How to help yourself or someone else who needs mental health resources

2012-12-22T18:31:00Z 2012-12-22T18:41:36Z How to help yourself or someone else who needs mental health resourcesStephanie Innes, Arizona Daily Star Arizona Daily Star
December 22, 2012 6:31 pm  • 

Figuring out where to begin can be daunting. So many agencies are referred to by acronyms or weird-sounding names that it can be hard to keep track of who does what and what everything means. Here is an overview:

WHO QUALIFIES FOR THE PUBLIC BEHAVIORAL HEALTH SYSTEM (ALSO KNOWN AS MEDICAID, AHCCCS OR TITLE 19, WHICH IS OFTEN WRITTEN TITLE XIX)

AHCCCS, short for the Arizona Health Care Cost Containment System, is Arizona's Medicaid plan that covers low-income people.

People can see whether they qualify for AHCCCS by going to www.healthearizona.org or calling the Department of Economic Security, Family Assistance Administration at 1-800-352-8401.

Also, for persons seeking behavioral-health services, the CPSA comprehensive service providers can help screen for AHCCCS eligibility and help you complete the application.

If you do not qualify for AHCCCS, you may be eligible for other benefits if you are determined to have a serious mental illness or other qualifying condition.

Anyone in Pima County can get publicly funded crisis-stabilization services through Community Partnership of Southern Arizona, regardless of income, eligibility or other factors.

COMMUNITY PARTNERSHIP OF SOUTHERN ARIZONA (CPSA)

This private, nonprofit agency manages Arizona's publicly funded services for behavioral health (which includes mental illness and substance abuse) for people who live in Pima County. CPSA receives money from the Arizona Department of Health Services' Division of Behavioral Health Services, which receives it from AHCCCS and from state government.

CPSA then distributes the money to what are known as "comprehensive service providers." These are the agencies that actually see and treat people with mental illness. If you use the public behavioral-health system, you are what CPSA calls an "enrolled member" of its network.

FACTS: CPSA serves about 32,000 people of all ages on an ongoing basis, about one-third of whom have a serious mental illness. Another 1,000 children and adults are seen each month at its Crisis Response Center. CPSA's community-wide crisis line receives about 500 calls every day.

LEARN MORE

Community Partnership of Southern Arizona

www.cpsa-rbha.org

Contact CPSA Member Services at 1-520-318-6946 or 1-800-771-9889 to discuss your needs. Translation services are available. Individuals with a hearing impairment may call 1-866-318-6960 for TTY.

CPSA Member Services is available 24 hours a day, but the best time to call is Monday-Friday, 8 a.m.-5 p.m.

ARIZONA DEPARTMENT OF HEALTH SERVICES: DIVISION OF BEHAVIORAL HEALTH SERVICES

The Arizona Department of Health Services oversees the Division of Behavioral Health Services. They're commonly referred to as "ADHS/DBHS" or "the division," and it's the agency that AHCCCS/Medicaid pays to oversee the state's behavioral-health services. ADHS/DBHS in turn pays the Regional Behavioral Health Authorities (RBHAs) and Tribal Regional Behavioral Health Authorities (TRBHAs) to oversee the system in their areas and pay agencies and individuals to take care of people with mental illness.

LEARN MORE

Arizona Department of Health Services/ Division of Behavioral Health Services

www.azdhs.gov/bhs/index.htm

Behavioral Health Services:

150 N. 18th Ave., No. 200

Phoenix, AZ 85007

Phone: 1-602-364-4558

Fax: 1-602-364-4570

PRIVATE INSURANCE PLANS

If you have private health insurance, whether purchased by an individual or through an employer or family member, you are most likely not eligible to enroll in the public behavioral health network that's managed by CPSA. You are what people in the field call a "non-Title 19" person.

Private insurance companies do not have to cover mental-health services, but federal law requires "parity," so that if your plan does cover mental-health and substance-abuse treatment, the co-pays and number of allowed visits must be the same as if you are seeking medical or surgical services. Contacting your insurance company and looking at the "explanation of benefits" is the best way to figure out what behavioral-health services are covered.

If you are "non-Title 19" you can still get help if you are found to have a serious mental illness, are in crisis, or meet other criteria. Call CPSA Member Services at 1-520-318-6946 or 1-800-771-9889 for more detailed information. Translation services are available. Individuals with a hearing impairment may call 1-866-318-6960 for TTY.

