate, we’re called to respond to
behavior that draws attention
— disorderly conduct, property
crimes, crimes against people.
It just seems more prevalent re-
cently.”
Shepherd said the Police De-
partment is set up to hold peo-
ple accountable for crimes they
may have committed, but in sit-
uations involving mental health
crises, police frequently de-
pend on staff at the Emergency
Room and counselors at South
Lane Mental Health — the local
nonprofi t dedicated to helping
residents of South Lane County
understand their mental and
emotional issues and take steps
toward improving their con-
dition — to consider the next
steps.
“If their actions are disor-
derly or they become fi xated
on something or someone, their
behavior can often be consid-
ered criminal,” Shepherd said.
“Part of our responsibility is to
try and make sure if someone in
crisis needs evaluation and try
to make it happen. We can hold
people accountable to a certain
degree, but we also depend on
South Lane Mental Health and
the ER for medical interven-
tions.”
Many treatments for mental
health crises in Cottage Grove
involve coordination between
staff at the ER and counselors
at South Lane Mental Health,
which treats about 1500 people
per year through counseling,
prescribing medications and
other interventions, according
In addition to counseling
from 33 therapists on its staff,
South Lane Mental Health visits
several patients in their homes
twice a day, every day, Main-
wald said, and the agency has
intensive programs for about 25
high-risk youth in the commu-
nity. It also operates housing for
about 20 people.
T
he approach is markedly
different from attitudes
about mental health that have
held sway in the past, according
to Mainwald and SLMH Execu-
tive Director Tom Wheeler.
“The philosophy has changed
to one of helping folks do their
best in their own communities,”
Wheeler said. “Twenty years
ago, the state spent 80 percent
of its mental health budget on
the 2000 or so patients in the
state hospital, but people started
to realize that wasn’t the way to
“The philosophy has changed to one
of helping folks do their best in their
own communities. Twenty years ago,
the state spent 80 percent of its mental
health budget on the 2000 or so
patients in the state hospital, but people
started to realize that wasn’t the way
to go. Approaching it as a community
health issue is more dignifi ed.”
— South Lane Mental Health
Executive Director Tom Wheeler
to Director of Services Valeria
Mainwald.
Still, dealing with patients in
crisis is not the most common
form of help SLMH offers its
patients, most of whom, accord-
ing to Mainwald, simply require
a little help to go about their
daily lives.
“It’s community-based, old-
school social work,” she said,
“anything from helping with
housing to trips to the doctor’s
offi ce to the Oregon Health Plan
— often, it’s routine, day-to-day
things that people with severe
mental or emotional problems
have a hard time pulling off.”
go. Approaching it as a commu-
nity health issue is more digni-
fi ed.”
Each of the agencies that re-
spond to mental health crises lo-
cally applauds the efforts of the
others, though certain drawbacks
accompany a more intensive
community emphasis, Wheeler
and Mainwald explained, many
of which are encountered after
the crisis.
“The acuity of the need has
increased,” Mainwald said.
“People are focused on the re-
model of the Johnson Unit, but
it hasn’t increased the availabil-
ity of beds for those who require
housing, and the population is
growing. There’s a new facil-
ity being built in Junction City,
but the state is closing as many
beds in Salem as they’re open-
ing there. Even if a patient is
suicidal, we might spend hours
looking for a place for them.”
In addition, the basic tenets
of a free society make seeking
out treatment for mental health
issues a voluntary act.
“Unless a person is immedi-
ately dangerous, they can re-
fuse treatment,” Mainwald said.
“That’s where the connection
between us and the other agen-
cies really helps people reen-
gage and helps us all share our
concerns.”
“The trouble is often that
certain people have issues, and
they seek treatment,” CGPD’s
Shepherd said. “They are treat-
ed, then they feel like they’re
fi ne and stop treatment, and the
behaviors come back.”
Increased demand for medi-
cal services brought on by the
Affordable Care Act has also
greatly increased activity in Cot-
tage Grove’s Emergency Room
and demand for services at
South Lane Mental Health, and
treatment isn’t always sought
(and isn’t available in Cottage
Grove) for the substance abuse
issues believed to accompany
about half the mental health cri-
ses locally.
But perhaps the biggest hur-
dle to treating mental health is-
sues is an unseen one.
“There’s a stigma to seeking
treatment for mental health is-
sues, but it’s totally fabricated,”
Kranitz said. “We’re talking
about treating a disease or dis-
eases, and there’s no shame in
that.”
“Most people don’t want to
seek out treatment,” Mainwald
said. “There’s a stigma involved,
it’s hard work and there’s a cost
involved. Life is more stress-
ful these days, and we’re more
visible to each other in a small
town.”
Still, help is available in Cot-
tage Grove for those who seek
it.
“We can’t reel them in, but
when they’re ready, we’re here,”
Wheeler said.
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