Patterns of Crisis: Mental health center sees familiar faces

Published 3:00 am Sunday, June 2, 2019

Derrek Vaughn | The Valdosta Daily TimesLegacy Behavior Health Services Crisis Center Director Lyndi Farnam and Chief Clinical Officer Roz Johnson said for people going through an acute mental health crisis, the center is available for them to keep them out of emergency rooms, jails or state hospitals.

VALDOSTA – Unfortunately, the staff at Legacy Behavior Health Services Crisis Center see a lot of familiar faces entering their doors.

Faces that have suffered repeated acute mental-health crises and, during these periods, pose a risk to themselves and the people around them.

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Lyndi Farnam, director of the crisis center, said the center has a recidivism problem in Lowndes and the surrounding counties. 

From Fiscal Year 2017-18 and FY2018-19, Legacy saw a nearly 23 percent increase of patients being admitted to the crisis center, from 1,059 to 1,301.

The staff stabilizes the people usually being dropped off by family, police or EMS at the center, make sure they are no longer an immediate threat to anyone and then release them back into the community.

“We are not a treatment facility,” Farnam said. “One of the biggest challenges we face at the crisis center is people not following up with treatment.”

Georgia’s mental health legacy

As part of the Department of Behavioral Health and Developmental Disabilities, Legacy was put in Lowndes County after Georgia shut down mental-health hospitals around the state back in 2014.

It was created to keep people suffering from mental-health issues in their community instead of being sent off to other parts of the state, Farnam said.

Legacy’s crisis center plays an important part in keeping people in the community. For people going through an acute mental health crisis, the center can keep them out of emergency rooms, jails or state hospitals.

Farnam said the crisis center stabilizes people to prevent them from harming themselves or another person before letting them back into the community to seek further treatment.

The crisis center is not a treatment facility, she said. It has 30 beds, and the typical patient will stay anywhere from five to seven days, Farnam said.

Even with the center, state mental health hospitals exist to care for people suffering from serious mental diseases. Hospitals act as a last resort, and the people in Lowndes County who need its resources are usually sent to Savannah, Farnam said.

Legacy Behavioral Health Services provides the primary mental health services for residents in its 10-county coverage area, which includes Ben Hill, Berrien, Brooks, Cook, Echols, Irwin, Lanier, Lowndes, Tift and Turner.

A community service board governs Legacy Behavioral Health Services. Board members are appointed by county commissioners of each of the 10 counties. A chief executive officer is hired to manage the board, which is funded by the state and other entities inside the county.

Pamela Cartwright, Legacy CEO, said a community service board is part of Georgia’s public system of care for behavioral health.

She said it acts as the state’s safety net for individuals suffering from behavioral issues.

The net is there to catch anyone suffering from a mental-health-related issue with limited to no resources.

Cartwright said it is authorized to provide services anywhere in the state. 

Unlike single-purpose providers, Legacy offers consumers a range of integrated services designed to address the needs of adults with severe and persistent mental illness, children and adolescents with serious emotional disturbance, persons with intellectual and developmental disabilities and those addicted to alcohol or other drugs.

“Anybody can come in whether they are insured or not,” Cartwright said. “We’re not going to put anybody out because of a lack of money.”

She said Legacy sees about 7,800 people a year. People going to Legacy can be suffering from anything between anxiety to suicidal thoughts.

Some will stay at Legacy’s crisis center, which is located inside Valdosta and available for individuals with extreme needs. Other individuals simply need someone to talk to, which Legacy also provides, Cartwright said.

“We service a broad spectrum of people,” she said. “We’re here to help.”

Recidivism in mental health

The crisis center is a small piece of recovery for people with mental-health disorders, Farnam said.

A person can visit the crisis center five times, but if that person fails to change their behavior after leaving, skips appointments with their outpatient provider and doesn’t take their medication, that person will continue to come back again and again.

Roz Johnson, chief clinical officer for the crisis center, said the center was seeing a high rate of recidivism. When staff looked into each case, it was always the same thing – the patient failed to follow up with treatment.

“It’s sad,” Johnson said. “A person would come here five times but only go to outpatient once.”

From Legacy or any of the other mental-health service providers in the area, there are plenty of outpatient treatment options available for people, she said. Many services, especially at Legacy, will not turn anyone away for money reasons.

They take people without insurance and the indigent.

Despite money seemingly not being an issue, many people refuse to seek the proper treatment for their mental illness, and Farnam and Johnson attribute this to a number of factors.

“Some may have anxiety sharing their story, getting help and receiving these services,” Johnson said. “There’s still that stigma of mental health. A lot of it is also substance abuse.”

Social stigma and a rampant drug-abuse problem is something the state of Georgia, let alone the crisis center, can do little to fight. These issues take far bigger solutions.

However, if there is a gap in services provided by the county and state that feeds to the problem of recidivism, it’s the lack of public transportation, Farnam and Johnson agreed.

Farnam said Legacy and the community have options for people, but those people who need them most can’t access them.

“We have the services,” she said. “The biggest barrier that I see is transportation in our local community and in our surrounding area.”

People don’t have the money to get themselves to the services, she said.

When getting treatment for a mental illness or substance-abuse problem means going without food or failing to pay rent, people will choose food and shelter most every time.

“That’s what people do,” Farnam said. “You’re going to take care of your immediate needs.”

The reason individuals are more frequently able to get help at the crisis center rather than at outpatient facilities is because they are typically driven to the crisis center by either police, family or ambulances.

Any other time, transportation is much harder to come by, Farnam said.

There are people, however, who just abuse the system. People who are content with their substance abuse or unwilling to seek help who repeatedly get sent to the crisis center but never follow up with treatment.

Johnson said the center takes care of people no matter the reasons.

“You shouldn’t be in this field if you don’t have empathy,” Johnson said. “If, God forbid, it were your grandma or family member, how would you want them to be treated? What would you want somebody to do for them?”

It’s about being a community that looks out for the most vulnerable without turning a blind eye, Farnam said.

“It’s much easier turning a blind eye when you go to your house every day,” she said. “But this is a community issue, and it affects not just us but everyone, and it’s increasing. We see it every day.”

Look for an additional SunLight article on mental health later this week in The Valdosta Daily Times.

Thomas Lynn is a government and education reporter for The Valdosta Daily Times. He can be reached at (229)244-3400 ext. 1256