Threatening Behavior Lexapro 06/02/2009 Maryland 19 Year Old Threatens People & Makes Reference to School Shooting: Uses Violent Language Summary:

Paragraphs 23 & 24 read:  "Crocker, allegedly made threats against his ex-girlfriend's new boyfriend at the end of 2007, according to a police incident report obtained through the Maryland Public Information Act. At the time, Crocker had been diagnosed with a bipolar disorder and was taking the prescription drugs Lexapro and lithium.

A subsequent police search of his MySpace and Facebook accounts turned up violent language and general references to a school shooting, prompting the police intervention, according to the report."



http://www.gazette.net/stories/02042009/bethnew201934_32481.shtml


With reduced access to treatment, more calls to officers are over psychiatric issues

by Andrew Ujifusa | Staff Writer

On New Year's Day 2008, 19-year-old Maxwell Crocker was awakened by seven Montgomery County police officers at his parents' Kensington home who handcuffed him and drove him to Suburban Hospital.

Crocker had committed no crime. But based on statements from his ex-girlfriend and postings on his personal Web page, authorities were worried he might. So, using a state law that allows police intervention in cases of possible danger, they took him into custody and delivered him to the Bethesda hospital for psychiatric evaluations.

Crocker, who has a history of mental illness, was released 24 hours later with a hefty bill. He was never charged by police.

What happened to Crocker, observers say, is happening more and more as access to mental health treatment is dwindling in the face of rising costs and government budget cuts, forcing police officers to join frontline health care workers in dealing with mental illness.

Esther Kaleko-Kravitz, executive director of the National Alliance on Mental Illness (NAMI) in Montgomery County, said lack of affordable housing and higher prescription costs mean more mental health patients are living with relatives instead of at facilities, and are unable to get the treatment they need, precipitating many crises.

"There are more calls to police from families who say, ‘I can't control my loved one,'" she said.

In 1995, there were 3,494 beds in Maryland for the state's mental health patients at acute-care hospitals, private psychiatric facilities and state hospitals, with 303 of them in Montgomery County, according to Pam Barclay, director of the Center for Hospital Services at the Maryland Health Care Commission. In 2008, the statewide number had dropped to 2,404 beds, with Montgomery County's total decreasing to 186.

Holy Cross Hospital in Silver Spring closed its psychiatric unit in 1999, while Chestnut Lodge, a private psychiatric facility in Rockville, shut its doors in 2000.

Kaleko-Kravitz said the jail has become one of the county's largest providers of mental health services.

About 35 percent of Montgomery County Police's patrol officers have undergone extra training in dealing with people with mental illness, according to Officer Joan Logan, the department's crisis intervention coordinator. The 40-hour training involves visits with mental health patients, and testing officers' ability to recognize certain mental illnesses and deal with mental health scenarios.

It also involves having officers wear iPods for extended periods, listening to tracks that simulate the voices that some schizophrenics deal with on a daily basis.

"They learn what it's like to do routine things when you're suffering from a thought disorder, when you're hearing voices," Logan said.

The training, which officers volunteer to take, began in 2000.

Mental illness was cited in about 3,500 calls to police for assistance last year, up nearly 1,000 in two years, according to county police records.

Logan said 1,850 of the calls resulted in a formal police report, with a majority requiring transport to a mental health facility. That number was 1,550 in 2007 and 1,200 in 2006. Suicides or attempted suicides are not included in those counts.

Suicides in the county peaked in 2007at 64, and were down by a few last year at 61.

Logan said the higher number of mental health calls has put more stress on members of the police's Mobile Crisis Team, which is specifically assigned to deal with mental health crises.

"I don't know who would do it if we didn't do it," she said.

The Montgomery County Crisis Center, located in Rockville, deals with 5,000 people face-to-face and 50,000 calls annually and tries to stabilize people with mental health crises in the short-term and release them within 60 hours, according to the center's director Dudley Warner.

"In other jurisdictions, without Montgomery County's resources, it would just be the police," Warner said.