ARIZONA STATE HOSPITAL (AZSH - PRONOUNCED 'ASH')

If a judge decides that a person is so impaired by mental illness that he or she cannot function or be psychiatrically stabilized with treatment in the community, the person can be ordered to the Arizona State Hospital in Phoenix. It's the most restrictive environment in the state for adults, and it's a last resort. The hospital has a secure forensic ward for people who are involved in criminal proceedings or have been convicted of a crime but have a serious mental illness, as well as a separate area for people a civil court judge has determined need such intensive care. According to the hospital website, courts usually require a person to have spent at least 25 days in a hospital to attempt psychiatric stabilization before sending the person there.

LEARN MORE

Arizona State Hospital (AzSH)

www.azdhs.gov/azsh/about_azsh.htm

Arizona State Hospital:

2500 E. Van Buren St.

Phoenix, AZ 85008

Phone: 1-602-244-1331

Fax: 1-602-220-6292

www.azdhs.gov/azsh/index.htm

 

 

PIMA COUNTY ADULT COMPREHENSIVE SERVICE PROVIDERS

CODAC Behavioral Health Services

Administration site

1650 E. Fort Lowell, Suite 202

Tucson, 85719

1-520-327-4505

www.codac.org

CODAC

Intake site

3100 N. First Ave.

Tucson, 85719

1-520-202-1840

CODAC

Intake site

4901 E. Fifth St.

Tucson, 85711

1-520-202-1840

CODAC

Intake site

127 S. Fifth Ave.

Tucson, 85701

1-520-202-1840

COPE Community Services

Administration site

82 S. Stone Ave.

Tucson, 85701

1-520-792-3293

www.copebhs.com

COPE Community Services

Intake site, La Cholla Case Management

1501 W. Commerce Court

Tucson, 85746

1-520-205-4732

COPE Community Services

Intake Site, Mesquite Case Management

2435 N. Castro Ave.

Tucson, 85705

1-520-205-4732

COPE Community Services

Intake site, Mary Ann Coady, M.D. Clinic

8050 E. Lakeside Parkway

Tucson, 85730

1-520-205-4732

COPE Community Services

Intake site, Green Valley/Villa Verde

170 S. La Cañada Drive, Suite 90

Green Valley, 85614

1-520-205-4732

La Frontera Center

Administration and intake site

502 W. 29th St.

Tucson, 85713

1-520-884-9920

www.lafrontera.org

La Frontera Center

Intake site

4891 E. Grant Road

Tucson, 85712

1-520-296-3296

La Frontera Center

Intake site

1141 W. Grant Road, Suite 100

Tucson, 85705

1-520-206-8600

La Frontera Center

Intake site, PPEP Behavioral Health

111 La Mina Ave., Suite 5

Ajo, 85321

1-520-387-5232

MHC Healthcare Behavioral Health Services (Marana Health Center)

Main Medical/Integrative Healthcare Center

13395 N. Marana Main Street, Bldg. B

Marana, 85653

1-520-682-1091

maranahealthcenter.org/our-services/behavioral-health

Pantano Behavioral Health Services

Intake site, Sells, (Intermountain Sells)

Tohono Plaza, BIA Route 19, Suite 403-409

Sells, 85634

1-520-383-1790

www.pantanobh.org

Pantano Behavioral Health Services

Intake Site (Intermountain Tucson)

5055 E. Broadway, Suite C104

Tucson, 85711

520-623-9833

520-917-6485 (New intakes)

CHILD/ADOLESCENT COMPREHENSIVE SERVICE PROVIDERS

Casa de los Niños

Intake site

140 N. Tucson Blvd.

Tucson, 85716

1-520-881-1292

www.casadelosninos.org

CODAC

Intake Site (Young Adult)

3550 N. First Ave., Suite 125

Tucson, 85719

1-520-202-1840

www.codac.org

CODAC

Intake Site (Youth)

1080 S. 10th Ave.

Tucson, 85701

1-520-202-1840

La Frontera Center

Administration and intake site (Children)

502 W. 29th St.

Tucson, 85713

1-520-838-3946

www.lafrontera.org

La Frontera Center

Intake site

4891 E. Grant Road

Tucson, 85712

1-520-296-3296

La Frontera Center

Intake site

1141 W. Grant Road, Suite 100

Tucson, 85705

1-520-206-8600

La Frontera Center

Intake site, PPEP Behavioral Health

111 La Mina Ave., Suite 5

Ajo, 85321

1-520-387-5232

MHC Healthcare Behavioral Health Services (Marana Health Center)

Main Medical/Integrative Healthcare Center

13395 N. Marana Main Street, Bldg. B

Marana, 85653

1-520-682-1091

maranahealthcenter.org/our-services/ behavioral-health

Pantano Behavioral Health Services

Administration and intake site

5055 E. Broadway, Suite C104

Tucson, 85711

1-520-623-9833

www.pantanobh.org

Providence Service Corp.

