On Friday as the world was about to enter the New Year’s Day three-day weekend, just after 5 pm the Vanguard received a frantic call from Kristin, the mother of an 18-year-old Davis High School student. Her daughter had experienced a mental health breakdown and was taken to the Aurora treatment center in Santa Rosa just after Christmas.
Kristin, her husband James and daughter Elizabeth had just come out of a two-hour meeting with Dr. Ruth Raykonti at Aurora Santa Rosa Hospital. Because the family deemed Elizabeth to be a danger to herself and others, Kristin stated she felt uncomfortable bringing her back into their home. Thus, Aurora Santa Rosa Hospital was making plans to release her daughter, not to the home, but rather to the Fourth & Hope emergency shelter and treatment center in Woodland.
Kristin, meeting with the Vanguard late last week, described how Dr. Raykonti’s assistant literally printed off the page from the Yolo County website on homeless shelters and handed it to them.
“She said that I could go to a homeless shelter,” Elizabeth told the Vanguard. “She gave us a list of options of different homeless shelters.”
Dr. Raykonti, according to Elizabeth, explained that “if I couldn’t go home, there weren’t many other options.”
As if turning an 18-year-old mentally ill patient over to a homeless shelter was not bad enough, Aurora failed to check with Fourth & Hope.
“We left the meeting, and (Kristin) went out to the car and she started making phone calls,” James explained.
Kristin, after making quick calls, soon found out that the homeless shelter would not take a high school student, even one who was over 18. Not only that, but they do not process intakes on a 
Saturday.
“I called Fourth & Hope and they said they didn’t take intakes on Saturdays,” Kristin explained. “So they wouldn’t take her in, even if the hospital brought her there.”
She was also told, “(Elizabeth) was too young, and even if she was 18, they don’t take high school students.”
As a result, Aurora, according to the family, would simply give Elizabeth a bus ticket, send her back to Yolo County by herself and turn her literally out on the streets.
When Kristin attempted to contact Aurora about this problem, she was unable to get ahold of anyone and Dr. Raykonti never returned her message.
“I never got any response,” Kristin said. “They told us they would drop her at the homeless shelter, but they never did any kind of research as to whether or not the homeless shelter would even take her. They would take her to the homeless shelter, but they would never help her through the process.”
She added, “That’s effectively just dropping her to the street in front of the homeless shelter and letting her fend for herself.”
James explained, “They said that they just provide transportation to the location, and since her coverage was ending… they were going to discharge her, and they don’t do anything but just discharge her to the location.
“They said, this is the law and here is where you are going to go,” James said. “That’s when they brought out the printout and said, here you go.”
Fortunately for Elizabeth, Yolo County stepped up. Some quick calls to June Forbes of NAMI (National Alliance on Mental Illness) and the Vanguard got the attention of Supervisor Matt Rexroad and Public Guardian Karen Larsen. Quickly, Yolo County stepped up for a patient who was not even theirs and got Elizabeth a spot at Safe Harbor Crisis House in Woodland, where she was on Friday when the Vanguard met her for the first time.
Elizabeth, whose name has been altered to protect her privacy, is, as stated above, currently a student at Davis High School. She has an IEP (Individualized Education Program) and a long history of mental illness. She was first hospitalized back in 2012 for MDD (major depressive disorder) and suicidal ideation. Since then, she has been hospitalized four more times for similar reasons.
This was her sixth hospitalization overall. She has been diagnosed with bipolar II disorder by two psychiatrists, and at various times over the last five years she has been diagnosed with anxiety disorder, borderline personality disorder, pervasive developmental disorder, and ADD (attention deficit disorder).
The immediate event that led to her latest hospitalization is shrouded in some mystery. Around 4 am on December 26, Kristin called the Davis Police regarding Elizabeth’s erratic behavior and threats against herself and the family. She was evaluated and transported to Sutter Davis Hospital, which managed to find her a bed in Aurora.
An incident had occurred on Christmas evening. Elizabeth was at a friend’s house with her friend, friend’s sister, friend’s mother and friend’s mother’s boyfriend. Kristin had been unable to reach Elizabeth until 12:30 am, when Elizabeth answered the phone crying and yelling.
When Kristin arrived at the friend’s house, she observed the friend’s sister being removed from the home by paramedics after being stabbed.
Elizabeth told them that her friend had a knife and had stabbed her sister. Elizabeth was covered in blood.
The Vanguard spoke to Davis Police Lt. Paul Doroshov, who confirmed there was a stabbing that evening that matched the description provided. However, because it was an ongoing investigation he was not able to offer any details. He did say that there has not been an arrest made and the investigation is continuing.
From there, things went downhill for Elizabeth. Her mother tried to find out what had happened, but she said Elizabeth grew more agitated. She would not tell her mother whether drugs or drinking had been involved in the evening.
The situation escalated when Elizabeth began to yell, break things, shove family members and kick a bedroom door. Elizabeth threatened suicide and escalated the threats. At this point, the police were called, and she was taken to Sutter Davis.
