Hawaii is one of two states that failed to participate in a nationwide study about the burden on police officers and sheriffs’ deputies who serve as pseudo street psychiatrists, transporting people with serious mental illness to hospitals for treatment.

Published Tuesday by the Treatment Advocacy Center, the study surveyed more than 350 law enforcement agencies about the drain on resources and financial cost of responding to psychiatric crises.

Alaska is the only other state that did not respond to survey queries.

“The failures of our national mental health system force law enforcement officers to serve as treatment providers — a role they play for no other medical condition,” read an excerpt from the report. “This national survey of sheriffs’ offices and police departments provides a unique view into the burdens they shoulder and the fiscal and societal consequences of the current situation. Law enforcement officers are overwhelmed, both by the crushing volume of mental health emergencies and the need to travel long distances shuttling people with mental illness from one facility to another.”

Key findings:

  • An average of 10% of law enforcement agencies’ total budgets was spent responding to and transporting persons with mental illness in 2017.
  • The average distance to transport an individual in mental illness crisis to a medical facility was 5 times farther than the distance to transport them to jail.
  • Nationwide, an estimated $918 million was spent by law enforcement on transporting people with severe mental illness in 2017.
  • The amount of time spent transporting people with mental illness by law enforcement agency survey respondents in 2017 sums to 165,295 hours, or more than 18 years.
  • 21% of total law enforcement staff time was used to respond to and transport individuals with mental illness in 2017.
  • The average distance to transport an individual in mental illness crisis to a medical facility is five times farther than the distance to transport him or her to jail.
  • Law enforcement officers waited significantly longer — almost 2.5 hours longer — when dropping a person off at a medical facility than if transporting to a jail.
  • Some officers reported having to wait with the individual for 72 hours or more until a bed becomes available.
  • Survey respondents drove a total of 5,424,212 miles transporting individuals with serious mental illness in 2017 — the equivalent of driving around the Earth’s equator more than 217 times.

In Hawaii, when police hospitalize people in crisis who pose a danger to themselves or others — but have not committed a crime — those people can’t be held against their will by doctors for more than 48 hours.

Often those interventions are inadequate.

Honolulu Police Department data released in 2018 shows hundreds of patients go on to repeated hospitalizations and brushes with law enforcement, sometimes just days or weeks after their release back into the public.

The doctor’s job in these situations is to yank the patient out of the throes of crisis. But for people with persistent mental illness, it can be all too easy to slide back into crisis again.

The hospital tracks thousands of what it dubs “super-utilizers” — patients who come to the emergency department repetitively for reasons including mental illness.

Last year, Queen’s spent more than $80 million on these super-utilizers. About half of the hospital’s resources are consumed by less than 5 percent of the patients, according to Dr. Howie Klemmer, chief of emergency medicine at Queen’s

It’s a complex problem that’s overwhelming emergency rooms and raising questions about the state’s lack of mental health resources and the merits of protecting a person’s civil liberty to refuse psychiatric treatment — even when they’re too sick to recognize they are suffering from mental illness.

The Treatment Advocacy Center gives Hawaii a “C” grade in its analysis of the state’s involuntary psychiatric treatment laws and its efforts to divert people with mental illness away from the criminal justice system.

Read more about Hawaii’s mental health crisis here.

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