Mental Health Services Turn a Corner in Yolo County

YoloDepartmentMentalHealthby Robert Canning

This week on NPR, two San Antonio mental health police officers were featured in a story about diverting mental health patients away from the criminal justice system, which has become the country’s de facto mental health system.

Also this week, a local man was killed by police after charging them with a knife. The Sacramento Bee has reported that he had a history of mental illness.

And finally, in this week’s Journal of the American Medical Association was an opinion piece advocating for affordable mental health care for all who need it, and recommending that crisis mental health care be available as an alternative to inpatient care.

For many years our public mental health system has suffered from stingy funding by the state. Services limped along with little continuity of care and lapses caused by the rise of managed care. The most needy mentally ill had few resources to call upon in a crisis. The economic collapse in 2008 pushed this system to the brink. In Yolo County the Department of Alcohol, Drug and Mental Health (ADMH) suffered massive layoffs and stopped providing a wide range of services, including active crisis/emergency care. When someone needed help in a dire emergency all they could do was go to an emergency room or call the police.

When someone called 911 for help because of mental illness-related crises, most often the police responded and delivered them to either the emergency room or the jail, depending on their behavior and the judgment of officers. With funding from the Mental Health Services Act, a few departments in the county have participated in Crisis Intervention Training, which is a 32-hour course to teach police officers effective interventions when encountering mentally ill individuals in the course of their work. This band-aid approach probably improved the outcomes some, but the law enforcement agencies were inconsistent in their participation and, at worst, did not participate.

In the next few months Yolo County will begin a new program that promises to change how crisis mental health care is delivered. In 2013 ADMH applied for a grant under SB 82, the Investment in Mental Health Wellness Act of 2013. County mental health programs were invited to apply to increase their ability to provide mental health care in real time as a crisis unfolds, rather than waiting passively at the emergency room or for the patient to be booked.

ADMH’s application attained the highest score of all grants submitted, and the county was awarded funding for a program. And with funds from a companion grant from the California Health Facilities Financing Authority, ADMH has purchased specially modified vans to support the crisis teams.

This fall, Yolo County will implement four Community Based Crisis Response Teams. As currently planned, there will be four teams – one each in Woodland, West Sacramento, Davis, and in Winters (covering rural Yolo). Each team consists of a mental health clinician and a peer counselor. Once law enforcement has ensured that the person in crisis is not a danger to others, they will do a warm hand off to the mental health clinician who will meet with the individual in the van that will have a seating area that is confidential.

The teams will be based out of the respective law enforcement agencies and will operate during the hours that these agencies experience the most calls involving the mentally ill or their families. Teams will be on duty five days a week 3:30 PM to midnight and off on Sunday and Thursday.

First estimates of the number of individuals served by the teams are over 2,200 annually. When a team is called out, their job will be crisis intervention and de-escalation. The core mission is safety and self-care planning – on the spot.

Citizens the team encounters will be offered direct access to emergency mental health services, Safe Harbor in Woodland, “fast track” ADMH appointments, and possibly hospital care. After-incident care will include peer counseling and short-term case management. The county plans to build in other services as the program progresses.

The Community Based Crisis Response Teams will increase the ability of law enforcement and our public mental health programs to provide services when clinics are closed – and when the crises occur. Added to the recently renewed services provided by Suicide Prevention and Crisis Services of Yolo County, our county has turned a corner to providing more light and hope for the mentally ill.

Robert Canning is a clinical psychologist who works for the state and specializes in suicide prevention.

About The Author

Disclaimer: the views expressed by guest writers are strictly those of the author and may not reflect the views of the Vanguard, its editor, or its editorial board.

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7 thoughts on “Mental Health Services Turn a Corner in Yolo County”

  1. London

    “Teams will be on duty five days a week 3:30 PM to midnight and off on Sunday and Thursday.”
    What happens when a mentally ill person is in a potentially violent situation before 3:30 p.m. or on a Sunday or a Thursday? Why can’t the service be rotated so the service is always provided to the public?
    Firefighters don’t take days off and hope that a fire doesn’t occur. Mental health service providers should be available 24/7 for this program to be a success.

