Mental Health Information Paper for Next Step Program Affiliates

Offered by Melissa Ham, Director, Special Operations,

Charleston Dorchester Mental Health Center, September 2016

www.charlestondorchestermhc.org

843-414-2350

Introduction

  • Mental health encompasses many illnesses, including: Post-traumatic stress disorder (PTSD), bi-polar disorder, schizophrenia, depression, Tourette Syndrome, delusional disorders, and more.
    • Many people hear voices; experience visual, tactile, and/or odiferous hallucinations; and/or have delusional beliefs.
    • The onset of schizophrenia and other mental illnesses is usually the age 18-20’s; bipolar in the late 20’s.
    • A delusional disorder is a belief based on an untruth, but may not be obviously untrue.  The person may say things that sound true but most of what s/he says is not true; some is, however, true.
  • Medicine can significantly help some people avoid the effects of mental illness.
    • If mental symptoms suddenly worsen, check for other medical problems.
    • Diabetes, if not controlled, can increase mental problems.
    • A urinary tract infection can make someone psychotic.

Encountering a Participant Possibly Having a Mental Health Episode

  • Condition of the Participant
    • It is very difficult to tell the difference between a person who is high on cocaine versus experiencing a mental illness episode.
      • A person drunk on alcohol is more obvious.
      • If a person is high on drugs or drunk it is useless to refer him/her to mental health resources who might be able to help him/her, principally because s/he will be unable to answer their questions coherently.
  • In a mentoring situation, tell the Participant that you need to ask someone to come in and help you help the Participant. 
    • It is best to have backup so that while the Lazarus Mentor is contacting mental health resources, the Samaritan Mentor and the third Volunteer can give their full attention to the Participant.
  • What to Do
    • Avoid sending/bringing him/her to an emergency room (ER) because the experience can be stressful for the mentally ill to sit in the ER waiting for care. 
    • Rather, give him/her a referral to a mental health agency that the Lazarus Mentor finds through the 2-1-1 Hotline Database.
  • Such an agency is the Charleston Dorchester Mental Health Center outpatient clinic in West Ashley whose hours are 8:30-3:00 M-F.
    • They like a person to have an appointment, but it is not required.
    • They offer the following services:
      • Individual counseling
      • Group therapy
      • Vocational rehabilitation of job skills
      • Nursing staff for injectable medications
      • See more about their “Highway to Hope RV” below.

Your Demeanor

  • Simply listen the person and take him/her seriously. 
  • The person may be having a fit because s/he is upset with his/her mental illness, medications, or both. 
  • Focus on the Participant because s/he has a sense that s/he needs to be heard.
  • De-escalation
    • Stay calm.
      • Use non-threatening body language.
  • Try to name the emotions you’re hearing (if you guess wrong, the person will tell you), for example:
    • Frustration
    • Sadness
    • Fear
    • Scared (women) or Mad (men)
  • Your goal is to keep the person talking until s/he talks him/herself down.
    • Ask him/her what s/he needs.
    • Be respectful and assume s/he is doing his/her best.
    • Don’t pretend to see, hear, or sense his/her hallucinations or delusions, just confirm you believe s/he experiences them.
  • Don’t try to make a person stay who wants to leave.
    • Tell him/her it must be frustrating to him/her to feel this emotion.
    • Give them a visible avenue out of the building.
      • The person may feel trapped in the place where s/he is in.
  • Unusual Situations—Paranoia
    • 99% of persons suffering from mental illness are not violent.
    • Paranoids, however, are the most likely to become violent if they feel threatened.
      • Keep your hands where the paranoid person can see them.
      • Let him/her know what you are doing before you do it – don’t move without telling him/her first.
  • When a person gets upset, s/he will usually get louder.
    • In this case, tell him/her that s/he is scaring people around you both.
  • If the Participant is trying to take charge in a dangerous way, instead of saying, “I feel threatened,” say, “I feel like you’re getting mad (or frustrated) with me.”
    • Pray with the Participant, invoking Jesus by name.
    • Have the third Volunteer leave the room and call 9-1-1.

Highway to Hope RV

An excellent resource is for the Lazarus Mentor to telephone is the Charleston Dorchester Mental Health Center Mobile Crisis Team, called the “Highway to Hope RV” at 843-414-2350.

  • General
    • Highway to Hope RV clinicians’ cell numbers are 843-209-9164 (Heather) and 843-412-8238 (Tripp).
    • This is the only such team in SC.
    • They provide 24/7 psychiatric emergency help for Charleston County.
      • This is due to the willingness of Charleston County probate judges to approve such engagements at any time day or night.
      • They will either talk you through help, or come to your site.
      • They need to check if the person is already in their clinical database system, so expect them to ask you many questions.
      • This help is also available during business hours in Dorchester County (843-414-2350).
      • The Berkeley County telephone number is 843-761-8282.
  • Process
    • The Mobile clinicians always visit in pairs and have a law enforcement officer along as well.
    • They assess the Participant, determine what kind of care s/he needs, help link the Participant to mental health resources on either an in-patient or out-patient basis, and implement the plan before leaving.
    • If you feel in danger from a Participant, immediately call the police at 9-1-1; don’t wait for the Mobile Unit to arrive.
    • Will take walk-ins.
  • Locations
    • The Highway to Hope RV and is located at the following places weekly:
      • Monday: One 80 Place Homeless Shelter, 35 Walnut Street, Charleston
      • Tuesday: Our Lady of Marcy, 1684 Brownswood Road, Johns Island
      • Wednesday: St. Paul’s Medical Clinic, 7610 Highway 164, Hollywood
      • Thursday: St. James Santee Clinic, 1189 Tibwin Road, McClellanville
      • Friday: SHIFA Free Medical Clinic, 1092 Johnnie Dodds Boulevard, Mt. Pleasant
  • Fees
    • Highway to Hope RV services are not free. 
    • They base fees on an individual’s and/or family’s ability to pay.
    • They accept third party payments through private insurance, Medicaid, Medicare, and self-pay.
    • However, they will not turn down a person due to his/her inability to pay.
  • Medications
    • The Highway to Hope RV does not have an onboard pharmacy but will help patients get a 90-day supply of medications.
    • Thy use sample medications and generic medications to reduce treatment costs.
    • They may have vouchers for use with area free medical clinics such the Harvest Free Medical Clinic in North Charleston.
    • They may help patients apply to drug companies for help.
      • Patient Assistance Program for low income patients.
      • If the Participant is homeless, the clinicians will ask the pharmaceutical companies to mail the prescription medicine to the Charleston Dorchester Mental Health Center outpatient clinic in West Ashley to make it easier for pick-up.
      • They may help with pharmacy coupons, such as the South Carolina Drug Card, that can save people up to 75% of the cost of brand and generic prescriptions at most major pharmacies.