My interview this week with St. Tammany Parish Coroner Dr. Charles Preston could have turned into several different stories if I had the time or front page space to do more with what he told me about the work at his office the past two years.
I met with Preston on Monday at the Coroner’s Office to discuss the raise approved last week by the Parish Council. Preston has been in office for over two years and has done a remarkable job taking over a department that was about as low as it could be, following a couple of years of intense media scrutiny that led to the former director going to jail.
The shame of it all is that the vast majority of employees in the office were unquestionably hard working, intent on doing their job every day. But as the saying goes, “one bad apple spoils the barrel,” so the folks showing up to work every day there must have dealt with a lot of unfair public comments that reflected on many people who did absolutely nothing wrong.
Preston has come into the office and changed everything, it appears, and certainly for the better. One part of our conversation about the mental health situation in St. Tammany got into the details of an individual seeking an Order for Protective Custody (OPC) and what it takes to get that done.
We’ve all heard about an individual who wants to get someone committed. I have always heard that you can tell the authorities that “so and so is crazy,” or something close to that, and can have them committed and held for 72 hours.
But Preston explained the entire process to me and it was very interesting to hear how it actually works, and what can or cannot really be done.
First of all, it’s not as easy as walking into the police station and accusing someone of “being crazy.” And for that matter, many people probably don’t know that it’s actually the Coroner’s Office who handles the entire situation now. It used to be the police or Sheriff’s Office, but now you seek the OPC through the Coroner’s Office.
When a request is made to hold someone for 72 hours the Sheriff’s Office picks up the individual, takes them to the emergency room of a local hospital, and after a physician evaluates the person, can hold them for three days. That is called a Physicians Emergency Certificate (PEC) to hold a person. But the evidence must be clearly there.
“Some people do fake it,” Preston told me. “I’ve had a person say, ‘my wife had me committed five times so now I want to get her committed.’ But it’s not that easy to do.”
He also said that an individual can be prosecuted for falsely getting someone committed.
What surprised me is that you can actually have an individual held for up to 15 days if the evidence is warranted. Once the PEC is executed and the person is held for 72 hours, the Coroner’s Office sends a Deputy Coroner to examine them, who can execute a Coroner’s Emergency Certificate (CEC) that can hold the person for 15 days.
One of Preston’s accomplishments since taking office is that he has hired real psychiatrists as his Deputy Coroner’s, so when the situation moves to that stage, there is a true, licensed psychiatrist who will make the evaluation. It never used to be that way and certainly ensures a proper diagnosis of the mental health situation is being made.
The only glitch in the law, Preston said, is that the Deputy Coroner is not allowed to offer treatment at that point. It’s the law and it’s one Preston is working to get changed.
“We need the psychiatrist to be allowed to prescribe medication and offer treatment to help the person and right now they are not allowed to do so at that stage,” he explained.
No doubt there is eventually a skilled physician, psychiatrist or mental health professional that will see the individual over the 15 days, but that delays help. It is the final piece of this puzzle the parish is working on solving by opening Safe Haven, a complete one-stop-shop for mental health services that will soon open at the former Southeastern Louisiana Mental Health Hospital in Mandeville.
Preston said the parish is still trying to improve the situation of having enough mental health professionals and beds for those who need it. He said there are only four hospitals in the parish that currently have mental health beds available and “they are mostly full,” he said.
He also told me there are only about 12 psychiatrists working in St. Tammany Parish and without doubt we could use more than that considering the way the mental health situation has been at the forefront of our news for so long.
It’s very clear that Hurricane Katrina had such a huge impact emotionally for so many people, and I know a number of people personally who were impacted very hard in a way that will probably stay with them forever. But the more services we can provide, and the more trained physicians to deal with those issues we can offer, is something that can help and is clearly something many of our leaders in the parish are continuing to work on.
Kevin Chiri can be reached by e-mail at kevinchiri@gmail.com.