While mid-year crime statistics are down 29 percent, compared to the same time period last year, one category of cases has steadily and significantly escalated in Fallbrook over the past three years. Frequently referred to as “5150s,” these cases involve individuals displaying signs of a mental disorder and come under the Section 5150 of the California Welfare and Institutions Code. in 2009, local deputies handled 85 of these cases, and in 2010, 134. with 79 in the first six months of 2011, this year is currently on pace for 158.

“I?m looking into the causes of this upswing,” said Lt. RobertHaley, commander of the Fallbrook Sheriff?s substation. “There are many reasons a person can be having problems like this with the economy down as it is; people are out of work, losing their homes; and many are experiencing severe anxiety and depression.”

Haley said when his deputies respond to a potential 5150 call, the first priority is to determine whether or not the individual appears to be a threat to themselves or others.

“We have to do an assessment,” he said. “We observe the individual?s physical appearance, see if they are clothed appropriately, try to determine if they have been eating properly, and ask them a series of questions, including if they usually take medication or not. We have to be incredibly cautious, because mental illness is a disease and sometimes people don?t know what they are doing.”

While calls have come in to the station regarding individuals seen out in public talking to themselves, Haley said, “Just talking to yourself doesn?t qualify [as a 5150]. further evaluation has to be done.”

According to the Journal of the American Medical Association, approximately 50 percent of people with severe mental disorders are affected by substance abuse. Haley said the effects of illegal drugs are very evident to law enforcement officers.

“Meth [methamphetamine] is probably the worst [in causing mental problems] from my observation, followed by other stimulants [such as cocaine and ecstasy],” Haley said, adding a disclaimer that he is not a physician and has not conducted any studies on the subject. Haley does, however, have 25 years of law enforcement experience in a culture that is no stranger to drug abuse.

Drug abuse and its resulting effect on the brain have been tracked by mental health agencies. According to the National Drug Intelligence Center, some serious mental disorders associated with chronic drug abuse include schizophrenia, bipolar disorder, manic depression, attention deficit hyperactivity disorder (ADHD), anxiety and panic disorders, obsessive-compulsive disorder, and more.

Professionals that provide counseling to individuals afflicted with drug-related mental health issues know only too well the negative effects these chemicals produce.

Marilyn Davies, a licensed marriage and family therapist with offices in Fallbrook and Temecula, has worked with patients in drug rehabilitation programs in the past.

“Those that have used meth, heroin, or crack for extended periods of time just aren?t thinking straight anymore,” said Davies. “It?s a very sad situation.”

Today, Davies focuses primarily on the wellbeing of families, and alcohol and substance abuse involvement presents itself frequently.

“The other issue that comes up with drug abuse is the destruction of family units; drug use is so damaging in so many ways; it affects all the family members because they are stressed out over the substance abuser,” explained Davies.

In many cases, experts have said it?s difficult to determine what came first – the mental disorder or the abuse of drugs.

Some individuals with mental illness take un-prescribed or illegal drugs to alleviate their symptoms – a practice known as self-medicating. One example would be a schizophrenic who uses marijuana in an attempt to control the disorder?s negative symptoms and calm them.

In other cases, mental disorders result from drug abuse. an example of this would be the use of the illegal drug known as ecstasy, which produces long-term reduction in serotonin function in the brain, leading to mental disorders such as depression and anxiety.

In handling some cases, deputies request assistance from the County of San Diego?s mobile Psychiatric Emergency Response Team (PERT), a non-profit organization that operates under the Community Research Foundation and is funded 100 percent by the County?s Health & Human Services Agency.

Developed to provide training and professional support to law enforcement in dealing with individuals with mental afflictions, PERT has 23 licensed clinicians throughout the county.

“Our licensed mental health professionals are dispersed throughout San Diego County; they work alongside uniformed law enforcement officers to respond to mental health crisis calls,” explained Jim Fix, executive director of PERT and a licensed clinical psychologist. when deputies encounter situations involving the mentally ill and feel they need assistance, Fix said, they radio their dispatch and request the closest PERT unit to respond. if one is not immediately available, help is still accessible.

“If there isn?t a team available close by, deputies have the ability to discuss the situation by radio or cell phone and being walked through the situation by one of our mental health professionals,” said Fix. “We try to always provide them with guidance and support.”

PERT clinicians make assessments and provide appropriate referrals and recommendations, with the goal of getting the person the treatment they need and averting further crisis.

Law enforcement officers regularly use the PERT resource and find it valuable.

“PERT is one of the best programs we have in law enforcement to utilize to help people with mental illness – not to just put someone in jail, but a door to open to help a person,” said Captain Gigi McCalla, commander of the Sheriff?s Dept. Lemon Grove station.

For those cases warranting it, Section 5150 permits an officer to involuntarily transport a person to an appropriate facility for up to 72 hours of mental evaluation.

Those taken into custody by Fallbrook deputies are generally taken to either Palomar Medical Center in Escondido or Tri City Hospital in Oceanside, both of which have secure evaluation facilities.

“Deputies take the individual to the emergency room to be admitted,” said Fix. “Then the emergency room staff evaluates whether the person should be admitted for 72 hours. Psychiatric liaisons evaluate the situation and consult with the patient; then they usually speak with the psychiatrist on call. if needed, the individual is admitted to the hospital?s behavioral health unit or one at another facility, or provided with referrals. The hospital makes the decision at that point.”

For members of the public, it can be disconcerting to encounter someone who is exhibiting signs of mental problems.

“If you encounter a person demonstrating some extreme behaviors, it?s best to keep a safe distance; back away; and go to an area where more people are located and get someone to call the Sheriff?s Dept.,” said John McLelland, crime prevention specialist for the Sheriff?s Dept. “I always tell people, when in doubt, call the cops and let them make a determination on the situation.”

Above all, Haley said, his deputies try to do their best to help those experiencing problems.

“We try to treat people with dignity and respect; sometimes they just need medical help,” he said.

When asked if Fallbrook appears to be unique in experiencing an increasing number of these cases, Haley said, “Fallbrook is just a reflection on today?s society in general.” Fix agreed.

“Other agencies are experiencing increases in these cases as well,” said Fix. “This phenomenon isn?t local to Fallbrook, it?s increasing everywhere.”