Administration and intake site

1161 N. El Dorado Place, Suite 103

Tucson, 85715

1-520-748-7108

www.provcorp.com/Locations/Arizona.asp

Providence Service Corp.

Intake site

3295 W. Ina Road, Suite 150

Tucson, 85741

1-520-748-7108

Crisis help

Emergency/Crisis/Need to Talk

If you or someone you know is having a life-threatening mental-health emergency (if, for example, thoughts of suicide or weapons or a potential overdose are involved) always call 911. Tell the dispatcher and responders if mental illness or substance abuse is involved.

If your crisis is urgent but not immediately life-threatening, call CPSA's Community-Wide Crisis Line at 1-520-622-6000 or 1-800-796-6762. The crisis line offers help to anyone in Pima County for a mental-health or substance-use crisis at any time every day, including holidays, as part of the publicly funded treatment system.

The trained, professional staff will help you figure out whether you need to come in to a crisis-stabilization facility, or whether another resource would better meet your needs. They have up-to-date information on immediately available resources in the CPSA system. Sometimes staff can help resolve your crisis over the phone, or they might dispatch a Mobile Acute Crisis (MAC) Team to you.

If you need to talk to someone but aren't having a crisis, try the HOPE Inc. Warm Line at 1-520-770-9909. It's operated from 8 a.m. to midnight every day by people who themselves are in recovery from a mental illness or substance-use disorder. HOPE Inc. is a peer-support organization that focuses on recovery and mental illness.

CRISIS RESPONSE CENTER

CPSA's new Crisis Response Center, just south of Ajo Way and Country Club Road, offers psychiatric urgent care to anyone in Pima County, regardless of age, income or other factors. If you are having a mental-health crisis and need immediate help, you can walk in to the center for services at any time (although it's helpful to call the crisis line first to let them know you're on your way).

The staff will assess your situation and provide care to stabilize your crisis. You might need some time in a safe, quiet environment to work through your crisis with people to support you. If you're on medication for a behavioral-health condition, it may need to be adjusted. Staff members who are in recovery from mental illness or a substance-use disorder will provide support, helping you understand what's happening and what to expect. You'll also have a chance to apply for AHCCCS or other care programs.

When your condition is stabilized, you'll get information on other community resources. If you're eligible for or already enrolled in the public behavioral-health-care system, staffers from CPSA providers will help you transition to other care.

Learn more about the Crisis Response Center at www.crisisnetwork.org, which has a short quiz that can help you decide whether you need crisis care. The Crisis Response Center is part of a complex on Pima County's Kino Campus that includes the University of Arizona Health Network's Arizona Medical Center - South Campus, with an expanded psychiatric emergency department, and the network's new Behavioral Health Pavilion.

SAMHC ( PRONOUNCED SAM-HACK)

SAMHC is another place to go for help with a mental-health crisis. SAMHC also will see you no matter how old you are, whether or not you have insurance or can pay.

SAMHC is open from 8 a.m. to 8 p.m. every day. It's at 2502 N. Dodge Blvd. (the entrance is on Flower Street, a couple blocks north of Grant Road). Staffers will help you figure out what's going on, evaluate your situation, help with crisis counseling, drug/alcohol assessment, figure out if you are eligible for AHCCCS /Medicaid and help you connect with services.

Learn more at www.samhc.com

COMPASS BEHAVIORAL HEALTH CARE (DETOX)

Compass is where to go for help with substance abuse. Call 1-520-624-5272 anytime, 24 hours a day.

Compass provides services for addictions to a variety of substances.

Detoxification facilities are at 2499 E. Ajo Way (across the street from UA Health Network's South Campus; entrance from Forgeus). Compass is part of the public behavioral-health system, and some of its services are also available on a sliding scale for those who don't qualify for AHCCCS.

