(Continued from page 7)

• Room for improvement
• Hall said his department is very pleased with their local medical personnel and their response to suicide situations--but they are frustrated with rules that prevent them from doing all they can to help people in need if they transport them out of the area for treatment.
• In a several-county radius around Aberdeen, S.D., most cases of suicidal people are taken to what's called 2-North--the Avera Mental Health Ward in Aberdeen. Sometimes people are taken directly to the Human Services Center in Yankton, S.D. The North Dakota State Hospital in Jamestown has the closest mental health facility for several Dakotafire communities in North Dakota.
• Sheriff Hall said that's not always the most effective solution.
• "We just went through one of these cases recently where we took a person (to Avera) and they held that person for 18 hours and then released them--and then within six hours we had to repeat the process," Hall said. "That tells me that first evaluation didn't help that person very much, and it makes it quite frustrating on our end because then we can't do our job to protect that person and the community as a whole effectively."
• Hall said he asked the county, which pays for the process, what happened in that first session to help the person and didn't receive an answer.
• "How can we be part of the solution in helping that person when we don't know what the main portion of that help is?" Hall said. "Mental health is a tricky deal, and I'm not a counselor, but I feel there are a lot of people out there who need help, and I don't know if they get it."
• The issue is the privacy rule of the Health Insurance Portability and Accountability Act, passed by Congress in 1996 and put in place in 2000. The intent is to keep people's medical information private--but Hall said that in regard to mental health, it keeps things too confidential.
• "If we understood the nature of their problem, maybe we could help … or prevent incidents from happening with that person in the future," Hall said. "But that's none of our business, apparently. Once we take them (to a mental health facility), we have no idea what happens to that person, and we're not supposed to ask. I'm not saying it should be public knowledge, but better cooperation between mental health evaluators and law enforcement needs to happen … We all want to see this person well, and that's not going to happen if there is no cooperation."
• Dale Elsen, sheriff in Marshall County, said they average one or two calls dealing with suicide a month, and there is no local agency to help suicidal people, so they are transported to Aberdeen. Dealing with mental health issues is a statewide problem, Elsen said--especially in rural areas. Lack of preventative services is one as

(Continued on page 9)