The young woman walked into her bathroom, sat on the toilet seat and pondered her next move. She reached into the medicine cabinet for a bottle of Tylenol PM, an over-the-counter pain reliever that most people have in their homes.

Instead of taking the prescribed two, maybe three, every couple of hours, she would take the entire bottle, hoping to put 24 years of memories and doctor’s visits in the past.

Her name is L.G. She’s a resident of Kittitas County, and instead of ending her life that night, she would wake up in the Kittitas Valley Hospital (KVH) Emergency Room finding herself in a familiar place—the same place she had been seven years prior when she first attempted suicide, days after she was diagnosed with schizophrenia.

Emergency crews would arrive on the scene after her brother found her unconscious on the bathroom floor. She would then be rushed to KVH, where doctors would find that L.G. was not on her medication for schizophrenia and was suicidal.

She would sit behind white walls for days, while doctors from KVH and counselors from Central Washington Comprehensive Mental Health (CWCMH) would make arrangements with her for post-treatment, just like years before.

She would have to see the disappointment in her mother’s face again and watch as her brother angrily blamed himself for being at work too long that day.

But it wasn’t his fault. This is what L.G. wanted—a break from all of the counseling sessions, prescribed medications and the feeling that she would always disappoint the ones she loved.

A growing problem

According to the 2014 Ellensburg Police Department (EPD) Annual Report, the number of mental health-related incidents in Ellensburg jumped from 89 incidents in 2006 to approximately 180 incidents in 2014—a warning to all in Ellensburg that mental health is a growing problem. L.G. is just one of the many cases.

For Ellensburg Police Chief Dale Miller, it’s another responsibility on an already enormous list of duties that the police department is expected to fulfill.

“The reality is it’s been kind of dropped into our lap,” Miller said. “And there’s this expectation from the public that we’re going to be able to spew some magic words that will take someone from a manic stage and bring them back to reality.  You can’t just fix [someone] who is in that state.“

Miller says that there is no set routine for responding to a mental health situation; every response varies depending on the level of the person in crisis (whether they are calm or agitated) and how many people are involved.

From there, police officers can assess the person they’re responding to and use de-escalation skills until a local mental health professional is there to help.

If necessary, EPD will escort individuals to KVH where a professional, usually someone from CWCMH, will then assess them.

A jump in responses

The Kittitas Valley Fire Department (KVFR) also felt a rise in their response rates for mental health-related incidents over the last couple years and some of those numbers reflect an increase around the college.

KVFR Deputy Chief Rich Elliot said, in addition to a bump around finals time, the fire department is already running double the amount of mental health-related calls in the last four to five years.

“We do tend to see a noticeable increase, we’re talking small numbers, in the dorms with new students,” Elliot said, “They’ll get to the end of the quarter, the end of the year and they’ll attempt. [But] they’re not usually the more serious attempts.”

However, Elliot also said that the KVFR is limited in how they can help.

“Our numbers will be smaller [than the numbers from the EPD] because we do not respond to incidents where there isn’t a diagnosed medical issue,” Elliot said.

Emergency personnel are educated to properly deal with people in crisis.

The training can be something as simple as communication skills to deal with family situations and people with disabilities to working with individuals with chemical dependencies.

When asked if the increased responsibility has fallen on KVFR’s shoulders, Elliot said his concern is that individuals in the community are already coming to them with progressive issues.

“It’s a bad symptom that it is getting all the way to us,” Elliot said. “Ideally, EMS would have limited involvement in mental health issues because [ideally] they would have already been identified and treated.”

Central sees surge in mental health-related calls

With records obtained from Central Washington University Police Chief Mike Luvera, the numbers of mental health referrals and suicide attempts have gone up by an alarming 115 percent, from 13 in 2012-13 to 28 in 2014-15.

In 2011, just two school years prior, there was only nine total. And the school year isn’t even over.

“This has been a pretty active year,” Rhonda McKinney, director of the school’s counseling clinic said. “We’ve had [Central Washington] Comprehensive Mental Health out here probably more than normal [and] we’ve had more hospitalizations.”

McKinney acknowledged that while she doesn’t know if the active year signifies a trend, there are certainly times of year that the counseling clinic can expect to respond to more mental health-related incidents.

“[In] winter quarter, we tend to see more students who are depressed and spring is when we see students who are more activated,” McKinney explained. “If the student has bipolar disorder, for example, spring is often when they will become manic and will either be activated with lots of energy or if they have been contemplating suicide in the winter, the spring is often when they will get enough energy on board to attempt.”

The community responds

CWCMH responds to the community in a variety of ways, usually beginning at the time of the incident. Comprehensive Mental Health responders will either arrive at the scene of a mental health-related incident by notification of local officers or meet the patient at the hospital and assess their needs.

“We will see you the same day, night or weekend. We prioritize those people [and] want to be there for them,” Division Director of Comprehensive Health, Harry Kramer, said.  “We ensure they have the basic needs, safety plan and supporting family.”

According to Kramer, the counselors work hand-in-hand with ER doctors to determine the condition of the patient, look into their psychological or social records and assess them for a variety of risk factors. These risk factors determine the likelihood that the patient will do something harmful to themselves or others.

Depending on the assessment, Comprehensive Health will often refer patients back to the community through a less restrictive option, typically 3-14 days with a local ministry, private therapist or mental health counselor. And in rare cases, patients are transported to Bridges Evaluation and Treatment Center in Yakima, Wash.

In response to the growing numbers from KVFR and EPD, Kramer said that although he’s not sure if these numbers signify a trend, they certainly are concerning.

“Any numbers going up are a concern,” Kramer said. “And so the question is can we meet those needs? And I believe we do that.”

Preparing for the future

Miller says that the Ellensburg Police Department will continue to respond to the communities needs through crisis intervention training (CIT), which is now required for all Washington state law enforcement effective April 2015. He added that while CIT has been around for about 10 years, law enforcement has always had some sort of psychological training.

“It’s always been part of the job,” Miller said. “There’s everything from 40 hour to eight-hour courses. We also have an officer in-house who trains our guys during in-service training. It’s so broadly available right now.”

Luvera added that the CWU Campus Police will also continue their crisis intervention training and continue to raise awareness on the college campus.

“I think that our students are walking in the door more stressed,” Luvera said. “Really what we’re trying to do is get the educational piece out there and make that information available. We [already] work closely with Comprehensive Health and our health and counseling center on campus. We’ll continue to do that.”

KVFR will also continue its training with emergency personnel on developing communication skills to help them properly deal with mental health crisis situations.

For the first year, Comprehensive Health will track substance abuse in relation to mental health-related incidents.

They’ve also added a two-hour youth first aid class for teachers and schools to raise awareness about mental health issues, and are in the process of streamlining mental health counselors into the school system.

“We plan to offer an eight-hour class to target school districts so they can get better trained on mental health and identifying [issues],” Kramer said. “We’ve [also] hired people in response to the needs within the community. We’re in front of the curve, one of the top in the State.”

Even if the numbers do not draw any direct conclusions, one thing is for certain, the community will continue to address mental health needs for many years in the future.