Saturday, July 30, 2016

[San Mateo County] Report: Youth mental health care lacking: Locals frequently transported outside county for treatment, said grand jury

A majority of local youth experiencing a psychiatric crisis who need to be hospitalized are shipped to a medical facility beyond county borders, complicating their treatment and presenting an issue which must be addressed, according to the civil grand jury.
The 13 hospital beds dedicated to serving local kids and teens suffering a mental health emergency may be inadequate, according to an investigation by San Mateo County Civil Grand Jury, but insufficient data tracking makes a definitive conclusion impossible.
Mills-Peninsula Health Services and the county’s Behavioral Health and Recovery Services, which work in conjunction to provide inpatient psychiatric care, should beef up their record keeping practices to offer greater insight regarding how local youth mental services can be improved, according to the grand jury’s report published Monday, July 18.
Most county youth who need inpatient psychiatric care are taken to hospitals in other cities such as San Francisco or Santa Rosa, despite the 13 beds reserved for such patients in San Mateo at Mills Health Center, 100 S. San Mateo Drive.
Studies show the teens and young adults experiencing a mental health crisis are less receptive to treatment when it is administered far from home, according to the report, making it imperative all is done to ensure the necessary accommodations are available inside the county’s borders.
“An already stressful situation worsens when an anxious and distressed patient is strapped down and driven by strangers for an indeterminate length of time to an unfamiliar facility,” according to the report. “In addition to the stress added by the actual transfer, the ultimate location of the facility can itself result in more problems for the youth and his support system.”
The county Board of Supervisors authorized contracting with Mills-Peninsula Health Systems to offer inpatient mental health care to youth and adults who use Medi-Cal, and the agreement is overseen by the San Mateo County Behavioral Health and Recovery Services division.
Under the agreement, when a patient needing psychiatric care is picked up north of State Route 92, they are taken to the Mills-Peninsula Medical Center in Burlingame. If they are coming from an area south of the boundary, they are taken to the San Mateo Medical Center, 222 W. 39th Ave. in San Mateo.
Should a child need inpatient care, and space is available, they are taken from their appointed referral site to one of the 13 beds at the Mills Health Center. If space is not available, they are transported to one of the other nearby facilities in San Francisco, Concord, Berkeley or other Bay Area cities.
But judging whether the existing beds are sufficient to meet the local demand is made more difficult due to the lack of pertinent data made available by either the county or officials with Mills-Peninsula, according to the report.
“The grand jury was unable to answer its original inquiry as to whether 13 inpatient beds for youth were adequate, as critical information was not available,” according to the report. “The grand jury could not determine if the information existed and was simply inaccessible, or if the information was never collected.”
It is clear, however, that those referred to by Mills-Peninsula Medical Center to the Mills Health Center are more likely to get a bed than those referred by the San Mateo Medical Center, according to the report.
The report shows slightly more than half, 52 percent, of the youth patients referred by the Mills-Peninsula Medical Center to the Mills Health Center for psychiatric care were admitted last year, a considerable disparity from the 29 percent of patients referred by the San Mateo Medical Center who were admitted locally.
“No matter which way the data is viewed, in 2015, [San Mateo Medical Center] referred the vast majority of its youth [psychiatric emergency services] patients to hospital facilities outside San Mateo County,” according to the report.
Though the discrepancy is obvious, the justification is not, according to the report, because the available data is insufficient.
“Mills-Peninsula Hospitals were unable to explain the disparity in the admissions rates for youth patients from [San Mateo Medical Center] vs. [Mills-Peninsula Medical Center],” according to the report. “Mills-Peninsula Hospitals also were unable to provide the grand jury with requested data relating to the provision of its services to the county generally.”
To remedy the issue, the report suggests the county Board of Supervisors should direct the Behavioral Health and Recovery Services department to focus on regularly tracking data which could better allow officials to understand the process leading toward ensuring local teens can get the psychiatric care near their homes.
Warren Slocum, president of the San Mateo County Board of Supervisors, and Supervisor Dave Pine both withheld public comment on the findings of the grand jury via email because they had not yet read the report. 
The grand jury has called to for the department to present a report on the issue to the county Board of Supervisors by the end of the year. The watchdog organization has no legal authority to implement policy change, but elected officials are required to respond to a report’s findings and recommendations within two months and governing bodies must respond within three months.
July 20, 2016
San Mateo Journal
By Austin Walsh

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