Terrebonne coroner outlines voluntary TIPS program to reach people with mental illness and addiction

Dr. Patrick Walker, assistant coroner with the Terrebonne Parish Coroner’s Office, asked the Terrebonne Parish Consolidated Government council on April 16 to endorse a voluntary outreach program to identify people with co-occurring mental illness and addiction and connect them to existing treatment.

Walker said the program, called Therapone Interception and Prevention Services, or TIPS, would “attempt to address the dual problems we have in our society of mental health and addiction.” He described using existing contact points — physician emergency certificates (CECs), orders of protective custody (OPCs) and the coroner’s office’s follow-up after overdoses and autopsies — to offer voluntary referrals and tracking for people at high risk of accidental overdose or suicide.

The pitch centered on people who have both mental-health conditions and an addictive disorder, especially opioid/fentanyl users. Walker told the council the program would not create new treatment capacity but would “plug them into a system like the behavioral health center, START, Compass, you know, outpatient program.” He said the coroner’s office already encounters these individuals at the parish’s two psychiatric facilities and at emergency departments and that the office’s deputies and staff could help identify people who test positive on drug screens and ask whether they want follow-up help.

Walker described the program as preventive and voluntary: staff would reach out to people identified during CECs and OPCs, obtain consent, and coordinate referrals to medication-assisted treatment or other appropriate programs. He emphasized the local gaps the program aims to fill: hospitals and behavioral facilities that discharge patients without a reliable social-work or psychiatric follow-up, a shortage of psychiatrists locally, and insufficient inpatient beds. “The social workers at the hospital are overwhelmed,” Walker told the council. He also said, based on his review of recent overdose autopsies, that fentanyl is the leading substance in accidental overdose deaths the coroner’s office handles.

Walker asked the council to consider startup funding. His written breakdown — read into the record — listed an intake coordinator/social-services position at $100,000, office expenses of $3,000, and a total startup ask of about $119,000. “Studies have shown … we can save $65 for every dollar that’s spent on these kind of programs,” Walker said in the meeting.

Council members and staff asked detailed questions about how TIPS would differ from recent state mobile-crisis initiatives and from programs tied to court supervision or existing community partners. Walker said the program’s distinguishing feature is that the coroner’s office already “comes in contact with every single individual that’s admitted to the two facilities that we have,” giving the office a daily opportunity to identify and reach people who otherwise “fall through the cracks.” He said the program would focus primarily on adults (18 and older) and would be voluntary; some patients would decline outreach.

Richard Warren, chief investigator for the coroner’s office, spoke in support of the preventive approach, saying coroner staff see overdose patterns and households in which multiple people are using. Council members and Parish administration expressed interest in further discussion and asked that administration explore funding options and possible coordination with ongoing county and regional initiatives, including planned crisis-center and health-unit projects discussed later in the meeting.

No formal funding vote or ordinance was taken at the April 16 meeting. Council members asked Walker to provide more operational detail (a refined job description and a more granular budget for the intake coordinator line) and invited further conversations among the coroner’s office, parish administration and other community partners.

Ending: Walker said if the council funds a pilot and the parish requests and allocates money, the coroner’s office would provide audits and periodic program statistics; he said he would accept accountability for program expenditures and performance. The council did not commit funds at the session but directed staff and administration to continue conversations and to look for potential funding streams.