Tuesday, June 28, 2016
Mental health services in Shasta County lacking, grand jury says
Shasta County faces a lack of services that put mentally ill people in crisis at risk, the Shasta County grand jury found in a recent investigation.
The panel says in its report, "A Mental Health Crisis, Following the Call: The First 72 Hours Matter," a lack of law enforcement training, a severe shortage of psychiatric inpatient beds and psychiatrists add up to situations that can lead sick people lingering in hospitals for days without mental health care.
"Access to mental health stabilization services for people in a mental health crisis is lacking in Shasta County," the report starts bluntly.
Dean True, director of adult services for the Shasta County Health and Human Services Agency, declined to comment on the report until the Shasta County Board of Supervisors has a chance to discuss it at a future meeting.
The grand jury looked deeply into what happens from when a 911 call is placed about a mental health emergency through the next 72 hours, a critical time when patients encounter law enforcement officers, medical practitioners and sometimes jailers. It found a woeful lack of services through each step of the process.
It recommends, among other things, that the Health and Human Services and law enforcement agencies create a mobile crisis stabilization team paid for by Mental Health Services Act funding, or the so-called millionaire's tax. Such a team made up of mental health professionals and law enforcement officers could help de-escalate crises and get patients help quickly and effectively, the grand jury said.
The way it works now is either police officers or sheriff's deputies respond to the crisis call along with EMTs. Sometimes these encounters go well, and sometimes not. In the past year, there have been a handful of occasions where law enforcement officers shot and killed mentally ill people in crisis and who were armed. The grand jury found that only 50 percent to 60 percent of the county's law enforcement officers have received crisis intervention training. This training teaches officers how to de-escalate a situation with a mentally ill person in crisis.
The grand jury said all local law enforcement officers should receive training every two years and recommends the county and cities of Anderson and Redding adopt a departmental policy to provide that training by the end of this year.
Anderson provides ongoing crisis intervention training, said Lt. Rocky Harpham.
Redding Police Chief Robert Paoletti and Sheriff Tom Bosenko have said they send officers when staffing and funding allow it.
Harpham said with crisis intervention, "You're trying to resolve whatever issue that you are being sent to and reduce the chance of yourself or the person you're dealing with being injured. You're trying to avoid confrontation and resolving it peacefully."
After law officers respond, the patient is transferred to one of the county's three hospitals for evaluation. While the grand jury applauded a recent move by the county to place mental health evaluators at the two Redding emergency rooms, it noted that because they are available only from 8 a.m. to 5 p.m. on weekdays, patients brought in after hours or on weekends are left waiting overnight or even a full day in the emergency room for evaluations. If the patient needs inpatient care, the county offers scant resources. Its single inpatient psychiatric facility, Restpadd, only has 16 beds for adults. The nearest facilities for children are in Sacramento. It's up to county Health and Human Services to find a place to send patients on Medi-Cal, and in some cases the wait can be days and weeks. In one case cited by the grand jury, a patient spent 45 days in the emergency room until the county found a bed in a San Diego facility. The grand jury pointed out that during that month and a half, the patient received no mental health services.
In addition to recommending the county create plans to establish more inpatient beds for adults and children, it also encourages the county to continue with its plans to create an after-hours walk-in mental health center to help mentally ill patients and their families before they reach crisis.
As part of its investigation, the grand jury visited Tehama County's crisis stabilization center, referred to as a Community Crisis Response Unit, established in 1993 when that county closed its psychiatric facility due to limited funds.
That facility does not allow patients to walk off the street and get help, according to Valerie Lucero, executive director with mental health services in Tehama County. Patients can be brought in by law enforcement or voluntarily.
"There is an assessment that's involved. This takes the place of what happens now when people are assessed in emergency rooms," said Lucero.
Restpadd has proposed opening a 16-bed psychiatric facility in Tehama County that would serve adults and children. The grand jury recommends the Shasta County board of supervisors look into providing inpatient psychiatric beds for children and set a timeline by the end of this year.
Redding resident Linda LeDue and former National Alliance on Mental Illness member said the grand jury report does a good job evaluating the current services in place, including the mental health walk-in clinic on Breslauer Way.
"But it excluded one thing from the report," she said. "One of the most shocking things is that most of the services are for people on Medi-Cal. If you're blessed to have insurance, then you can only go to the emergency room."
She said that when her boyfriend, who has private insurance, needed mental health services, he could not find any facilities in the county and had to go to Woodland and Vallejo for help. The report "is giving the impression that these services are for everyone."
June 25, 2016
Redding Record Searchlight
By Nathan Solis