DDN Investigation: Few people pink-slipped by police are committed

Few pink slips make it to probate court supervision

Efforts by local police to “pink slip” someone in a mental health crisis because an officer believes the person is a danger to themselves or others rarely result in the person being involuntarily committed, a Dayton Daily News investigation found.

Of the 255 individuals pink-slipped in the first three months of this year by Dayton police, only nine actually had a case opened in probate court, meaning they were involuntarily committed and given a court-mandated treatment plan.

Many others walk right out the door, sometimes coming back in contact with police hours later.

“They oftentimes are back in our communities before the paperwork is done. Within two hours, three hours. We ask these questions. How can this happen?” Doug Jerome, president of the Montgomery County Association of Police Chiefs, said in May. “We don’t get a lot of answers.”

People with severe mental health issues are more likely to end up in jail, our investigation found. Nearly half of the more than 800 inmates of the Montgomery County Jail are on medication for mental illness.

“When we talk to county sheriffs across the state, they’re like, ‘We got people in our jail that really shouldn’t be there,’” said Luke Russell, executive director of the National Alliance of Mental Illness (NAMI) of Ohio.

And in some recent local examples, individuals who police and neighbors attempted to steer to mental health treatment ended up becoming a threat to the community.

Tragic outcomes

The man who shot four people at a Beavercreek Walmart on Nov. 20 purchased his weapon just two days before the shooting. Dayton Daily News reporting showed how Benjamin Charles Jones, 20, of Dayton, was able to purchase the gun after having been pink-slipped twice in 2022 for suicidal ideation.

Due to medical privacy laws, it is not clear what happened in the assessments for Jones the two times he said he was suicidal. But he never made it to the supervision provided for in probate court, according to a lack of records at local county probate courts. That could have potentially prevented Jones from purchasing his weapon, or at least provided an opportunity for additional, more intensive treatment.

Police respond to the scene of a shooting on Monday, Nov. 20, 2023 in Beavercreek, Ohio. Police say a shooter opened fire at a Walmart, wounding four people before apparently killing himself. The attack took place Monday night at a Walmart in Beavercreek, in the Dayton metropolitan area. (Marshall Gorby/Dayton Daily News via AP)

Credit: AP

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Credit: AP

Mental illness is not an indicator of gun violence, mental health advocates say. But some instances have mental health advocates questioning if people would have gotten into certain situations if they received help sooner.

On May 5 of this year, 57-year-old Michael Bagley was arrested and later charged with inducing panic after a reported disturbance at around midnight led to a standoff that lasted hours into the morning and involved a heavy police presence on the 600 block of Kings Cross in West Carrollton.

A neighbor said Bagley exhibited mental health problems for years, but he had become increasing erratic and aggressive while also refusing help.

SWAT crews were on scene Sunday morning, May 5, 2024, on Kings Cross Court in West Carrollton for a man yelling out his door who reportedly made threats to shoot police. Karen Korn/CONTRIBUTED

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For three years, the police and neighbors were trying to figure out what to do, she said.

“The law makes it so that nobody can do anything for him to help him,” Karen Korn said in May. “...This is a tragedy because we need a different system. We just need something different so that this isn’t what it comes to.”

Few make it probate court

Pink slips are forms, printed on pink paper, that police officers and other qualified individuals can fill out to refer someone to an assessment by a medical professional to determine if that person is an immediate threat to themselves or others.

The person can agree to voluntarily accept treatment and be released. Or the medical professional can have them held — usually at a psychiatric facility — and mandated to begin treatment. Since the person is being held against their will, the process is overseen by probate courts who make sure the committed person’s rights are protected and monitor compliance with the treatment plan.

Montgomery County Probate Court recently began tracking pink slips and how many get transferred to probate court. The Dayton Police Department filed 87 pink slips in January, of which five were converted to probate court, according to the court.

In February, Dayton police had 67 pink slips and zero were converted to probate court. In March, there were 101 pink slips filed by Dayton PD, which resulted in four people getting committed under the probate court and one case was expunged, the court said.

That means for the first three months of the year, only about 4% of the time when Dayton police pink-slipped an individual did that individual make it before Montgomery County Probate Court.

“Our officers, in particular, understand that mental health issues are complex in nature and are trained to deal with individuals humanely irrespective of how many times they might come in contact with the same individual,” Dayton police officials said in a statement.

More incarcerated than in psych beds

Law enforcement has become the frontline of mental health crisis response with jails and prisons being the new asylums, mental health experts say. Local and state agencies in Ohio are trying to fix decades of failed mental health policies.

