Photo: Etowah County Probate Judge Scott Hassell (pictured at left) stands with Mobile Crisis Assistance Team External Programs Coordinator David Weaver in front of a painting commissioned for the courtroom painted by a woman experiencing mental illness. (Katie Bohannon/Messenger)
By Katie Bohannon/News Editor
An innovative and invaluable resource is aspiring to transform mental health care in Etowah County, with community pillars uniting together to create a more efficient and accessible support system for those in need.
Compassion and service coincide with The Mobile Crisis Assistance Team (MCAT) to prioritize the health and quality of life for those countywide experiencing mental illness, addiction or crisis situations. With the betterment of individuals and families at its program’s forefront, the MCAT embarks on a courageous mission to revolutionize the county’s approach to mental health – responding to emergencies with effectiveness, preventing crises with insight and educating the public to evoke positive change.
In mid-October, the Eto-wah County Commission approved a $220,375 budget for the MCAT for the 2022 fiscal year, demonstrating its support of a program originating months prior, when Etowah County Probate Judge Scott Hassell first pitched the concept to the commission. Before assuming the role of Probate Judge, Hassell served as the Chief Deputy of Corrections at the County Detention Center and a member of the Hokes Bluff City Council. Likewise, Hassell’s leadership as both a pastor and a therapist enlightened him to a prevalent challenge impacting Etowah County’s response to mental health care: timely and efficient access to services.
Almost a decade ago, Alabama’s closure of state-run mental hospitals altered the course of patient treatment and shifted care toward community mental health centers such as Attalla’s CED Mental Health Center. While CED Mental Health provides a myriad of services for adults and children, offering public and privately funded mental health and substance abuse treatments, Hassell emphasized that resources remain limited across the state.
When an individual experiences a mental health crisis, the probate office becomes involved through an involuntary commitment, a procedure that places a person in the custody of the State Department of Mental Health for treatment. Involuntary commitments are initiated through filed petitions and hearings are held by the probate judge to determine whether or not commitment is granted. Outpatient or inpatient treatment is then assigned, should commitment be granted.
Hassell shared that on several occasions, this process proves greater than necessary. Often, the solution resides in simply providing individuals access to needed services. He attested to significant advancements concerning treatment and medication for serious mental illnesses, describing a common scenario he witnesses firsthand with reoccurring cases.
In certain circumstances, once an individual experiencing mental illness receives positive treatment to their benefit, he or she makes progress without recognizing consistency’s role in recovery. If that person, who is feeling better and out of the hospital, does not follow up with outpatient treatment, once either the medication dwindles or treatment subsides, decompensation occurs, resulting in relapse.
Hassell discovered that the time in-between – when patients leave treatment and return to their routines – proves crucial in shattering the cycle. He noted that many crisis situations that arise throughout the state and end in poor outcomes parallel similar scenarios, with those involved experiencing untreated mental illnesses. Though Hassell’s love for people and desire to help others initiated his service as a therapist, as the years progressed, he noticed an unprecedented need for change.
The story of a local 19-year-old inspired that change, prompting Hassell to act.
“You only see what you see, based on your experiences in your profession,” said Hassell. “I saw one side of mental illness. There was a whole other side that I missed.”
Vibrant, empathetic and red-headed Max Cochran impacted Hassell in a profound manner, when he discovered that the 2017 Gadsden City High School graduate lacked the access to dire mental health assistance in Etowah County. Max recognized that while his family loved and supported him, he struggled with mental health – being diagnosed with attention deficit hyperactivity disorder and depression.
“We learned there’s not a very good organized mental health structure for treatment of young adults and adolescents,” said Max’s father, David Cochran, in a previous article with The Messenger. “There’s not many ways of getting help, not enough research or resources. We would call and try to get Max in to see somebody, and they would say we can see him in two to three weeks and if that’s not good enough, call 911. If you’re struggling with issues that were as severe as Max would struggle with sometimes, you shouldn’t have to wait [until there is a crisis].”
Max juggled medication and counseling to improve his challenges. While Max’s own caring nature extended efforts to help those around him, his internal battle worsened overtime and Max tragically took his own life in 2018. As Hassell learned more about Max and his parents’ establishment of MAXimizing Mental Health, Inc. to provide services for youth combating mental illness, his wife Mindy reminded him of his original goal as probate judge: to affect the county in a positive way, to act with boldness and make a difference.
The result manifested in Etowah County’s Mobile Crisis Assistance Team (MCAT).
Etowah County’s MCAT mirrors a proven system launched over 30 years ago in Eugene, Oregon, known as Crisis Assistance Helping Out On The Streets or CAHOOTS. The CAHOOTS model mobilizes two-person teams comprised of a nurse, EMT or paramedic and a crisis worker experienced and trained in the mental health field. Focusing on non-violent de-escalation tactics and harm reduction techniques, CAHOOTS teams respond to a vast collection of differing mental health crises, from conflict resolution and suicidal threats to substance abuse.
Composed of compassionate citizens, equipped professionals and trained social workers, counselors and medical personnel, the MCAT nurtures humanistic care and essential encouragement for persons countywide. The team specializes in crisis response for individuals with a serious mental illness, who pose a danger to themselves or those around them, assisting mental health providers with monitoring and supporting individuals under outpatient commitment.
Several collaborative positions work together to ensure the MCAT’s adept operation. Katrina Hill, who Hassell referred to as “the gatekeeper,” will serve as the Probate and CED Liaison. Hill upholds responsibilities such as the intake of IVC petitions, scheduling commitment hearings and coordination with the Alabama Department of Mental Health and local hospitals, while facilitating successful communication of the county’s mental health services between the probate office and CED.
