Law enforcement on front line for mental health crises, aftermath of suicides

(This article was funded in part by the USC Annenberg Center for Health Journalism's California Fellowship, where Black is a Fellow.)

Deputy Robert Julian mostly works alone. Not because he necessarily wants to, or because he's a lone ranger who works best on his own, but because of a lack of deputies in Mendocino County.

If a difficult case arises, he can call backup in the form of two deputies from up north, but otherwise, "We usually try and handle it ourselves," he said, driving down the empty highway, listening to Alan Jackson on the radio.

"There's a romance to it," he said, "being the lone deputy."

Years ago budget cuts to the Mendocino County Sheriff’s Office led to fewer deputies guarding the County, and a lower salary is part of that equation. Julian can think of three deputies who left recently to take up positions in wealthier Sonoma County.

Mendocino County's South Coast doesn't have the problems of aggressive panhandling and bigger crime the larger cities in Mendocino County experience. Instead, the area has mostly crimes related to substance abuse, domestic violence, and burglary.

It’s a beautiful day. The often-present fog is gone, and the deputy is distributing paperwork and responding to calls at various locations in the Point Arena and Gualala area.

But paperwork and house calls are only a small portion of the job. The rest of the job is chance: a chance call for a civil dispute, a chance call for trespassers, and sometimes, a chance call for a mentally ill person.

“Fifty-One Fifties,” are what mentally ill people considered a danger to themselves or others are referred to colloquially by those who treat them, a reference to Section 5150 of the California Code, which provides for a 72-hour involuntary commitment in such cases.

People specifically come to the coast to commit suicide, said law enforcement in Fort Bragg. “They don’t come here to think,” said Detective Ze Lima. “They come here to finish.”

“I think it’s something to do with the ocean,” said Deputy Jesse Van Wormer.

In March, an elderly couple from Burlingame died by what law enforcement believe was a suicide pact. Wolfgang and Linda Bayer were found dead in their car of gunshot wounds on Highway 20 in Fort Bragg. Investigators discovered the couple had forwarded a letter to a relative before driving to the coast outlining extensive medical problems and financial difficulties.

A month later, the nation was shocked when Sarah and Jennifer Hart drove down from Washington state and into the ocean near Mendocino, with their six adopted children in the car.

Julian has dealt with several 5150 cases over his few years on the South Coast. He remembered a call he responded to for a suicidal woman at the Redwood Coast Medical Services center in Gualala. She was barefoot and pacing inside the lobby, and at one point he remembers she dropped into a crouch, looking as if she were going to wrestle him.

He classified her as a 5150 and wanted to take her to the Mendocino Coast District Hospital in Fort Bragg, but she was concerned about who would feed her cats, he said. Hospitals are the first place 5150 patients are taken in their journey to receive mental health care.

It took him about a half hour, but eventually he convinced her. Julian doesn’t see the need for training to deal with 5150 patients for himself personally. “We’re not doctors,” he said. “We don’t diagnose.” Law enforcement deals with only the entry of a 5150 patient to the hospital; so as long as an officer has the natural ability to diffuse a situation, Julian doesn’t consider the process an issue.

But other deputies disagree with Julian, and say more needs to be done for the 5150 cases they deal with, primarily because mental illness isn’t illegal, and adding a law enforcement officer can escalate a situation and turn it dangerous.

“You’re taking a cop that has virtually no [mental health] training,” said Sgt. Dustin Lorenzo, “and forcing the cop to detain this person, who is noncriminal.”

Unless the officer is very good at communication, it can easily spiral. “It becomes a criminal situation,” he said.

In the Fort Bragg deputies’ time dealing with the mentally ill, they end up classifying as 5150, they found the best strategy is to treat them humanely. “Most people are cooperative as long as you’re not treating them like a criminal,” Lorenzo said, adding the patients are not handcuffed. But for every patient, “We have to go the extra mile to get them help.”

For law enforcement in Mendocino County, this setup can feel like a failure, since officers deal with the entry of a 5150 patient, but also act as coroners. They respond to suicides, homicides and drug-related deaths, sometimes noting the patient they’d sent in for help did not receive the help they needed.

“We don’t know what happens in that middle. And it’s not like we are jaded or distrustful of mental health, [but] those are the only two perspectives we get,” Lorenzo said. “We caught this in time and sent them to you, why didn’t? — what led to their death?”

Anne Nicole Shapiro was one of those people without a middle. Shapiro was from Boulder, Colorado, and after spending time in China and Korea moved to Mendocino County. She lived in Little River, joined a women’s choir, and worked as a reading coach in public schools. She had been receiving mental health treatment for bipolar disorder, and on Jan. 6, 2016, had spent the night at a care facility in Willits.

She was last seen at 5 a.m. on Jan. 7, 2016. She was reported missing three hours later. At noon, she was found dead at the MacKerricher State Park beach 40 miles from Willits. No one knew for certain how she’d gotten there, since she didn’t own a car. Several local news outlets reported her case, but after a few days, Shapiro’s story fell away.

Her death was classified as undetermined by the Sheriff’s Office, as they were unable to identify if her deah was a result of suicide, homicide or another natural cause.

A year earlier in 2015, Mendocino County Sheriff Tom Allman had begun a two-year journey to get a tax measure to support mental health services and reinstate a psychiatric health facility in-county to replace the one that closed in 2000. Allman is well acquainted with mental health and the darker side. In 2005, his older brother died by suicide, a decision he still finds inexplicable, frustrating, and “stupid.”

Today more than half of Mendocino County adult residents need or receive behavioral health services, according to HealthyMen, which tracks the County’s health statuses. About 15 percent of people on Medicare are receiving treatment for depression and about 13 percent of Mendocino County adults reported they were in mental distress for more than two weeks out of a 30-day period. Almost 6,000 calls were made to the County’s Crisis Access Line and about 2,700 people were treated for mental or behavioral health from 2017 to 2018.

“There’s always a stigma,” said Jed Diamond, Ph.D.

Diamond has worked in the County for 25 years in mental health and now sits on the Measure B oversight committee. “There’s a feeling of ‘those people.’ [People] don’t recognize they really are us. We all know people—friends, family—that are challenged with depression.”

That was part of the likely impetus that helped Measure B to pass, he said. “I think there was a recognition; we really do need services.”

It’s laudatory, he said, and also unusual.

The next installment of this series on the state of mental health in Mendocino County will explain how 5150 patients receive treatment, how hospitals are ill-equipped to deal with these patients, and the move to implement Measure B funding.

[This story was originally published by the Independent Coast Observor.]