Those policies included the deinstitutionalization movement of the 60s and 70s, which was supposed to have been addressed by the 1963 Community Mental Health Act.

Dr. Esam Alkhawaga is a psychiatrist at the Greene County Jail, seeing as many as 10 incarcerated patients per day. MARSHALL GORBY/STAFF

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The Dayton Daily News has reported on how the failure to provide an alternative to institutionalization left people with severe mental illnesses unhoused, and thus, more likely to end up incarcerated.

There are 10 times more individuals with a severe mental illness ― such as schizophrenia spectrum disorders, severe bipolar disorder and/or major depression with psychotic features ― in jails or prison than in state psychiatric hospitals, according to the Treatment Advocacy Center, a national policy and research organization.

Nearly 1/2 of inmates have mental illness

About 43% of people incarcerated at the Montgomery County Jail, as of July 1, were receiving mental health medications, according to the Montgomery County Sheriff’s Office.

“The strain put on our jail and local justice system is that of every jail and justice system across the country,” said Teresa Russell, director of criminal justice outreach at the Montgomery County Sheriff’s Office.

Not only are they holding people before their alleged criminal offenses have been adjudicated, but jail staff are having to step into the realm of mental health care.

“This includes effectively managing care for those individuals in correctional settings, specifically those refusing such care, as well as what judges and probation officers face in finding alternatives for community placement for people with significant mental illness,” Teresa Russell said.

Nowhere else to go

Emergency rooms and the justice system may become revolving doors for some with severe illness if there are not enough inpatient psychiatric beds or other places to provide them with services they may not be able to obtain themselves due to their mental state.

“While it’s frustrating for law enforcement to have a second or third encounter with a resident they have taken to the hospital, those individuals are touching jails due to a criminal offense that warranted arrest,” Teresa Russell said.

“Sometimes those offenses are minor and unfortunately, jails across the country ― not just the Montgomery County Jail ― often see arrests of people with mental illness because there was no option to hand them off directly to an appropriate program they may be eligible for,” she said.

Nearly 80% of state psychiatric hospital beds are occupied by forensic patients, who are people who are in the custody of the criminal justice system, according to the Treatment Advocacy Center.

People who are incarcerated and waiting for a bed in a state psychiatric hospital typically wait a month for a bed to become available, according to the center, which also says this can put those individuals at risk for worsening psychiatric symptoms.

Ohio allocated $10 million for a new mental health hospital in Dayton, which was included in Ohio’s capital budget signed by Gov. Mike DeWine last month. It will take years to build and the total cost of the hospital is estimated at around $273 million, according to initial estimates from the Ohio Department of Mental Health and Addiction Services (OMHAS).

OMHAS currently operates six regional psychiatric hospitals, spending more than $300 million of its annual budget on hospital services, the largest part of its budget. Its entire budget is $1.2 billion for fiscal year 2024 and $1.1 billion for next year.

Experts: More still needed

Even with the 200-plus beds coming to Dayton with the new behavioral health hospital ― a move applauded by mental health advocates, providers and law enforcement ― more is needed in the continuum of care surrounding needs of people with severe mental illness.

Inpatient beds for people to get stabilized, mental health rehab facilities for short-term housing and then long-term housing needs, such as group homes with supports, are among what’s needed, Luke Russell with NAMI Ohio said.

“We need more group homes for people with mental illness where they can go and live and have support,” he said.

Dayton previously had an inpatient psychiatric hospital called Twin Valley, also known for years as the Dayton State Hospital. In June 2008, the state of Ohio, under the administration of then-Gov. Ted Strickland, closed Twin Valley Behavioral Healthcare’s Dayton campus, a 110-bed mental health facility located on Wayne Avenue. The closure left a gap in care in the region for people with serious mental illness and their families. JIM NOELKER\STAFF FILE

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Recovery supports with treatment are more likely to be successful, he said.

“Right now, we have some people, they can get treatment, but they don’t have any place to live,” he said. “So what happens is then they’re hard to find, care coordination becomes difficult, and they become medication incompliant. They don’t take their meds, and then we get into these situations. It’s kind of like these revolving doors.”

NAMI Ohio was among the groups who said the new mental health hospital coming to Dayton is much needed, but there is still more work to be done to get a network of care in the community envisioned in the 1963 Community Mental Health Act.

“The system is not failed. It was just never built after that whole movement to community mental health treatment, which happened in the 60s,” Luke Russell said.

Sydney Dawes and London Bishop contributed to this story.

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