Rolling the Crisis Dice: Calling for Help During a Behavioral Health Crisis

By Leigh Scott

I recently had the unfortunate experience of trying to get mental health support for someone very close to me. They were in an acute crisis. The co-morbidities included trauma history, brain trauma, and a history of addiction all exacerbated by recent loss. Trying to navigate the mental health system while they were in crisis was made all the more difficult by the fact that they were on probation. 

If I called for a wellness check, I might have gotten a co-responder unit that included a mental health worker, but police involvement invited the potential for escalation or violation of probation. The Alachua County Crisis Center’s Mobile Response Team wouldn’t have intervened because there was a legal history that included violence. I couldn’t call the Gainesville Fire Rescue Community Resource Paramedicine program because it wasn’t during operating hours and there wasn’t any acute drug involvement. They could not just go to therapy because of the history of seizures and potential brain trauma, and that’s not a realistic option in the middle of a crisis. 

I felt stuck. Frozen. Helplessly watching someone I love struggle. If there had been any outside observers of their behavior, police would likely have been called and they’d be sitting in jail waiting to see a judge who cared very little about brain trauma, history of mental health issues or any other mitigating circumstances. This would be a cut-and-dry violation of probation and this person would sit and wait on their fate with little to no mental health intervention. (I know all too well how easy it is to end up with incarceration instead of support - read about my personal experience here).

If someone in our community has a behavioral health crisis, there are several gaps in the system. To start, if someone is in fear of the police or has been traumatized by institutions, they will not call 911. Even if they seek alternative emergency responses, the currently available programs are limited in the support they offer and are not always easily accessible. For example:

• The Alachua County Crisis Center is a great resource for mental health support in our community. It also has 24/7 Mobile Response Teams for mental health crises, but they do not dispense medication or handle physical health issues, and there are several things they will not respond to (e.g. someone with a history of violence).

• The Gainesville Fire Rescue Community Resource Paramedicine (CRP) program is amazing. CRP shows up to overdoses and addiction crises and travels with a medic and social worker to build relationships and connect people to resources. However, it does not have a mental health component, is not dispatchable from 911, and does not operate 24/7. 

• The co-responder programs consist of a mental health worker from Meridian Behavioral Healthcare riding along with a crisis-trained police officer and can be dispatched via 911. They do not operate 24/7 and the rules of engagement require the officer to make first contact, which can leave the mental health support as an afterthought. And of course the  co-responders still include the police, which carries the risk of trauma, physical harm and arrest for the person in crisis.

The current system is outdated and unable to respond to present-day needs. 50 years ago paramedicine didn’t exist as a profession, but it was recognized as a crucial gap in emergency response. Similarly, while our modern first responder system has some good parts, the currently available resources each lack a key cog in the wheel of behavioral health. It should not be a guessing game as to what you’re going to get when you call for help. In the situation I faced, or any of hundreds of other examples of people in our community in acute crisis, what’s needed is support and what people are getting is a huge gamble on whether they receive care or incarceration. 

Dozens of communities around the country have already started building alternatives that show how our systems can work together to offer people support and resources in crisis. One prime example is CAHOOTS (Crisis Assistance Helping Out On The Streets) in Eugene, Oregon. CAHOOTS is dispatchable through 911 and offers not only immediate stabilization of individuals in acute psychological distress and addiction crisis, but then offers follow-up support or care, referrals, advocacy and transportation to their next steps. Each team travels with a medic and behavioral health professional so they are ready to help in whatever way the case calls for. Eugene is a university city of comparable size and demographic makeup to Gainesville, so CAHOOTS is a feasible model for our community. 

That’s why Links Not Locks is advocating for an alternative first responder program. We envision teams of medics, mental health professionals and social workers, easily dispatched from 911 or 988. See our proposal here or visit our website for more information. These teams could address all angles of behavioral health - whether that’s medication, mental health counseling, rehab or community resources - without police intervention. An alternative crisis response will save lives and connect people to the support they need in real time. Otherwise we are just frozen; paralyzed in fear by having to roll the dice that you may get an armed response rather than a compassionate one. 

