MAYVILLE - A mental health crisis can take many forms, some more serious than others.
Some require police assistance and some do not. Some incidents require immediate treatment at a hospital while others can be managed by an outpatient center.
There have been recent events in the county involving mental health incidents, some of which led police to transport subjects to the hospital for evaluation. On a national level, experts have questioned the mental state of the man accused in the Newtown, Conn., shooting, and the individual involved in the movie theater shooting in Colorado.
According to mental health experts, there are numerous causes of an incident. Factors include stress, genetics, infections, substance abuse and more. Marshall Greenstein, a mental health professional operating an office in Jamestown, said economics, too, can play a role in an incident.
"I think more and more that economics and the stress of low-paying jobs and layoffs is having an impact, especially on men," Greenstein said. "It's been hard-wired into our heads that we have to bring home the income. Once that's lost, men lose a part of their identity.
"Once that happens, they dwell on the situation. There is a mental, emotional and physical sense of hopelessness, and it can bring out the ugly and worst of people."
A lack of family support also can play a role, he said.
"Whether it's someone who is having problems or a mental issue, it's been proven just having family and friends can get people through tough times," Greenstein said.
The mental health landscape is complex in Chautauqua County, to say the least. But there are several outlets for an array of mental health crises, ranging from a county-funded mobile crisis team to psychiatric assistance for firefighters and police officers.
"There is a whole gamut of services in the county for a mental health crisis," said Raquel Spears, services coordinator for Chautauqua Opportunities Inc. "There is single point of access, outpatient care, family services and more."
Chautauqua Opportunities, funded by the county and contracted to provide numerous health care services, offers a comprehensive mental health program.
The mobile crisis team is staffed with mental health professionals and peers. It's available to any county resident experiencing a mental health crisis or distress from 5 p.m. to 9 a.m. and 24 hours a day on the weekends or holidays.
Not everyone is aware of the services, however.
"There is a lack of understanding and knowledge that we are here," Spears said. She did note Chautauqua Opportunities is determined to cut down on the number of unnecessary hospital visits by promoting less-intrusive measures for its mental health service.
First responders in Chautauqua County dealing with potentially emotional problems have access to the Critical Incident Stress Management Team. The group was formed more than 15 years ago and is led by a mental health expert.
According to Julius Leone, county fire coordinator, the stress management team typically will meet after large-scale incidents. For example, if a child is killed in a fire or accident, the team will assemble for a debriefing involving firefighters, police and emergency medical technicians.
The key to defusing a high-stress incident that may lead to mental health problems is to meet soon after the incident occurs, Leone said.
"If there is a bad accident or a fire, we can have a debriefing right away with this group," he said. "First responders can sit down with their peers and a mental health expert and go over what happened.
"Anytime there is a fatality we want to meet as soon as possible. People are affected different ways in these situations, so it's important we have that access to some help."
Some instances, however, require professionals to find first responders who may be experiencing a mental health incident. Leone said standard protocol in the county is for fire chiefs to contact dispatch if they believe a member of their department is having an issue. The stress management team will then assemble and review the situation before reaching out to the individual.
"If someone is really having some issues we will work through the leadership team and make contact," Leone said. "We want to make sure that someone doesn't fall through the cracks."
But getting a firefighter or police officer to seek help after a high-stress incident isn't always an easy task. Depending on the situation, though, a first responder may not have a choice; mandatory counseling is in place to ensure police officers receive psychiatric care after a death or serious injury while on the job.
"Many officers may need some help but don't want to seek outside assistance," Chautauqua County Sheriff Joe Gerace said. "Depending on what happened, it can be mandated, even if it's through disciplinary action. But there are policies in place that under certain situation that care is provided, no option."
The sheriff alluded to the stress management team, noting its importance for police agencies and its officers in the county. "It helps folks cope when something happens," he said.