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Sun. Jul 14th, 2024

Power struggle: Mental health patients are in the middle of a fight between elected leaders

By Vaseline May30,2024

Sheriff’s deputies escorted the handcuffed man to the conference room on the eighth floor of the Omaha-Douglas County Civic Center. Inside, members of the Douglas County Board of Mental Health, which oversees the mental health care of hundreds of people each year, prepared to discuss his progress.

Also present: Crystal Rhoades, Douglas County Clerk of Court.

Douglas County District Court judges had threatened earlier that day to hold her in contempt of court, the latest rebuke in a yearlong fight between Rhoades and other elected leaders over the key, but underfunded, mental health board.

The handcuffed patient who appeared before the board on May 14 had invited a Flatwater Free Press reporter. But given Rhoades’ presence, his attorney said, it would be better if the reporter was not in the room.

“I wouldn’t think it would be right for (my client) to potentially be drawn into a political (fiasco),” said Henry Nunn, the patient’s public defender who, after speaking with his client and bosses, successfully appealed against attending the hearing by Flatwater Free Press. .

Since June 2023, Rhoades has raised concerns with the Douglas County Board of Mental Health. She claims she is being asked to do unauthorized legal work, a crime punishable by a $500 fine and/or three months in jail. She also claims patients’ rights are being violated, according to emails obtained by Flatwater Free Press through a public records request.

The board chairman and other leaders, including Sheriff Aaron Hanson, disagree. They say there is a half-century of precedent behind many of the board’s practices.

Borgeson

The political furore has led to calls for a mental health board review, something Mary Ann Borgeson, a county commissioner since 1994, said she has never seen.

“If this system, which everyone seems to have thought has worked so well for so long, has gaps and problems, then to me this is a really good time for us to look at it,” she said. “So I consider it a good thing.”

The Mental Health Board process begins when someone – a family member, a police officer, a doctor – believes someone is mentally ill and dangerous and is unwilling to seek treatment. The Mental Health Board then works with doctors to create a plan or submit the person to a state-run regional center or other treatment.

The board also oversees the deployment and treatment of people under the Sex Offender Commitment Act. Each of Nebraska’s six judicial districts is required to have a Mental Health Board. The Omaha-based board processed at least 844 petitions in 2023, according to data from the Douglas County Sheriff’s Office.

The board, which has no budget or staff, is dependent on several provincial offices for its functioning.

The sheriff’s office serves arrest warrants and brings people to the board. The public defender represents them. The county attorney lobbies for specific treatment options. And the district court clerk serves as connective tissue, certifying orders, attending Mental Health Board meetings and preparing files.

Rhoades, elected in 2022, believes the preparation of those files is a legal practice that should be handled by the county attorney. She has also tried to make other changes that ruffled feathers in several other county offices.

Rhodes

Last summer, a supervisor in Rhoades’ office announced that Mental Health Board meetings would be held at the clerk’s office. Some meetings have already taken place there. Typically, however, the board meets people suffering from serious mental illness in hospitals and treatment centers. This has been happening for almost fifty years, the chairman says in an email. Rhoades said the changes were intended to save money and “limit the office’s overall liability.”

Leaders at the public defender, county attorney and sheriff’s offices have raised logistical, ethical and financial concerns. In July, emails flowed between board chairman Michael McLellan, who accused Rhoades of obstructing the board, and Rhoades, who claimed patients’ rights were being violated “left and right.”

McLellan retained two attorneys from the Nebraska attorney general’s office, although a spokesperson recently said that office had “nothing on the matter.”

The back and forth continued via email, through meetings, and in formal letters. Ultimately, district court judges intervened and issued several orders to keep board operations at the status quo.

Earlier this month, Rhoades sent a new letter to district court judges announcing changes, including reassigning several duties previously performed by the clerk. The justices responded again, ordering Rhoades to leave matters as they were, and citing statues suggesting she not speak publicly on Board of Mental Health matters.

“This order shall be enforceable under all available remedies, including but not limited to contempt proceedings,” the order reads.

Some of Rhoades’ objections may not be unfounded, said Douglas County Public Defender Tom Riley. Although for decades it was assumed that people appearing before the board would be represented by the public defender, Rhoades pointed out that his office was not officially appointed to represent those clients. A court order later made it clear that Riley’s office would represent all people appearing before the board.

Riley

The court administrator declined comment, saying the judges wouldn’t either. Rhoades declined to speak for this story, citing the judge’s order. McClellan declined to be interviewed, saying he did not want to answer questions from reporters he believed Rhoades had influenced. Attorney Don Kleine did not respond to interview requests.

“There were some cuts for pragmatic purposes, and not strictly by the book, so to speak, and she raised some of those things,” he said, “and she wasn’t wrong about some of those things. ”

Rhoades has the right to question her role in the governance process, Borgeson said. But the continued hostility, which comes from all sides, bothers the longtime provincial board member.

“We (must) stop all this nonsense and come to the conclusion: if we want to change the process, let’s change it,” she said. “But we have to keep the person we serve at the top.”

Tim Heller, chairman of the state Advisory Commission on Mental Health and Substance Abuse, said the board is failing to adequately serve people in mental health crises. Heller has filed multiple petitions with the Douglas County Board of Mental Health for his son, who suffers from serious mental illness. Heller said he often speaks with families who find the mental health experience confusing, scary and ineffective.

For Heller, the bickering over responsibilities on board misses the point.

“It needs to be torn down and completely rebuilt,” he said.

One problem, Heller said: The board has no teeth and can’t ensure patients stick to their treatment plans. Heller said similar groups in other states have programs to identify and help people who deviate from treatment plans. He said the area also needs more mental health resources, something everyone interviewed for this story agreed on.

Some solutions exist: A pilot program run by the Sarpy County Board of Mental Health currently assigns a caseworker to patients. Heller believes a social worker can help people better navigate Nebraska’s mental health system, which recently became the subject of a U.S. Department of Justice civil rights investigation.

Local officials should focus on lobbying the Legislature for changes, Hanson said, and not get lost in internal fighting.

“I absolutely believe we need to take a fresh look at mental health governance,” Hanson said.

Hanson

While the board’s functions have seen few interruptions due to the internal wrangling, at least one person feels it has affected him: Adrian Martinez, who invited the Flatwater Free Press reporter to his Board of Mental hearing Health on May 14.

Nunn, Martinez’s public defender, had suggested in the hearing room that Rhoades should not be there, resulting in a tense back and forth. Nunn withdrew his objection after Riley said he told him he was wrong.

In an interview, Riley also said he told Nunn to advise his client that it is generally not beneficial to have a journalist at a mental health hearing, where unflattering information may be shared. His advice, Riley said, had nothing to do with Rhoades’ presence.

In a letter Martinez wrote the next day entitled “Violation of Rights,” he said he was told the reporter’s presence would be bad for his case and that “under duress I had no choice but to object.” . His right to a public meeting, to introduce the press to the inner workings of a government that has become an integral part of his life, was denied for one reason, he wrote.

“Politics is what all the fuss was about.”

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