    1. tj

      Yes, wouldn’t it be much better if the “clinicians” were on call as needed rather than sitting around at the police station waiting for a call, and then not available when needed on Sunday or Thursday, or during daytime hours when there are crisis calls?

      I’m dubious about the term “clinicians”. Like the term “mental health worker”, what qualifications will these people have?

      Safe Harbor is a board and care facility, not a medical facility, and it doesn’t have any licensed staff to offer mental health services, and as a care facility it has a very poor record with state licensing, in particular failing to administer prescribed medications, and “losing” patients’ medications. (And there was the staff rape of a resident on the premises during the daytime, which the county likes to ignore.)

      I wonder how many severely paranoid patients will be willing to enter the confined quarters of the special van?

      It’s good an effort is being made, but this may not be as well thought out as it should be.

      (This article begins with the statement that the man in Woodland charged police with a knife, but we don’t know if that’s true or not. That’s the excuse the cops made for shooting him. Why they would be in striking distance of a knife is a significant question.)

      1. Robert Canning

        Safe Harbor is a crisis emergency shelter not a board and care. It is operated by the Yolo Community Care Continuum (Y3C) and takes referrals from many sources. Staff works with the individual in crisis to come up with a short-term treatment plan and often can get them linked to other resources.

        Re. the issue of hours of operation, these hours are the ones that have the most need. Of course it would be nice to have staff 24/7 but that is not a reasonable solution. Possibly in the future we will have small short-term treatment sites (possibly like Safe Harbor) that are open in several communities. SB 82 is a start.

        The staff will be licensed mental health professionals – social workers or counselors.

        Re. the incident in Woodland, all news reports stated that he had a knife and charged the officers. I relied on the Sacramento Bee for my statement.

    2. dlemongello

      I was thinking the same thing, coverage 24/7 on an on call basis. Waiting around for calls from 3:30 to midnight seems very inefficient, unless there really are so many calls it’s pretty much a given they will be coming in. As for the gaps, I would think a rotation of teams would better address those times rather than just on or off.

  2. London

    Re: news reports of arrests, not convictions: often a newspaper gives the news based on the law enforcement report of the incident. I don’t know how many staff the Sacramento Bee has dedicated to their arrest news. In Davis, the Enterprise does not have many staff to investigate the “other side” when someone is arrested, not convicted. It would be interesting to hear followup regarding the news that the mentally ill man wielded a knife.

  3. tj

    The man was shot, fatally, within just a very few minutes of the arrival of the police. No report that they had time to arrest him first. He was just talking loudly to himself; that’s why someone called the police.

    Safe Harbor is licensed by CA Community Care Licensing as a board and care facility. Accurate information is NOT available by phone, but if you review Safe Harbor’s state file in person, it contains many serious citations. This is surprising because most of Safe Harbor’s residents don’t have the time, energy, and wherewithal to file complaints with the state. The complaints on file are just the tip of the iceberg.

    Safe Harbor can call itself a crisis shelter, and take clients for short terms stays, but it’s still just a board and care with lots of problems.
    One thing it does do very well, as does it’s parent organization, YCCC, is salesmanship: self promotion is its best attribute.
    Knowing what I know first hand, I wouldn’t board my dog there. YCCC’s history of abusing clients covers almost 10 years that I’m aware of.

    Is the author of the above article affiliated in some way with YCCC?

    The article itself is the best description of the new program that I’ve read yet.

    It should be noted that YCCC has been contracted with the county for quite some time to answer calls to the crisis line re suicide. Night staff at the Farmhouse and Safe Harbor answer those phone calls. Those staff are “mental health workers” making about $10/hour, no licenses.

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