Thursday, October 18, 2018
It wasn’t exactly the proverbial “one small step for man, one giant leap for mankind,” but given Santa Barbara’s crushing need for acute-care psychiatric bed space, it might have been the next best thing. In late August, executives of the county’s three major hospitals — Cottage, Marian, and Lompoc Valley — sat down with Santa Barbara County executives, including mental health czar Alice Gleghorn, to discuss ways to increase the number of short-term acute-care psychiatric beds, as well as some longer-term options. Nothing specific came out of that meeting. Another such gathering is planned for this November.
Still, the very fact that it happened is monumental, offering a glimmer of hope that care providers who traditionally have worked on their own might work in concert to meet a great, unmet health-care need. Currently, Santa Barbara County has only 16 acute psychiatric care beds where patients deemed to pose a danger to themselves or others can be held against their will. Those beds are provided in the Psychiatric Health Facility (PHF) operated by the county’s Department of Behavioral Wellness. Numerous grand juries over the past 30 years have bemoaned the county’s conspicuous dearth of psychiatric bed space; so too have elected officials and mental-health advocates. But never before have leaders of the major hospitals come together with government officials to do something about it.
According to Terri Maus-Nisich, assistant county administrator, the aim is to get as many as 22 additional beds online. The first meeting was preliminary in the extreme, she said. “We talked about how we could best work together to develop involuntary crisis beds. We don’t have any details worked out, like who does what, where, under what venue, and at what cost to the county,” she said. “Even so, it was huge.”
For the past eight years, Maus-Nisich and the county have been talking with Marian Regional Medical Center in Santa Maria to convert abandoned hospital space into mental-health care. But those talks have yet to bear fruit. It turns out the space would have to be physically separated to accommodate the two different uses, according to state requirements. It would take 18 months to process such an application, let alone fund it and build it. There’s also been some talk about converting the old Lompoc hospital. Cottage offers 20 beds in its psychiatric wing, but those are strictly for voluntary patients with private insurance. To meet the community needs, any new beds would need to accept federal Medi-Cal payments. “Collaborative discussions are in progress, and we will be happy to discuss at a later date as plans develop,” said Cottage spokesperson Maria Zate.
Word of these talks has been the buzz among mental-health advocates and was mentioned Monday at a meeting for an initiative called Stepping Up, a loose-knit amalgamation of mental-health, law enforcement, and elected officials and advocates trying to keep people with mental illness out of jail. According to statistics released at that meeting, 1,812 of Sheriff’s Office calls originate with people experiencing severe mental-health crisis. On average, each of those calls took 1.2 hours to resolve, often involving as many as two deputies and one supervising sergeant. Of those, 587 involved individuals deemed actively suicidal. Those calls took 1,500 combined service hours to address. These statistics were used to illustrate a pilot program known as “co-response policing,” in which mental-health workers team up with casually dressed deputies in unmarked cars to respond in ways less likely to exacerbate the situation.
Commander Kevin Huddle, the Sheriff’s Office point person for Stepping Up, closed the meeting with this statistic: In 1960, when the United States population was 150 million, there were 600,000 mental-health beds; today, he said, the population is 330 million, and there are 60,000 beds.