Fewer people being involuntarily held thanks to SLO's new mental health facility, data shows

Oct. 11--A $1.2 million facility that opened last year to stabilize people who are in the midst of a mental health crisis has had a big impact on alleviating strain on resources needed for more urgent cases, data released by the county shows.

Namely, seeking help at the new facility means fewer people -- nearly half -- are requiring intensive treatment at the county's in-demand psychiatric inpatient unit, which can only serve 16 people at a time.

As part of San Luis Obispo County's 2018-19 Annual Report, the Behavioral Health Department announced that its available mental health services greatly expanded with the opening of the Crisis Stabilization Unit (CSU) in March 2018.

The voluntary, adults-only residential care facility takes people who may be suffering severe depression or another very serious mental health crisis but who are not yet considered a violent threat to themselves or others.

At the 2,130-square-foot facility, located behind the county psychiatric unit at the Behavioral Health Department on Johnson Avenue in San Luis Obispo, contracted care specialists from the mental healthcare provider Sierra Mental Wellness Group to treat patients, calm them and connect them with a therapist or find them outside placement, for up to 24 hours.

With the new facility in place, the county has seen a roughly 48% reduction in law enforcement requests to admit individuals to the 16-bed psychiatric health facility -- known as the PHF, or "puff" -- where patients may be held involuntarily for up to 72 hours if they are a danger to themselves or others.

The PHF has in recent years been criticized for long wait times for admission, "antiquated and unsafe" facilities, and for PHF staff's role in denying a bed for a mentally ill Atascadero man who later died in San Luis Obispo County Jail custody more than a week after a judge ordered he be treated at the PHF in 2017.

Since then, the county has enacted a long list of policy changes and has expanded mental health and medical services available at the jail and to the public.

New facility in demand

Frank Warren, prevention and outreach coordinator and division manager with the Behavioral Health Department, said Thursday that county officials are pleased with results from the CSU and are looking for ways to let the public know of its existence.

"As people become more aware of the CSU, the department is confident it will continue to grow and meet the needs of the community," Warren wrote in an email. "We have met many benchmarks and continue to develop the program to meet our ultimate goals of reducing the impact of crisis on law enforcement and hospitals."

The CSU served 271 individual residents with 307 total stays during its first year of existence from April 1, 2018, to March 31, 2019, according to data from the Behavioral Health Department.

Sierra Mental Wellness Group staff can treat up to four patients at once at the facility, where the primary goal is to prevent the need for people to be admitted to an inpatient psychiatric hospital setting.

Law enforcement requests for admitting individuals to the county's inpatient Psychiatric Health Facility reduced by 47.7% from 218 referrals the prior year to 114 in the CSU's first year of operation, according to county data.

Of the 271 people the CSU served, 65 referrals were made to outpatient services, such as private treatment centers, and 46 were enrolled.

Of the same 271 people, 46 referrals were made to community based services, such as Transitions Mental Health Association, and 25 were verified as enrolled, the data shows.

Warren said Thursday that the county is close to receiving more recent data that he expects will continue to show positive results.

Treatment staff offers community outreach

Beyond the apparent successes of the new facility, the department's annual report says Sierra Mental Wellness Group staff there began providing mental health training to law enforcement and other emergency departments.

In the training, staff reviews with the agencies their policies and protocols for CSU admission, criteria and discharge of clients to the facility.

CSU staff also has a liaison specific to law enforcement agencies to provide additional training and education to police about their referrals to the CSU in efforts to decrease inpatient psychiatric hospitalizations, a news release about the training states.

Sierra staff also introduced the facility and its available services to the college community at the Cuesta College Job Fair and California Polytechnic State University Health Center, the report states.

This year, the Behavioral Health Department entered into an agreement with Tenet Healthcare, which operates Twin Cities Community Hospital in Templeton and Sierra Vista Regional Medical Center in San Luis Obispo to allow for mental health crisis workers from the CSU to be available within the hospitals.

The county extended its contract with Sierra Wellness Group to now place qualified and trained mental health staff in each emergency department to provide mental health crisis evaluation, support emergency department staff and facilitate transfer to the CSU or PHF as needed, the report says.

The county says this collaboration creates more expedient care and reduces the length of stay in emergency rooms for individuals suffering from mental health crises.

Youth crisis triage also added

The county says it has also made gains in expanding its ability to timely treat mental health crises in minors.

The Behavioral Health Department was successful in obtaining a statewide grant offered by the Mental Health Services Oversight and Accountability Commission to provide a Youth Crisis Triage Program.

With the grant, the county expanded its mobile Mental Health Evaluation Team to include a specialist in youth crisis response, along with case management from a peer.

The county says the three-year program will focus on crisis calls from schools and emergency departments and was launched near the end of the 2018-2019 school year.

That program aims to serve more than 350 young people per year, the county says.

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