Napa County Grand jury reviews Crisis Center

By NATALIE HOFFMAN Register Staff Writer | Posted: Monday, June 7, 2010 12:00 am

The county’s Crisis Center is falling short when it comes to documenting who can authorize involuntary mental health holds and where those patients are evaluated, the 2009/10 Napa County grand jury reports.

Released May 10, the report marked the grand jury’s first investigation of the Napa County Health and Human Services Agency’s Adult Mental Health Emergency Response Center.

Crisis Center workers intervene in mental health emergencies. They can recommend 72-hour emergency holds on patients deemed at risk of hurting themselves or others.

State law requires counties to designate hold facilities and document who can authorize them, but the county’s records are outdated and incorrect, according to the report’s findings.

The grand jury cited oversight problems and a lack of representation from involved agencies.

A 2006 supervisory committee included personnel from Health and Human Services, local law enforcement and Queen of the Valley Medical Center, but lacked representation from law enforcement in Calistoga, St. Helena and St. Helena Hospital, the grand jury said.

Law enforcement officers are authorized to instigate holds and St. Helena Hospital is used “extensively” for psychiatric evaluations, the report said.

The grand jury found “an inconsistent understanding” of the agreement between participating agencies and said the roles of participating staff and organizations were unclear. Discrepancies in patient hold records, a lack of scheduled county staff meetings and no contract between the county and Napa State Hospital for holds were among other findings.

Although about 75 percent of Napa County residents live in Napa, city residents use 87 percent of the county’s mental health services, the grand jury said. Between 2005 and 2009, more than 1,500 patients were held for the three-day evaluations, according to the report.

The report recommended stronger oversight measures by the Napa County Board of Supervisors, with updated lists of which county employees can authorize holds and which agencies can evaluate patients.

Elizabeth Emmett, the public information officer for Napa County, said the Napa County Board of Supervisors will respond to the report at their regular meeting June 29. County officials cannot immediately comment on the report’s findings, she said.


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