December 15, 2007
Bethel Detox Alternatives Project
YKHC Office of Public Relations
In 2007, the Alaska Mental Health Trust Authority and the State of Alaska's Division of Behavioral Health embarked on a project to help communities that have significant public safety and emergency room problems with alcoholism to identify solutions to assist Alaska communities.
YKHC received a grant from the Trust through the State in August and in September entered into a contract with the Mary Elizabeth Rider Consulting Group to help the community and region assess its current status and options.
Their job is to interview key informants, conduct a literature review, identify and review data from YKHC, Yukon Kuskokwim Correctional Center, and the Bethel Police Department about inebriated people, facilitate meetings within the community and between the community and the State of Alaska-then in early 2008 deliver a plan of action including factors that outline the community's preferences in addressing the inebriates and alcoholism.
In late October, the consulting team interviewed approximately 25 key people who deal with the issue of inebriated individuals, their safety, their health care, and their families to help understand the problem and how it directly and indirectly affects the community.
In November, 30 local residents gathered to review the preliminary report from the interviews and talk about the current ongoing situation of inebriated people in Bethel. The report states that police are the first line of response in alcohol related incidents and are mandated to address the problem under current Alaska statutes (Title 47.37), but do not have the necessary staffing available. They also get burned out by having to constantly deal with this social problem, according to the report. It takes a half hour to four-and-a-half hours for a police officer to admit someone to the YKHC Emergency Room.
The need for safe protective custody holding capacity is staggering. The ER at the hospital in Bethel has nine beds. It typically receives three to four people for protective custody each day, sometimes as many as 13 per day. Last year's total came to more than 1,000 admissions. Additionally, many protective custody cases have other medical problems involved besides alcohol. These may include being suicidal or having physical injuries and may require additional special attention.
Since 2004, inebriate youth cannot be taken to the Bethel Youth Facility for sleep-off, so all youth must go to the YKHC ER. At least 300 minors are currently being admitted each year. The Yukon-Kuskokwim Correctional Center in Bethel does 12-hour protective custody holds in two rooms-five inebriates per room. Those who are severely intoxicated must go to the hospital for medical care and clearance. Often, the women's protective custody room at the jail is filled with men, which requires women to be referred to the YKHC Emergency Room.
Calling for action, the Bethel group that reviewed the consultant's findings declared a crisis in emergency response, substance abuse treatment, and community health. They will research the issues and the response capacity surrounding this crisis, and hold another community meeting January 7, 2008, with key policymakers in state government, local governments, and regional agencies and with the Alaska Mental Health Trust.
Following the next meeting, the consultants will work with community members to prepare a draft report on the next steps for the community. The draft report will be available for the community's review in late January followed by a final report to be delivered by the first of March, 2008.
Armed with these locally-sensitive potential solutions, the community can approach the Alaska Mental Health Trust Authority and State of Alaska about its plan to locally manage inebriates and alcoholism with their financial help.