The Vanguard made several attempts to contact Aurora Santa Rosa Hospital to understand just what their policy is. When the Vanguard first spoke to someone in the business department and described the situation, they were stunned and said that this wasn’t their policy.
The Vanguard had made multiple attempts to speak to either the Chief Executive Officer or someone authorized to speak to the media, but was never allowed to do so.
Finally, two days later, the same individual informed the Vanguard that under privacy laws, they would not be able to give any facts.
“It sounds like you don’t even have a story,” she said. “I know that the parents might have gotten a sympathetic ear with the facts that they are speaking about. However, this is an adult and your information is coming from the parents of an adult.
“We’re just not trying to hide anything,” she said. “There’s just nothing to defend at this point.”
While Aurora was willing to drop the 18-year-old at a homeless shelter in Woodland over New Year’s Day weekend, Yolo County was able to get Elizabeth into Safe Harbor within about 30 minutes of getting in touch with Karen Larsen.
In fact, someone from Safe Harbor personally went to pick her up and drive her to Safe Harbor.
“We understand that’s not normal,” James explained. But the alternative was that Aurora would give her a bus ticket to Yolo County and put her on a bus.
Julie Freitas, a manager at Yolo HHSA (Health & Human Services Agency), declined comment for this report, citing privacy issues.
However, in a text exchange with Kristin, she said, “Aurora can be difficult to work with. It’s our hospital of last resort.”
June Forbes of NAMI-Yolo believes that the start of the problem here was a shortage of local beds, requiring Elizabeth to be placed out of county in Santa Rosa “where staff doesn’t have as thorough a knowledge of after-care options in her own county so the after-care option they chose is not in reality available.”
The second problem, she said, “[i]s (that) conservatorship doesn’t seem to have really been considered as an option for this vulnerable young woman.”
On the other hand, she said, “[w]hat went right is that the public health system in Yolo County even though this girl was not their patient, jumped on it and found (something) appropriate for her at the last minute on a holiday weekend.”
“I think we ought to crow about that,” she said. “Not often am I willing to crow and applaud about the public mental health system, but that time, yay.”
When the Vanguard met with the family at Safe Harbor on Friday, Kristin discussed some of the program options that Elizabeth now will have access to, thanks to the work of Safe Harbor.
They still have a lot of long term concerns about Elizabeth, but at least they feel right now that they are headed in the right direction.
—David M. Greenwald reporting
no one cares about the TRUTH I share in the crappiest state in the crappiest country….but I would be interested to see what Dr. Tia has to share…. it is ALWAYS the most brilliant of children in Davis who commit suicide or drop out…I could share WHY but most folks on here would just throw stones at me…
Thank goodness for the Vanguard, Ms. Forbes, Mr. Rexroad and Ms. Larsen. Sadly this “passing the buck” is the norm these days when it comes to caring for the difficult patients. Seems like some “providers,” lacking what was once considered normal human compassion and just plain common sense and decency, just want to deal with the easy patients and easy money and bus the others to “wherever.”
“no one cares about the TRUTH I share in the crappiest state in the crappiest country…”
Then why are we still cursed with your presence? You mendaciously tell us, over and over again that you are leaving and like a bad penny, here you are.
” it is ALWAYS the most brilliant of children in Davis who commit suicide or drop out…”
Gratefully this is more of your bee ess.
“I could share WHY but most folks on here would just throw stones at me…”
I’ll bet you won’t deprive us of such a golden opportunity.
JH, you fail to see the irony. This is an article about mental illness. I will not say more .. . . connect the dots.
” .. . . connect the dots.”
There went my French roast. http://www.everythingsg.com/styles/default/xenforo/smilies/naughty.gif
I see John Hobbs took the bait.
This is a great example of why we need to demand cooperation and coordination of public and private MH and other social services entities… those unwilling to do so should consider being “de-funded”. Not a good idea to set up a new entity… that type of cooperation/coordination I’d be willing to fund, either by a tax, or a individual stream of donations. without it, would be somewhat disinclined to do either. Waste of money.
Got distracted, so didn’t finish… FWIW, between taxes, insurance premiums, and charitable donations, we already fund at least some of these entities…
I have no special knowledge of this case. I will share what I do know about juvenile/young adult mental health hospitalizations from personal experience.
Hospitals that deal with “mental illness” are wildly different in their competencies. Within Sacramento County, without specifying facilities, I have seen on juvenile wards everything from exemplary care to frank neglect. The latter so bad that on one occasion, I had to check out my son AMA , despite suicidal ideation, as the only way to keep him safe from a violent situation that the staff had allowed to escalate over the course of one week to the point where one patient knocked another out in a situation the staff knew was ongoing but did nothing to prevent. Fortunately we were able to secure him a bed in a competent facility within two hours during which time he was under my direct observation. And yes, I pulled MD strings to make this happen which should never be the case and speaks to the inadequacy of our system since a lay person would not have been able to accomplish this. I knew who to call for admission.
