Construction work is ongoing for a new crisis triage center at the University of New Mexico Hospital in Albuquerque, New Mexico. Pictured on March 1, 2023. (Photo by Megan Gleason / Source NM)
Instead of law enforcement taking people to jails or hospitals, New Mexicans could be sent to crisis triage centers to help with mental health needs.
This will happen if House Bill 373 makes it through the Roundhouse.
The legislation passed unanimously through the House Health and Human Services Committee on Wednesday. That was the bill’s first committee. It still has a long journey ahead in the two and a half weeks that remain this session.
Jamie Michael is the Health and Human Services director in Doña Ana County, the home of a crisis triage center. She acted as an expert on the bill on Wednesday.
Right now, Michael said law enforcement can only take people to jails or emergency departments. “I think we all agree that those two environments are not the best for most people who are experiencing a crisis,” she said.
This bill would tack on crisis triage centers as an option to take patients, voluntarily or not. Michael said a range of people could be brought over, from someone who’s intoxicated to a person that’s suicidal to someone just having a bad day.
“The primary purpose was really to take that opportunity of a crisis and connect people to care, connect people to medication, connect people to outpatient or inpatient services,” Michael said.
She said most patients in other states who come into involuntarily transfer decide to get into voluntary care “because it’s a nicer place than a jail or an emergency department.”
There are only three licensed crisis centers in the state, located in Albuquerque, Santa Fe and Las Cruces. Another one is in the works at the University of New Mexico Hospital, also in Albuquerque.
A few lawmakers voiced concerns about how this bill would apply to areas in rural New Mexico where there aren’t crisis centers nor the resources or staff available to set them up.
“We are a mostly rural state. I am so happy that we have success in Las Cruces and we can copy that. That’s very exciting,” Rep. Kathleen Cates (D-Rio Rancho) said. She continued to ask if a rural county center could be run by one or two people.
Michael said the crisis triage centers that are already set up can act as regional resources. “We want to serve our neighboring counties,” she said.
Anyone living in the Four Corners of the state would still have to travel hundreds of miles to access the existing centers. For someone living in Hobbs, it would be a four and a half hour drive spanning over 250 miles to get to the closest center in Las Cruces.
Bill sponsor Rep. Doreen Gallegos (D-Las Cruces) said figuring out the long drive to actually make it to the facility would be up to law enforcement and sheriff’s departments. Michael said emergency services could also help handle transportation.
To get the patient back home, Michael said centers can offer transportation services, like the one in Doña Ana County does. Or, she said, family or friends could come pick them up.
“Transportation is always a challenge,” she said.
The bill’s Fiscal Impact Report pointed out a few other concerns.
New Mexico has had a health care provider shortage since before the pandemic, and the centers would need to have enough staff to keep up with an influx of involuntary patients. The report said the Department of Health would survey crisis triage centers to see if there are enough officials to handle the new patients.
There’s also a potential legal risk, according to the report, because patients who are involuntarily admitted to hospitals must be evaluated psychiatrically to ensure they aren’t a harm to themselves or others.
Rep. Joanne Ferrary (D-Las Cruces) asked about this, and Michael said there would need to be specific standards and trainings implemented at the centers.
Part of the bill’s intention is also to reduce incarceration rates, but the small number of centers could limit that potential, according to the report.
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Rep. Stefani Lord (R-Sandia Park) questioned what law enforcement officers are supposed to do if a facility is full, but Michael said the model is designed to never turn anyone away. She said across the country, centers have never been completely full. That’s because they have open spaces that don’t require beds for patients and it’s a quick turnaround, she said.
“People are moving through the facility so quickly that we’ve never come to a place where it’s been too full.”
Rep. Harlan Vincent (R-Ruidoso Downs) said he’s concerned about the safety of the providers and patients in these facilities. He asked if there is security or law enforcement present, and Michael said no.
She said it’s not necessary because the purpose of the facility is to aid with behavioral health needs, not typically violent behaviors. And for some people whose symptoms come off as frightening or aggressive, there are staff who know how to work with that, she said.
“The security comes from how the clinician and peers are trained to interact with individuals,” Michael said.
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