Sonoma County overhauling mental health services for those in crisis

From the outside, 3322 Chanate Road is not a bad-looking place. It’s a rather handsome structure, with a California mission-style red-tile roof and a low, single-story profile that sits unobtrusively atop a sloping wooded hillside.

But it’s entirely something else inside the building that houses the county’s psychiatric emergency services, or PES. The beige walls and floors, dreary hallways and cramped rooms invoke a frightful institutional feeling.

“I know how I would feel if someone pulled me out of my life and brought me here,” said Stephen Parsons, client case manager for the agency.

Parsons said there’s nothing welcoming or comforting about the facility, which is used to treat 4,500 people annually who suffer from psychosis, severe depression, bipolar disorder, schizophrenia and co-occurring substance abuse.

Built as a remote tuberculosis sanatorium in 1938, the building has outworn its usefulness, Parsons and other county mental health officials say.

With an eye on delivering more modern and humane emergency mental health services, the county is gearing up for a major move in the fall to a new facility that could dramatically improve services for those in a mental health crisis.

“It’s really the first step in us trying to develop a one-stop behavioral health wellness campus,” said Michael Kennedy, director of county mental health services.

That goal begins with the relocation of psychiatric emergency services to a west Santa Rosa business park at Sebastopol Road and Corporate Center Parkway. The space, rented in a development called The Lakes, will allow the county to more than double the size of its PES center from 7,000 square feet to 15,000 square feet. The county also hopes to lease more space in the future for outpatient behavioral health services, Kennedy said.

The new location will be more visible in the community, closer to the Sam Jones homeless shelter on Finley Avenue and easier for west Sonoma County residents to reach, he said. Many of the people who use the agency’s services are low-income residents with Medi-Cal or lack health insurance.

Sonoma County Supervisor Shirlee Zane, a vocal advocate of public mental health services, said the move will help move the county away from a traditional PES model to crisis stabilization. That allows the county to focus more on immediately treating a mental health crisis rather than waiting until patients arrive at whatever inpatient psychiatric hospital receives them.

“We want to also, of course, improve treatment,” she said. “We will have the capacity to house both voluntary and involuntary clients separately. Also we’ll will have a section only for minors, which is really important - to have minors separate from adults in terms of treatment.”

The new facility also will allow voluntary and involuntary patients to be kept separate, and existing crisis stabilization services will be augmented and provided in specialized areas.

Mental health officials said the current psychiatric emergency services model was developed when the unit was attached to a 30-bed acute inpatient psychiatric unit. PES was the admitting unit for the psychiatric hospital. But the county inpatient unit was shut in 2007, one year before Memorial Hospital closed the last remaining inpatient psychiatric hospital on Fulton Road.

Though a new for-profit inpatient psychiatric hospital reopened in 2013 at the Fulton Road location, it’s a freestanding facility, which means it is not tied to a general acute care hospital and therefore does not qualify for Medi-Cal reimbursement for adult patients.

The new 95-bed facility on Fulton Road, operated by Aurora Behavioral Health Care, is for the most part off-limits to Medi-Cal patients, many of whom continue to be sent outside the county if they require being admitted to an acute psychiatric hospital.

For those who have arrived at psychiatric emergency services involuntarily, the unit had become a sort of limbo for mental health patients in crisis, as they waited to be sent to inpatient hospitals in Marin, Contra Costa or Sacramento counties. Involuntary stays can legally be for as long as 72 hours.

The Sonoma County’s new facility will no longer be called PES and will focus on quickly stabilizing patients in mental health crisis, officials said. To that end, more staff, more beds and peer support will be added, said Parsons. The county, he said, is currently in the process of taking input from local mental health experts and family and behavioral health clients to design the new facility.

“It will be the kind of place where people who walk in will feel welcome,” Parsons said.

In the old building, the hallways were not designed for the kind of patient observation necessary in mental health facilities, he said. Staff are unable to see what’s happening in the hallways unless they step out of whatever room they’re in.

“A good crisis stabilization unit has open space and makes use of modern materials such as glass walls,” Parson said.

Randye Royston, section manager of adult outpatient services and access for the county mental health program, said the relocation and evolution is “long overdue.”

“This is a nice old building. We’ve really outgrown its usefulness and we’re looking at more modern, nicer accommodations that are more conducive to healing,” Royston said.

The new facility will feature the same number of beds as the current one, about 12, Kennedy said. After that, six beds will be added every six months until the facility expands to 30 beds, he said.

Over time, the budget - currently $2 million - will increase but the county hopes to contract with private health plans and others to bring in more revenue, Kennedy said.

The state recently received $2 million in state grant funds from SB82, the Investment in Mental Health Wellness Act of 2013.

Improvements will allow the county to meet the needs of anyone in crisis, not just patients who are arrive involuntarily.

More available space in the new building will give the county the flexibilty to provide medical clearances for patients, which currently must take place through local hospital emergency departments.

“We really want to provide a place for people in mental health crisis to get the treatment they need and get stabilized and have a really friendly place for people, both clients and family,” Kennedy said.

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.