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Zappala: Allegheny County Jail could house violent mentally ill for treatment

| Friday, May 10, 2013, 12:01 a.m.

The treatment that mentally ill patients in Allegheny County undergo has several gaps that need to be closed, and leaders should consider making space in the jail for those who are prone to violence, District Attorney Stephen A. Zappala Jr. said on Thursday.

In a four-page letter to County Executive Rich Fitzgerald and Council President Charles Martoni, Zappala laid out problems with the way the county delivers mental health services, referencing John Shick's shooting rampage at Western Psychiatric Institute & Clinic in Oakland last year. One person was killed, and five were injured.

Zappala said there's a shortage of residential treatment programs and Western Psych has been unwilling to accept referrals for patients with drug and alcohol problems unless it has previously treated them.

“Ultimately, these (procedures) limit the care and support available for psychiatric patients,” he said.

UPMC released a statement: “At all times, every patient in need of psychiatric services will be treated at Western Psychiatric Institute and Clinic of UPMC, regardless of diagnosis.”

Dr. Bruce Wright, chief of psychiatry at St. Clair Hospital, agreed that the county lacks options to deal with violent mentally ill patients.

“There's a lack of structured and supervised facilities,” Wright said. “As far as the jail goes, I think it's a good idea. I don't think he's saying put them in the general population. If it's a separate unit, it doesn't mean they're incarcerated.”

Vic Walczak, ACLUstate legal director, said the issue “bears further study.”

People who commit crimes who have mental health problems are treated in the jail. If a judge deems them incompetent to stand trial, they are typically sent to Torrence State Hospital in Westmoreland County.

Police officers, doctors and county delegates can force people to undergo an emergency mental evaluation if they haven't committed crimes. A doctor in an emergency room would have to agree, and the person could be held and treated for five days in a hospital that has psychiatric facilities.

If a doctor deems further treatment is necessary, a hearing takes place at the hospital. Longer stays can be ordered.

Zappala said the county could use some of the $14.3 million it is paying Western Psych this year for mental health services for a special jail pod.

The district attorney cited a UPMC security report detailing changes at Western Psych and other hospitals, including having armed guards in the health system's Pittsburgh hospitals and metal detectors in emergency departments.

UPMC is designing two centralized security command centers — one to cover hospitals in Allegheny County and another to cover hospitals outside the county.

Bobby Kerlik is a staff writer for Trib Total Media.

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