No Adults in the Room: My Journey Navigating the Mental Health and Carceral System

By Leigh Scott

There is a unique problem in America - using cages as the answer to behavioral health concerns. Locally, there are over 1,000 beds available at the Alachua County Jail and only 35 at the rehab center. There are unlimited spaces in the criminal court, but in the mental health diversion court, where you may be connected to resources, they are limited to 35 slots. 

For someone caught up in the system, it often feels like there is not a reasonable adult in the room who can say, “Something is wrong here.” No one narrative can capture the myriad of absurd and terrible things that result from this overreliance on incarceration, but here is my personal experience of needing compassion and instead receiving cruelty.

The Devastation

In 2007, my wife passed away on our fifth wedding anniversary. I was a young widower and a single father of two. It was a gut punch of epic proportions. There are all the emotionally ravaging, sleepless nights you would expect - watching your son say goodbye to a coffin, having to answer your five-year-old daughter about why mom isn't coming back, sleeping alone at night with the impression of your wife still outlined in the blankets. But what you don’t see are the real, tangible effects it has. You go from two incomes down to one. The person you’ve trusted for years to make decisions with is suddenly not there. Those effects last long after the well-wishers and casseroles run out. Soon you’re left to navigate your devastation on your own. 

This is the part of the story any reasonable human would say, ”Go get help. Seek out therapy.” I agree. If I had that magical rewind button it would be the first thing I’d do. But the thing with trauma is that when you’re in it, you don’t see how bad the effects are. Plus, when you are a single father hovering around the poverty level, resources and time are very limited. You’re in a numbed-out-running-on-pure-adrenaline mode where you do anything you can to just keep getting through the day and not appear in pain to your children. 

Two years passed and I was getting worse. Every night I went to bed and thought about suicide. I rationalized it by saying, “The good parts of my life are over and the kids could get life insurance if I make suicide look like an accident.” I’d developed some bad habits with self-medicating, lack of sleep, poor diet, self-loathing, and survivor's guilt to the point I couldn’t enjoy anything. And because of all those habits, a deep sense of shame. It would only take a small storm to blow me off course. 

The Storm

The storm came in the form of an argument with my friend, which finally pushed me over the edge. I took our shared vehicle and went to CVS to get something to drink. While I was at the counter, I saw the chemical- computer duster. If you’re not familiar with computer duster, it's an aerosol can that you can use to clean your computer keyboard off. It can also be misused as an inhalant. It was a quick way to pass out and could also kill you. Either of those options sounded like a winner. So I got a can and went to my car and started inhaling. Inhaling this duster is like sending you into a time portal. Inhale it, pass out, wake up 30 minutes later, and inhale it more. This goes on for a really long time and you lose all sense of time and direction and, most importantly, don’t have to feel for a while. I thought I was gone for about 15 minutes and apparently was gone for almost eight hours. 

My friends and family were freaking out. They were unfamiliar with how to respond and were concerned, rightfully so, that I was going to commit suicide. So they called the non-emergency line, not 911, thinking this would be less punitive. They conveyed the problem. “Leigh has been gone for hours. We think he’s using inhalants and trying to commit suicide. He is in our car, our shared vehicle.” The woman at dispatch stated very calmly, “Well he hasn’t been gone long enough to be a missing person, but if you report the car stolen, we can have sheriff's deputies look for him.” 

The Force

At this point, I was in and out of consciousness and alternating between driving through a neighborhood and walking. I saw my friends and family and the look on their faces was not good. “Leigh, what are you doing:? We’ve been looking for you.” I responded, “I don’t wanna live anymore.” Now, the thing about duster is - when you inhale, it gives you this slooooow, deeeeep, air-filled space-voice. So it came out, “AHHH dooooon’t waaaahhhna liiiiive anyymooooore.” As I was walking, I saw the cops. They yelled, “Freeze, Mr. Scott!” I inhaled the can one last time and yelled back, “I’m alreaaadddyyy froooozen!” This did not elicit the laughter I had hoped. They seemed mad. Big mad. They promptly released a dog on me. The dog bit me around the legs and ankles. I tried to kick it away so they flipped me over on my belly and reached underneath me and tazed me. Seemed like the appropriate amount of force for someone who is suicidal and intoxicated. Just for good measure, they punched and kicked me as well. The headlines in the paper the next morning read, “Rookie deputy has electrifying first day on the job.” Ha-fucking-ha. 