David Weaver assumes the role of External Programs Coordinator, monitoring compliance with individuals under outpatient commitment orders of the court and organizing monthly Mental Health Court AOT dockets and overseeing the intake of guardian and conservator petitions.
Hassell commended the ceaseless support the MCAT received from its inception, sharing that countless elected officials, community partners and municipalities expressed their willingness to participate and establish the program.
“It’s been phenomenal,” said Hassel, on working with the Etowah County Commission, cities and organizations. “That’s why I feel very confident we’re moving in the right direction. I’ve worked in public service for over 20 years, both in the private and public sector. I have never been more proud than I am to serve today with the folks we have in office. Nothing is perfect, but to see all of these folks come together in a form of solidarity to say, ‘We identify this as a problem in our community and we want to be a part of the solution,’ makes me feel good. The community needs to know they can take great pride that these governmental entities are working.”
All Etowah County Commissioners emphasized their united advocacy of the MCAT, alongside the City of Gadsden, which serves as another stakeholder. Hassell foresees all municipalities in the county contributing in the future, including faith-based organizations, hospitals and non-profits.
“The City of Gadsden identified funds available for mental health assistance through the American Rescue Plan,” said Gadsden Public Affairs Coordinator Michael Rodgers. “Mayor Sherman Guyton, his administration and the city council all agreed on the need for improved services for citizens with mental health concerns, and funding for the Mobile Crisis Assistance Team was included in the ARP budget. The city is excited to partner with the county and Probate Judge Scott Hassell for this much-needed program.”
“The MCAT shows local leadership is moving in a direction where we’re willing to work together with our cities to solve problems at hand,” said Etowah County Commission President Jamie Grant, thanking Hassell and all involved. “We have a judge who sees we have a problem in Etowah County and understands the importance of change. We have a commission who is willing to not just talk about the problem, but find ways to resolve the issue – working with our judge and partnering with our cities to benefit our families, hospitals and jail.”
The MCAT’s fluid approach adapts to the current needs of the community, evolving alongside society to sustain itself for perpetuity. Its timely response strategy seeks to eliminate the waiting period when people experience urgent crises, with frequent scheduled follow-ups monitoring individuals progress to minimize relapses. Though its team will remain available to assist Monday through Friday during business hours, Hassell is striving to provide after-hour care with trained paramedics countywide. Should a person require help outside of MCAT hours, that paramedic will tend to the situation promptly for MCAT personnel to follow up afterward.
“We want to support and empower our other partners,” said Hassell, describing how MCAT will alleviate the saturation of local resources. “We want to free CED up so they can focus on their core mission; we want to let the deputy sheriff and police officer be law enforcement and not social workers. We hope to empower them by taking some of those things off their plate.”
“As a paramedic and assistant chief on the fire department, it’s what we run into almost daily – people who have an addiction problem or mental illness,” said Etowah County Commissioner Tim Ramsey. “The MCAT gives us another tool in the chest to address the problem. I applaud Judge Hassell for being that person who is willing to spend the time that it takes to create something that, I really believe, is going to have a positive impact on our community. It has the potential to do great things…it’s already being well received, and I think with the more positive feedback from the people touched by MCAT, others will realize it’s a valuable program.”
Rather than wait for a crisis to strike, the MCAT’s mission hinges on more than response alone: it focuses on prevention and education. The program’s prevention methods arise in continuous check-ups and support, while its education factor shatters the stigma plaguing mental illness, connecting with the community to enlighten, inspire and broaden their understanding.
“So many folks don’t understand what mental illness is,” said Hassell. “They don’t understand what we can and can’t do [to help], but the biggest thing is just listening and compassion. If I have a heart attack or gallbladder problems, those are organs of the body that are diseased. People will say, ‘We’re praying for you.’ They’ll send you cards. The brain is an organ of the human body. If it’s diseased, we have a stigma attached to it…even still, we’ll whisper behind people’s backs. The folks suffering from [mental illness] and their families feel alienated, isolated and embarrassed. Part of what we’re hoping to do is educate folks that it’s okay – we want you to know that we’re here for you.”
The implementation of the MCAT unfolds in four phases, the first two of which are completed. Phase One revolved around the concept’s development and explored funding sources, while Phase Two ensured approval by stakeholders and secured the program’s funding. Phase Three includes hiring and training key staff members and appointing CMHO partners from other agencies. Phase Four signifies the program’s official launch, with Hassell anticipating boots on the ground by December 1.
Etowah County’s MCAT application represents a community’s considerate recognition of its citizens, signifying a program that values each life and grants a voice to the voiceless. Its establishment illustrates the power of unification between caring leaders advocating for their county – providing resources, information and transformative care, while ministering hope for a brighter tomorrow.
“I think sometimes we forget that the heart of people in Etowah County is good,” said Hassell. “You look at 9/11…on 9/12, you have crews from Gadsden and Etowah County going to help. The same with Hurricane Katrina and the list goes on and on. That’s our culture and that’s our history. Our elected leaders are a representation of that. Things like the MCAT remind us of that.”
“We want this project to be a collaborative effort with all our citizens. We’re going to be constantly evaluating the needs of the community and how we can make things better. If they see a need, let us know about it. There are so many faith-based organizations in our community, churches and non-profits – we invite them to come. We want to partner with them. You will find a willing participant and a willing partner with us. [Through the MCAT] we don’t offer a cure, but we offer hope. We’re going to stand beside you during the journey.”