OTHER CRISIS CONTACTS

24-hour national crisis hotlines:

• 1-800-SUICIDE - HopeLine Suicide Hotline

• 1-800-273-TALK - National Suicide Prevention Lifeline

SUICIDE/CRISIS HOT LINES BY LOCATION

• Pima, 1-800-796-6762 or 1-520-622-6000

• Maricopa, 1-800-631-1314 and 1-602-222-9444

• Graham, Greenlee, Cochise and Santa Cruz, 1-866-495-6735

• Gila River and Ak-Chin Indian communities, 1-800-259-3449

• Yuma, LaPaz, Pinal and Gila, 1-866-495-6735

• Mohave, Coconino, Apache, Navajo and Yavapai, 1-877-756-4090

NEW CRISIS RESPONSE CENTER

The Community Partnership of Southern Arizona's Crisis Response Center opened in August 2011, after voter approval in a 2006 Pima County bond election. It offers 24/7/365 crisis services to anyone in Pima County and is near the UA Health Network's South Campus, just south of Ajo Way and Country Club Road. The center has separate areas for adults and for children and adolescents in crisis. An expanded psychiatric emergency department is in the same complex, along with inpatient units for people who need hospitalization.

The center treats everyone, regardless of insurance status or enrollment in AHCCCS (Arizona's form of Medicaid), and staff will help people determine whether they are eligible for benefits that would pay for ongoing treatment. You can bring someone to the center or go there yourself and be evaluated and given guidance for future behavioral-health care.

Definitions, terminology and jargon

TITLE 19/NON-TITLE 19 (TITLE XIX/Non-Title XIX)

A person who meets certain income requirements can qualify for the public behavioral-health system and is called a "Title 19" client. Someone who does not is referred to as "non-Title 19."

BEHAVIORAL HEALTH

This includes mental health, mental illness and substance abuse.

SERIOUS MENTAL ILLNESS

This is when a person's emotions or behaviors, because of a mental disorder, are so affected that he or she has a hard time living day to day without ongoing support and treatment. It has a long-term impact on the person's relationships, employment and ability to get along with others, and makes it harder to function in other aspects of life.

The term generally applies to persons age 18 or older, but research has shown some serious mental illnesses begin before that. Disorders such as bipolar disorder, schizophrenia and some types of depression are considered serious mental illnesses.

CPSA's Comprehensive Service Providers or SAMHC can make an official determination of serious mental illness that means the person is eligible for some publicly funded services.

MEDICAL V. LEGAL COMPETENCE

Assessing a person's mental competency means different things in different venues.

In the medical or psychiatric arena - such as determining if a person with a serious mental illness should be hospitalized, even against his will - the measure is if the person is a danger to self or others, persistently or acutely disabled or gravely disabled.

These are civil actions involving the court. Terms such as "civil commitment petitions," "Title 36," "pre-petition hearing" and "emergency petition" are all part of the process that allows a person with a mental illness to be hospitalized if a judge, relying on expert and witness testimony, decides it's in the person's best interest.

That's different than determining competency in the context of a criminal proceeding. "Rule 11" is shorthand for the need to figure out if a person who has been charged with a crime has the ability to understand the charge and the trial process and can assist his defense attorney.

After a person is evaluated under Rule 11, a judge must decide if the person is competent (which does not mean the person is not mentally ill), incompetent but restorable (with psychiatric medication or other treatment the person can be made to understand and assist in his own defense), or incompetent and not restorable. This last category means the person cannot legally be tried for a crime, because he is not now and never will be in a mental condition to understand the legal system and assist in his defense. When that happens, if the person is diagnosed as having a serious mental illness, he may end up being civilly committed to a hospital under Title 36. If the incompetency is caused by brain damage, for example, he will be released from jail but not necessarily hospitalized.

INVOLUNTARY COMMITMENT/ HOSPITALIZATION

A person must be found by a court, relying on psychiatric professionals, to be a danger to himself or others, "gravely disabled" or "persistently or acutely disabled" before he can be hospitalized for court-ordered evaluation.

COURT ORDERS FOR MENTAL-HEALTH EVALUATION AND TREATMENT/TITLE 36/EMERGENCY PETITION/CIVIL COMMITMENT

In the Tucson area, seeking a court-ordered psychiatric assessment starts with a call to the 24-hour Community-Wide Crisis Line at 622-6000 or 1-800-796-6762. Any responsible person may apply for a court-ordered evaluation of a person who isn't willing or able to be evaluated voluntarily.