The Cage

I was now in the belly of the beast - the Alachua County Jail. Because it was a suicide attempt, I was stripped of all my clothing and placed in a green straightjacket-type suit known as “The Turtle Suit.” I was taken to H-pod. The entire way there, I was mocked and laughed at. “Oh, he gon’ kill himself. Not the turtle suit. They got you in the turtle suit?” Cops and inmates alike, laughed as I was led to a solitary confinement cell. I got one phone call, but nobody answered and now I was alone. No pillow or mattress, I curled up on the concrete floor and began to cry. I remember how cold my tears felt on that floor. How alone I felt. How scared I was. 

I didn’t know anything about jail, the legal system, or mental health care. I didn’t know how long I’d be there or what would happen to me. Nobody visited me for at least two days. No visits from medical or mental health professionals, and my food was slipped through a slot in the door. I was allowed out of my cell for one hour a day to pace around by myself and use the phone to make collect calls that nobody knew how to answer. 

After a week, a mental health professional came to see me. She was stoic and devoid of care. She read from a list of questions that were clinical and never once looked up at me. “Are you a harm to yourself or others?” “Do you take medication?” “Do you have a support system?” After five minutes, we were done. Back to my cell. Was I getting medication? Going home? Does she know where I can get a support system? The answer to all those questions was no. I did not have $1,000 to bond out, my support system all had their own lives and were too busy to help me, my kids were being taken away, and I was not leaving jail. 

I learned then that once you’re in jail, wearing that uniform, you lose your identity as a human. The attitude among jail staff is, “This is just the way things are, and I’m just doing my job.” And it’s not just the guards that lack compassion. Nurses, therapists, pastors, and addiction counselors all come with bias that affects their ability to provide care. 

The System

This terrifying, lonely time in the mental health pod at the jail went on for weeks until one day, I got a visit from my public defender. I’m not even exaggerating a little bit when I say that she looked like the Beetlejuice character that smoked the cigarette through the hole in her throat. She came in and said, “You are facing Grand Theft Auto and Battery on a Law Enforcement Officer for kicking the police dog. Maximum of five years”. I was astounded. No prior felonies and, more importantly, I didn’t steal a car. My friends and family had already gone to the State Attorney's office to sort that out. But the Beetlejuice lawyer was unfazed by this fact. “If you take this to trial, you could get a dog lover on the jury, and then you’ll get the maximum.” She advised me to enter what is known as an “open plea” to the judge, which means I would forgo all of my rights to a speedy trial and just hope for a merciful judge. 

What I didn’t know at the time were two essential facts: 1) the job of a public defender is not to exact justice for you, it’s to save the state the financial burden of a trial, and 2) my judge was what is known as a “million-year judge,” or a judge whose sole mission is to give out a million years in prison during his time on the bench. With those two facts omitted from my decision-making process, I agreed. And I got the maximum - five years in prison. All from being depressed, inhaling duster, getting beaten, tazed, and bitten by a dog. My reward for all of that was not mental health counseling or support or resources, it was further isolation and brutal treatment at the hands of the Florida Department of Corrections. 

The Alternative

At no point in my story, was there an adult in the room that offered support, care, or had the guts to say, “Something is wrong here.” This is how our community has decided to respond to a mental health breakdown. The solution was for me to be in a cage. It has yet to be explained to me how this was “justice” for me, my family, or really anyone at all. 

If you’re trying to withstand the storm of a mental health or substance use crisis, life feels lonely and fragile. But it doesn’t have to be that way. What if our fragile existence was met with support and understanding? Imagine if the first responder had been a social worker instead of an angry cop with a taser and a dog. Or if there were actual therapeutic services available at the jail instead of cold floors and colder people. Or a justice system that aimed for fairness rather than just caging people as long as possible. Or, to go back to the root of things, readily accessible mental health and substance use services that were rooted in the community. These things are possible, but first we have to be the reasonable adults in the room who can stand up and say, “This is not ok.”