Competency of discharge plans is also widely variable and, in my opinion, sometimes involves cursory, or no assessment by a psychiatrist ( as in my sons case) but excessive dependency on the word of supervisorial ( custodial) staff.
Again, I have no knowledge of this facility or situation, but am not at all surprised by the report as written and find it to be credible given my direct personal experiences.
I am baffled. When did it occur to anyone to call the Vanguard when they are in personal crisis? Is that similar to calling Seven-On-Your-Side, Dr. Phil, or Superman? Is this a new service of the blog?
Hmmm… good points for thinking about…
Good observation Alan. Maybe it was the threat of the Vanguard possibly doing 147 negative articles about the facility? 😉
Actually Aurora’s response was you have no story, Yolo County is the one that made this all end well.
Alan: People when they are faced with a moment of confounding bureacracy often contact the media hoping that by shedding light on the situation, something good will come of it.
“Bureacracy” (sic) usually [though, not always] applies to government entities… here, you say it was the County who ‘came through’… interesting possible dichotomy of thought in your 9:43 and 9:44 posts…
There is also corporate bureacracy, no?
Notice bracketed qualifier…
Googling the organization, I think you may well have hit on a truly dark/mercenary/scam underbelly… am starting to think (after several Google searches) to think this (Aurora) is a sham, privately held, and only pretends to be legit. Follow the money, if you can… I tried by Google, but saw nothing positive.
Might even be ‘franchises’… can’t drill down into management or funding… I tried… something “smells”… they started in 2000… 15 facilities in the US… phenomenal rate of growth… ~ 1/year…
Would be interesting to see their billings to private parties, Medicare/MediCal, and “operator”/CEO’s compensation… also, patient outcomes… you’ve shed light on one… I ‘know’ enough that I’ll steer any family/friend member far away from them… as in HELL NO!!!
They appear to be as far away from transparent as you can get… opaque…
http://aurorabehavioral.com/aboutAurora.php
No clue as to funding or management.
Am thinking this story should be forwarded to appropriate State and Professional watchdogs… something about a ‘smell from Denmark’…
Several years ago, we saw a story in the Sacramento Bee about how a doctor at the UCD Medical Center spent substantial time calling around to different shelters in Sacramento trying to find a bed for a homeless patient. The Citrus Circuits robotics team got the idea that the police and emergency rooms might find it useful and quicker to be able to find a shelter that has an open bed using the Internet. The programmers on the team then developed a web-based program to help the Davis Police Department find out if beds are available at the Davis Interfath Rotating Winter Shelter. It is being launched this winter. If this pilot works, we will work on developing it for a wider region, perhaps starting with Yolo County.
She is in very good hands now with YCCC and Safe Harbor. It seems to me that we need to do a better job of informing parents and patients about available options for minors and, especially, definitely before and as teens “age-out” (turn 18). She essentially is now in charge of her own care, but there appears to be no transition from being a child to being an adult. This transition should have started happening last year to avoid this crisis. Did no one consider, “What if…?” With her history, there should have been a plan that went beyond calling the police. This young lady could have very well ended up homeless and the community’s problem or in prison and hopelessly confused about how she ended up there. She could have hurt or killed someone or herself. Aurora Santa Rosa Hospital needs to be taken off the list of resources for Yolo County for now, I think, unless they are viewed as merely a temporary babysitting service and not allowed to make decisions about releasing patients.
Glad the girl is okay…
But she is so dangerous that her own mother and family are afraid to have her at home… and now she is staying at the Yolo County Crisis shelter that houses women and their small children fleeing domestic violence.
Uh- huh. Another reason….
No, CTherese Benoit. She is at Safe Harbor – a Short-term residential treatment home for adults who are experiencing acute psychiatric symptoms. Treatment is designed for individuals who need an intermediate step between a hospital stay and returning home, or who wish a more structured, supportive setting in order to prevent a psychiatric hospitalization. This is not the shelter for domestic violence victims.
Well that is a relief to hear. Safe Harbor Crisis House when I looked it up shows itself to be a domestic violence shelter for women and kids. I would not have been surprised if she were there. Glad she is not but also very glad she is okay. Yolo sure does not need any more tragedies with kids.
There is a domestic violence crisis house with a similar name in Utah.
The Sacramento Bee ran a very good (horrifying) article about patient dumping http://www.sacbee.com/news/local/homeless/article193308479.html; and it seems that hospitals are either directly or indirectly complicit in this practice. Sutter here in Davis needs to vet ANY place it unilaterally discharges patients. Aurora should be off the list.
David, is that something you could ask Sutter Davis to comment on?
I could try
There is no try. There is only do and do not.
Valid response. I have been known to do this myself. Not making light of this particular situation, I have been in a similar situation in different circumstances with family and know well reaching that point of desperation when there appear to be no possible options that are remotely sane. Was simply amused by the “who ya gonna call?” aspect of the quoted line. Let’s hope “Possible Scam Mental Health Facility Busters” (The Vanguard) is able to shed light if indeed something is amiss.