Providers from the emergency room, the mental health clinic, and county mental health organizers get to meet face to face with sheriff’s deputies, Fort Dodge police and jail staff monthly at meetings of the Stepping Up initiative.

The nationwide initiative, which Webster County became part of in March 2016, has made a difference but challenges are still great, according to Shawna Dencklau, Webster County assistant jail administrator.

“With the jail, in my opinion, it is not getting any better with mental health. It’s getting worse,” Dencklau said. “There are a few good cases we have had where we prevented them from coming to jail, but those are few and far between. We’d like to get more of that; it’s just difficult.”

The county jail is not the best place to treat a mental health disorder, both providers and local law enforcement have said. Officials would prefer to get them help, instead of sending them to court or to jail.

-Messenger photo by Joe Sutter Webster County Chief Deputy Rod Strait, left, and Fort Dodge Police Capt. Ryan Gruenberg listen during the monthly Stepping Up meeting between mental health providers, law enforcement and jail staff.

One recent example was highlighted by Melissa Klass and Ronni Arnold, both with UnityPoint Health’s Berryhill Center mental health clinic.

When the patient was acting out, it turned out he hadn’t been getting his court-ordered shot. So staff were able to meet him and give him the injection in a gas station parking lot — no jail time, and no emergency room visit needed.

On the other hand, more people have been arrested recently for simple misdemeanors, “being loud and obnoxious,” Dencklau said. One was arrested recently for an aggravated misdemeanor.

“Yes, you should have been arrested because you assaulted someone. But did you assault someone because you wanted to, or was it because of mental illness? This guy did self-harm to himself, so obviously it was a mental illness,” she said. “Is there anything we can shorten the judicial process because it was mental illness, and not have to wait months to go through the judicial system?”

Fortunately, UnityPoint Health’s Berryhill Center has been able to bring mental health providers directly into the jail.

Unfortunately, the jail can’t force anyone to see the doctor if they don’t want to.

“I really wish we could make them see you when they’re in the jail. It’s just, if I don’t want to see you I don’t have to. And it’s a waste of you guys’ time,” Dencklau said.

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Communication is improving, but there’s still challenges there too. Privacy laws limit how much providers can share with the police, for instance, members at the meeting said.

However, the jail staff does provide a list every day of who has been arrested so that providers will know — and Dencklau said she could add more organizations to the list of who is getting that data.

Police need a simple way to find out if a person needs mental health care, said Fort Dodge Police Capt. Ryan Gruenberg.

“If we’re dealing with them, we’re probably called to them because of someone else calling in, because of a disturbance,” Gruenberg said. “When we get there, it does not make the situation better because they hate us. At times where we offer to call their provider, or call whoever else, they tell us to pound sand, so we either have to let them go and we just get the call half an hour later, or …”

“If they’re not willing to tell us anything, it would be nice to have a generalized number to call.”

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In the coming year, the county’s health care system hopes to have more peer support in place to address this, said Alison Hauser, administrator for the western quadrant of County Social Services.

CSS is the 22-county mental health treatment region to which Webster County belongs.

One organization is “trying to hire some additional staff so they could be available after hours,” Hauser said. “That would be county-funded, so if you assessed the situation and found it was necessary, and safe as well, they could diffuse that situation. But we have to have staff hired, we have to have them trained.”

Hauser hopes to have a pilot program started by February, though it couldn’t handle a large volume of calls at first.

One goal for the coming year is to get housing involved in the Stepping Up initiative, said Melissa Klass, Assertive Community Treatment team leader for Berryhill.

“I think stable housing is a big concern in this community,” Klass said. “More and more people are living in unsafe conditions.

“They have limited resources and they are not getting the things they need, when they go to housing and say, ‘I have bugs. My door doesn’t lock. I don’t have keys to get into my building,'” she said.

“Then people end up on the street, or they end up staying with people, and you end up getting calls because the neighbors are upset.”

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Also in the coming year, Hauser has hopes that an Iowa program called SafeNet RX will be able to provide medication to those who can’t afford it just getting out of county jail.

In the past the program was limited to those who had been in prison, she said, but it’s recently expanded to other parts of the justice system.

Several new participants were at the meeting Thursday, and were happy to share what their organization could do and learn about opportunities from the others.

While the police department has been to previous meetings, it was Gruenberg’s first time there.

“We’re excited to learn about some possibilities and avenues we can take as far as the people we interact with on a daily basis,” he said.