But Logan said in general, the process for getting mental health patients connected to resources to help can be confusing.

"If I had a mental illness, I don't think I would find this system easy to navigate. I would find it very frustrating," Logan said.

Crocker was the subject of a Maryland Emergency Petition, which allows an individual with a mental disorder who "presents a danger to the life or safety of the individual or of others" to be admitted for evaluation with or without consent. Law enforcement officials and mental health professionals can petition for emergency evaluations without the approval of a judge, although any interested person can petition for an evaluation through a District Court judge.

Crocker, allegedly made threats against his ex-girlfriend's new boyfriend at the end of 2007, according to a police incident report obtained through the Maryland Public Information Act. At the time, Crocker had been diagnosed with a bipolar disorder and was taking the prescription drugs Lexapro and lithium.

A subsequent police search of his MySpace and Facebook accounts turned up violent language and general references to a school shooting, prompting the police intervention, according to the report.

The emergency petition law was loosened in 2003, dropping language that required an individual present an "imminent" danger. State Sen. Jennie M. Forehand (D-Dist. 17) of Rockville said the change was made at the request of families and mental health advocacy groups who were worried about ongoing situations where the threat was not immediate or absolutely clear.

Kaleko-Kravitz also said the change has allowed more people who truly need psychiatric evaluations to get them, and that generally she thinks emergency petitions are a useful tool.

Logan said the change has made police officers' job easier, because it eliminates the need for a subjective judgment of "imminent" danger.

Crocker, who said he was on probation from Albert Einstein High School in Kensington for mental health issues when he was taken to Suburban, explained in a December interview that his 2007 writings were artistic and not directed at anyone.

But he also said his reference to a school shooting "crossed the line."

No weapons were found when police searched his parents' home on Jan. 1, 2008.

"Maxwell's a volatile personality," said his father Steve Crocker, "but I never thought he was remotely dangerous."

Crocker said after roughly 24 hours of evaluation and observation by a physician and mental health professionals, he was discharged and told only that he should be given a lower dose of his medication.

"I was distraught that I was there," he said in December. "I felt like a criminal. I looked like a criminal."

He also said he was awakened to sign a form stating he had been admitted voluntarily, which he did, though now he says he would have never agreed to do so if he had been thinking clearly.

Individuals brought to hospitals on emergency petitions are asked to declare whether they are there voluntarily or involuntarily. The answer can change who is responsible for paying the bill.

Representatives of Suburban Hospital declined to discuss the specifics of Crocker's case citing privacy laws, but said a patient would not have been asked to sign paperwork in the manner Crocker described.

Maryland law says the state will provide reimbursement for involuntary admissions from emergency petitions. Voluntary admissions are not specifically mentioned in the law.

Since he was on a probationary period for mental health expenses at the time, Crocker's insurance company will not pay his $2,000 bill from Suburban Hospital.

Problems associated with paying the bills for evaluations done by emergency petitions are not uncommon, according to Lynn Albizo, executive director of the Maryland chapter of NAMI. But she said there is often little people can do.

"I feel for them, and I think there's unfairness. You shouldn't have to go bankrupt over health care costs," she said.

Crocker lives with his mother in Silver Spring after his parents divorced, and works at a pizza restaurant in Washington, D.C. He said his credit has been wrecked by the process of fighting the hospital bill. He said he believes he should not pay for something he believes was ultimately involuntary on his part, and is preparing to file a grievance with the Maryland Attorney General's office about the bill.

"I absolutely will not pay for it. I will not pay for it given the principle of the matter," he said.



Crocker, allegedly made threats against his ex-girlfriend's new boyfriend at the end of 2007, according to a police incident report obtained through the Maryland Public Information Act. At the time, Crocker had been diagnosed with a bipolar disorder and was taking the prescription drugs Lexapro and lithium.

A subsequent police search of his MySpace and Facebook accounts turned up violent language and general references to a school shooting, prompting the police intervention, according to the report.