Unit in Fayetteville called likely

Attorney says UAMS building best for mental health crisis beds

A mental health crisis stabilization unit in Northwest Arkansas will likely open on the Fayetteville campus of the University of Arkansas for Medical Sciences even if campus leaders don’t want it, Washington County’s attorney said last week.

Washington County is getting money from the state government to set up one of four, voluntary, 16-bed crisis units in Arkansas for people experiencing severe mental health problems who might otherwise be arrested and put in local jails. The first of the four opened in Fort Smith about a month ago, but the Northwest unit is still waiting for a home.

Washington County attorney Brian Lester said the best location is on the fifth floor of the UAMS building at North Street and College Avenue.

The county built the building, owns the land it

stands on and has leased it to the university for $1 a year for about a decade under an agreement that lasts until at least 2029. The floor was the psychiatric department for Washington Regional Medical Center when the hospital occupied the building, so Lester said it has some of the necessary safety features.

UAMS Northwest Regional Campus has other plans for the space, Associate Vice Chancellor Pearl McElfish wrote in a February letter to Washington County Judge Joseph Wood. She didn’t specify those plans, but said fifthfloor renovations will begin this year. She then suggested going to an open floor in the free WelcomeHealth clinic next door, which also sits on county-owned land and pays the university for a sublease of the space.

“While UAMS Northwest is very supportive of your locating the CSU in the lower floor of the building currently occupied by Welcome Health, our plans do not contemplate placement of such a unit in the main building,” McElfish wrote. “Security concerns alone would militate against such a decision.”

UAMS Northwest spokeswoman Dana Engelbert last week said the campus is moving office and program space to the fifth floor to make more room for clinical care on the second.

Pulaski County is working with the University of Arkansas for Medical Sciences in Little Rock for its unit, but McElfish pointed to the center’s nearby Psychiatric Research Institute. She said the Northwest region doesn’t have a similar facility.

“Additionally, the University of Arkansas Board of Trustees has recently reinforced the need for this campus to focus on current priorities and limit investments in new endeavors,” McElfish wrote.

UAMS statewide recently eliminated hundreds of positions and cut millions of dollars in spending.

Lester said the county judge has considered WelcomeHealth as well as building a new location, but wants to control costs as much as possible. He said the open WelcomeHealth space could need about $1 million in renovations, for instance. The $1.6 million provided annually by the state for each unit is for operating costs once the units are open, not construction beforehand.

Washington County has reached out to the statewide UAMS leadership and other officials to compel the Northwest officials to cooperate, Lester said. The county can force the issue under state law and draw up an amended lease to meet its own needs, he added.

“That kind of seems to be our last resort,” Lester said, but if the local UAMS campus doesn’t change its mind, “that’s probably the route we’ll go.”

“I would prefer that they respect that this land was given to them by Washington County,” Lester added. He said taking this approach wouldn’t mean kicking UAMS out entirely, but adjusting the lease to take charge of the fifth floor.

Engelbert declined to comment on the county’s potential action, saying the county hasn’t contacted her organization since February.

Lester said the unit should take about two months to begin accepting patients from Benton, Carroll, Madison and Washington counties once it has space.

All of the units are meant to help stabilize patients and refer them to longer-term care at more established providers, such as Ozark Guidance. Stays would likely stretch to up to three days or so, Lester said.

The Fort Smith unit took in 25 people in its first month, and its director last week said she expects it’ll pick up

over the coming months.

A person with severe depression, bipolar disorder or other mental illness is 10 times more likely to be in a jail than in a mental hospital, according to an oft-cited statistic in a 2014 report by the nonprofit Treatment Advocacy Center. The U.S. Substance Abuse and Mental Health Services Administration estimates one in five adults experience mental illness in a given year.

Put those together, and Washington County’s jail houses hundreds of detainees with diagnosed mental health issues, Sheriff Tim Helder has said in recent years.

A local coalition called Judicial Equality for Mental Illness, which includes local law enforcement officials, pushed for years for a system to divert people with mental illness from jail and prison. Gov. Asa Hutchinson and other state officials formally joined the push last year amid frequent overcrowding in the state’s lockups.

“It is exciting to see that Arkansas is doing something that other states will look at and learn from, adapt, and we will lead,” Hutchinson said at the Fort Smith unit’s opening. “This is important for our nation.”

Nancy Kahanak, coordinator for the judicial group and retired Ozark Guidance case worker, said law enforcement departments have trained their officers on handling mental health needs and are just waiting for a place to go. In the meantime, she plans to watch how things go in Fort Smith and learn from what goes smoothly or otherwise.

Kahanak said the UAMS spot in Fayetteville would be a good home for a local unit, with a central location and health care providers and students nearby.

“It seems like it’s obvious that that would be the best place, and it’s been totally unclear why they’re reluctant to have that space be used,” Kahanak said of UAMS.

Northwest Health said last year its Springdale medical center would host the crisis unit, but officials later realized the unit couldn’t be part of a hospital under federal and state rules, Lester said.

Northwest recently added several beds to its inpatient behavioral health program at Springdale. The program includes 47 beds and started about a decade ago in partnership with multiple area providers, including UAMS Northwest.