Mental health crisis plan sought
EL CENTRO — Key stakeholders are working on a roadmap to improve the local mental health crisis management system and reduce acute care hospitalizations of psychiatric patients.
The effort is being led by the county Local Health Authority and is expected to produce the so-called “5150 Management Initiative” by fall 2019.
The numbers “5150” refer to a state law that allows for the temporary and involuntary commitment of individuals who may pose a danger to themselves and others due to mental illness.
“Mental health has become a crisis across the United States,” said Dr. Adolphe Edward, El Centro Regional Medical Center chief executive officer. “And it’s no different in the state of California.”
Both local hospitals are among the multiple entities and agencies participating in the discussions. In the past year, each hospital has recorded more than 300 encounters with individuals in need of intensive psychiatric care, he said.
At ECRMC, the cost of providing care for those individuals reached nearly $2 million, said Edward, an LHA commissioner and member of its executive committee.
Countywide, there were 1040 encounters in the past year that resulted in individuals being provided outpatient and inpatient psychiatric services as a result of 5150 holds, county Behavioral Health Services reported.
The situation has been challenging to address, especially as it relates to finding a place at the right psychiatric level to house the individuals, Edward said.
Neither ECRMC nor Pioneers Memorial Hospital are equipped to act as acute care psychiatric hospitals, since neither has the requisite mental health nurses and psychiatrists, he said.
Some relief is expected to come with the grand opening later this month of Jackson House El Centro, a private 10-bed, 6,500 square foot facility the county has contracted with to operate a voluntary, short-term acute residential treatment program.
Currently, there is one mental health provider for every 790 residents in Imperial County. The statewide average is one mental health provider for every 310 residents, according to information provided by Pioneers Memorial Healthcare District.
Edward said he was encouraged by LHA’s current initiative and the participation and leadership of numerous entities and agencies, including the County Executive’s Office, Public Health Department and Board of Supervisors, to name a few.
“Today’s efforts are lining up to where we should be heading toward a solution,” he said. “This is a very resource-intensive issue.”
The local effort got partly underway in June, when LHA issued a request for proposals to develop the roadmap. It has since approved a $125,000 contract with Oakland-based Resource Development Associates, which has 30 years of experience supporting mental health systems throughout California, an LHA press release stated.
The RDA-led initiative has facilitated three multi-stakeholder work sessions to date, with an additional session scheduled for September or October, pending stakeholders’ availability and agreement, said Diego Gamboa, LHA health program coordinator.
The initiative’s development has included community surveys, focus groups and interviews with community members that have experience with the Valley’s mental health crisis management system, local mental health providers and various stakeholders, LHA reported.
“The 5150 Management Initiative was created to improve our community’s ability to provide the right care at the right time in the right place,” Gamboa said in a written statement.
Multiple local police departments acknowledged taking part in the workgroup sessions and that their officers have undergone various levels of training related to mental health crisis intervention as part of their employment.
“Our officers receive mental health training as a component of our perishable skills training which is mandatory every two years,” said El Centro Police Department Cmdr. Aaron Reel.
Supervisors and field training officers are also required by the California Peace Officers Standards and Training program to take additional crisis intervention training, he said. The training is mandatory and contains several components on dealing with mental illness and de-escalation.
“Our personnel at the patrol level have all attended this training within the last two years,” Reel said in an email.
Likewise, local fire departments have been participating in the 5150 roadmap initiative.
Though the El Centro Fire Department’s firefighters have not undergone the same level of relevant training as local police officers, its EMTs and paramedics have received behavioral emergencies awareness training as part of their initial training, said El Centro Fire Department Battalion Chief Cedric Ceseña
The training helps the department’s medical personnel identify the problem, formulate a treatment plan and treat the patient with a handful of treatment interventions available to them, he said.
The involvement of public safety personnel and first responders is considered crucial to the roadmap’s development, officials said. Often, they are the ones who may initially encounter an individual experiencing a mental health crisis.
“We have provided input regarding strengths and weaknesses in the current system design,” Ceseña said. “Additionally, we worked together with the research principals in order to help them identify valid data points which would be beneficial to their research.”