Sonoma County health department slashes mental health crisis center services

Although mental health emergency calls to law enforcement have been surging, the county's health department is cutting beds available in its mental health crisis center to half of what was available just two years ago.

The cutback to 12 beds has alarmed law enforcement agencies that rely on the center as the preferred place to take people who seek urgent help with behavioral health issues.

Lt. John Snetsinger, mental health liaison with the Santa Rosa Police Department, said the crisis center is vital to the city police department.

'Mental health is a significant issue in our community and we deal with it every single day,' Snetsinger said. 'Having the ability to take people to a facility to deal with a psychiatric situation is optimal, and if there are not enough beds, we have to take them to a hospital.'

Health experts and law enforcement officials say there is no other place in the county to take people to assist them during a mental health crisis, except for hospital emergency rooms. That option is costly for patients and time consuming for police officers and sheriff's deputies.

Nevertheless, the county health department has a financial crisis of its own, partly because of the costly operations of the emergency mental health center known as the crisis stabilization unit. It was allotted $8.2 million in the 2018-2019 budget, but because of people overstaying at the center the county had to pay $4.6 million last year to cover costs not reimbursed by the federal government, said Barbie Robinson, director of the county department of health services.

A typical patient stay should be up to 23 hours, but Robinson said people are staying up to three days, if not longer, while waiting to be transferred to a psychiatric treatment center. That escalates treatment costs for the health department and leaves fewer beds available on a daily basis, she said. This year so far, almost 900 people have been treated at the crisis center.

After reviewing the health department's approved budget for next year, Robinson said eliminating beds from the crisis unit was the least disruptive option. The department managed to spare a few of its behavioral health programs Sonoma County supervisors slated to cut during county budget negotiations in June, but to accomplish that the crisis center lost four of its 16 beds. There were 24 beds in 2017.

Santa Rosa Police Department and the Sonoma County Sheriff's Office reported that over the past five years they have received a surge of calls requesting help with a psychiatric situation or condition that required taking a person to the crisis center or to a local hospital.

City police last year responded to 541 such calls. The number has been steadily increasing, from 299 calls in 2015, to 462 calls in 2016, and to 491 calls in 2017. When officers respond to a call from a person who might be a threat to themselves or others, the first place they try to take them is the county's crisis center. When police officers have to take people to local hospitals, it could take hours of waiting with them to receive treatment.

Already the limited availability of beds at the county's crisis center is affecting the police department's ability to do its work efficiently, Snetsinger said.

'We do not get the same speed of service at the hospital, since they are dealing with medical emergencies,' he said. 'We are forced to wait with the patient until we can make other arrangements or eventually get them into the crisis stabilization unit.'

Last year, county sheriff's deputies responded to 280 calls for mental health emergencies, down from 305 in 2017. The numbers still are staggeringly high, Sheriff's spokesman Sgt. Spencer Crum said.

'These numbers only represent a fraction of those calls where we deal with people with mental health issues,' Crum said, referring to additional calls about possible suicide attempts and people reporting behavioral concerns regarding homeless individuals.

Tom Bieri, executive director of the Community Support Network in Santa Rosa, said belt-tightening measures have placed limitations on how the county crisis center is being used by outside mental health care providers. The support network operates nine group homes in Sonoma County focused on providing varying degrees of supportive housing options to those coping with a mental health disorder.

Bieri said years ago his organization had a partnership with the county that allowed for some of his patients to get immediate assistance at the crisis center. Or those who needed a temporary place to stay went there, he said, but now that is no longer an option.

The responsibility of taking care of people with mental health conditions has shifted away from the county's crisis center to local hospitals, which are not always equipped to deal with a mental health crisis, Bieri said.

Bill Carter, director of the behavioral health division of the county health department, said the county is moving ahead with plans to open a psychiatric health center next spring in a partnership with the Marin County Health and Human Services Agency. The hope is that it will alleviate the pressure on the crisis center by offsetting patient overstays, Carter said.

An additional 16 psychiatric beds will be available, 14 for Sonoma County patients and two for Marin County patients.

The health department has been working for three years to establish the psychiatric center in response to the desperate need for it, Robinson said.

'This is a good investment because with the crisis center we are unable to move people out quickly because they are unstable and there are no other places to send them,' Carter said. 'I expect by next year we will have a much stronger system.'

You can reach Staff Writer Alexandria Bordas at 707-521-5337 or alexandria.bordas@pressdemocrat.com. On Twitter @CrossingBordas.