Crisis Response Center or SAMHC staff members help people through the process, which varies based on whether the need is urgent.

An application for emergency admission for evaluation is used when the person in need of evaluation is a danger to self and/or others and requires immediate hospitalization. When the patient arrives at the emergency department, he is examined by a psychiatrist who determines whether emergency admission is necessary. If the patient is admitted on the emergency application, he will be further evaluated over the next 24 hours (excluding holidays and weekends). The evaluating psychiatrist will decide whether the patient requires court-ordered evaluation.

The hearing could result in a court order for treatment, which typically involves a hospital stay until the person is stabilized, followed by outpatient care. If the person doesn't comply with outpatient treatment - by not taking medication, for example - the court can order him back into the hospital, if other less-restrictive solutions are not appropriate

The court order, which is good for one year, includes a certain number of days available for inpatient treatment. Those periods differ depending on whether the person is deemed a danger to themselves (90 days), to others (180 days), "persistently and acutely disabled" (180 days) or "gravely disabled" (365 days).

Calls can be made anonymously to a crisis line to report concerns about someone's mental health. However, people who make formal petitions to the court are identified once the case is in the legal system.

If a person needs immediate evaluation because he might be a danger to himself or others, call 911.

DANGER TO SELF OR OTHERS

Under Arizona law (A.R.S. 36-501), a person is considered a "danger to others" if a mental disorder affects his judgment so much that he can't understand that he needs treatment, and if the person continues to go without treatment it "can reasonably be expected" (based on medical opinion) to result in "serious physical harm."

A person with a mental disorder is considered a "danger to self" if:

• She has attempted or makes a serious threat of suicide.

• Given her history and the circumstances, the threat seems likely to be carried out.

• She needs to be hospitalized to prevent serious harm or serious illness.

"Gravely disabled" means a person is likely to experience serious physical harm or serious illness because he is unable to provide for his own basic physical needs. Being unable to provide yourself a place to live or being homeless may be an indication of grave disability, but on its own does not mean a person is a "danger to self" under the law.

According to the law, "persistently or acutely disabled" means having a severe mental disorder that meets all the following criteria:

• If not treated has a substantial probability of causing the person to suffer or continue to suffer severe and abnormal mental, emotional or physical harm that significantly impairs judgment, reason, behavior or the capacity to recognize reality.

• Substantially impairs the person's capacity to make an informed decision regarding treatment, and the impairment keeps him from understanding and expressing understanding of the pros and cons of accepting treatment and alternatives to the specific treatment offered after the pros, cons and alternatives are explained to him.

• Has a reasonable prospect of being treatable by outpatient, inpatient or combined inpatient and outpatient treatment.

DECOMPENSATE (OR "DECOMP")

"Decompensate" describes what happens when the condition of a person with mental illness who has been stable and functional, often on medication or other therapies, deteriorates and the person shows worsening symptoms of his illness. A decompensating person is likely to end up in a mental illness crisis if he's unable to get treatment.

RBHA (PRONOUNCED 'REEBA')

Arizona is divided up into geographical areas, and a Regional Behavioral Health Authority, or RBHA, is the agency the state puts in charge of managing services for people who live in that area and qualify for public services. In Pima County, the RBHA is Community Partnership of Southern Arizona, or CPSA.

A Tribal Regional Behavioral Health Authority (TRBHA) does the same thing for eligible people who are residents of a tribal nation, like Pascua Yaqui. Members of the Tohono O'odham Nation do not have a TRBHA and are served by CPSA.

CRISIS INTERVENTION TEAM TRAINING (CIT)

This trains law enforcement officers to help them identify when mental illness could be involved in a police call, defuse potentially dangerous situations and keep all parties safe.

RECOVERY

Recovery begins as soon as a mental illness is diagnosed and continues as the person's illness is managed. Education, support and, in some cases, medication help the person be responsible for his or her own progress. It includes overall health and wellness, relationships and opportunities to hold a job, help others with a mental illness and/or be active in the community.

How to help yourself or someone else

As others have said, if you see someone having a heart attack on the sidewalk you'd not hesitate to call 911 for help. But if someone is visibly agitated or displaying signs of mental illness, we aren't so quick to act - or to know what to do.

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

About this blog

Arizona Daily Star health reporter Stephanie Innes brings you the latest health information. Contact her at sinnes@tucson.com

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