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Saturday, February 23 , 2019, 3:27 am | Fair 39º


Santa Barbara County Mental Health Director Details Service Improvements

Supervisors, speakers ask for pilot program of Laura's Law after update presentation on crisis stabilization and residential units

ADMHS Director Alice Gleghorn details the changes to the department and new mental health facilities created after multiple audits and consultant reports.
ADMHS Director Alice Gleghorn details the changes to the department and new mental health facilities created after multiple audits and consultant reports.  (Frank Cowan / Noozhawk photo)

Just over one year ago, Alcohol, Drug and Mental Health Services Director Alice Gleghorn began her work with Santa Barbara County, and immediately started getting asked when she would be giving an update on the changes happening within the department.

When she joined, the county was two years into an extensive shake-up of the department’s processes after a slew of audits, consulting reports and complaints that ADMHS was not serving people properly.

On Tuesday, Gleghorn reported to the county Board of Supervisors that she was glad to finally give an update about the extensive changes made, which she said have reached every part of the department.

Leaders from the department took to the microphone over the course of a three-hour talk, but noticeably absent from Gleghorn’s presentation was any mention of Laura’s Law.

That law would allow a judge the ability to order a 6-month treatment program for an adult with an untreated mental illness who is unlikely to survive safely in the community.

Earlier this year, Gleghorn had expressed concern that the department could not take on another effort in addition to system changes.

The supervisors voted 3-2 to punt on the law, but had set aside $120,000 to begin a pilot program eventually.

More than a dozen speakers implored the supervisors Tuesday to start the program, which they said is needed by a few people who cost the system a lot of money.

The board ultimately voted unanimously to receive the report and have Gleghorn return in 120 days with options on how to implement the pilot program.

When the board asked Gleghorn if she could return before budget talks begin in late February with data and a plan for the program, they got an emotional response.

With her voice shaking, Gleghorn told the board that she’d spent 80 hours a week for the last several months working on Tuesday’s report about systems change.

To have to return with more data and a program design for Laura’s Law on such short notice “is not a promising prospect for me,” she said.

It was clear from the grueling meeting, which spanned from the afternoon session into the evening hours, that the department has made significant progress, particularly in its crisis programs.

The improvements have been a necessity, since the department must meet standards from state and federal agencies that make up a significant source of funding for the department.

Since Gleghorn’s tenure began, nine audits from various agencies have taken place.

One of the biggest accomplishments of her tenure has been the opening of a Santa Barbara Crisis Stabilization Unit, where up to eight patients can stay for up to 23 hours while receiving treatment and medication from medical staff.

The system is designed to intervene with people earlier, to prevent them from getting to the mental health crisis stage where they end up in a local emergency room or another restrictive setting.

Supervisors also approved funding to purchase a building for a crisis stabilization unit in Santa Maria on Tuesday. The department hopes to open by next June.

Santa Barbara County Mental Health Services Act Division Chief Refugio Rodriguez provides an update for the Board of Supervisors Tuesday. Click to view larger
Santa Barbara County Mental Health Services Act Division Chief Refugio Rodriguez provides an update for the Board of Supervisors Tuesday.  (Frank Cowan / Noozhawk photo)

The department has been able to add crisis teams in all areas of the county and is using data to follow-up with those treated.

The department has also made strides to connect patients with peers who have been through the mental health system, and made efforts to reach out to family members and patients with bilingual staff.

Dr. Ole Behrendtsen, the department’s medical director, said that the county has made significant strides.

The county has 16 beds in its psychiatric unit, but actually needs about 40 beds based on national averages, he said.

With the addition of the crisis stabilization and residential units, “we’re really filling in those gaps,” Behrendtsen said. “We’re very happy with that.”

The department still faces challenges.

Lack of in-county safe and stable housing and high incarceration rates of people with mental health and substance abuse continue to remain a problem.

A high number of people incompetent to stand trial are also taxing the system.

“All these folks really overburden our system and our budget,” Gleghorn said.

A high vacancy rate, about 22 percent, also persists for psychiatrists that the department desperately needs.

“Many places across the country are having trouble hiring physicians and this is not unique to psychiatry,” Gleghorn said.

The county is often in competition with counties paying higher rates.

County Supervisor Doreen Farr was disappointed not to hear a plan for implementing a Laura’s Law pilot program, as were many of the people who showed up for public comment during the mental health services presentation. Click to view larger
County Supervisor Doreen Farr was disappointed not to hear a plan for implementing a Laura’s Law pilot program, as were many of the people who showed up for public comment during the mental health services presentation.  (Frank Cowan / Noozhawk photo)

Supervisor Doreen Farr said that she had hoped to hear about Laura’s Law as part of Gleghorn’s presentation.

“It’s clearly on the hearts and mind of a lot of people in our county,” she said.

Supervisor Peter Adam reminded the board how dysfunctional the department has been in the past.

“It’s a tremendous job that you’ve just done, and it’s not over yet,” he said, adding that ADMHS needed to stay focused on the change efforts before taking on more responsibilities like Laura’s Law.

He also expressed empathy with families who are tired of waiting.

“This has got be one of the most difficult things to live with ever,” Adam told the audience.  

Over a dozen people spoke during public comment, commending what has been done but urging the supervisors to do more because lives are at stake.

Lompoc Police Chief Pat Walsh spoke during the meeting’s public comment session, and stated that Laura’s Law would be a good thing for the community.

In the 15 months since Walsh has been chief, one of his officers was involved with a shooting with a mentally ill person. Both survived, but “this is what keeps me up at night,” he said.

Deedrea Edgar, who works with mentally ill people daily in her role as a public defender for the county, spoke passionately about the gaps in the system.

She lamented the numerous committees with their endless acronyms, consultants and grand jury reports that all point out the same things.

“We know the gaps,” she said, adding that more money needs to be directed towards treatment than incarceration.

“I see people hanging themselves with their underwear. I see homeless people with bugs crawling out of their skin because they have mental illness. I have a very tough day and I don’t get a decade and consultants to fix it,” she said.  

“I have families crying in my office every day… Somebody has to be held responsible.”

Speaker Gina Aceves said her daughter is in jail and suffering from PTSD.

Aceves said that her daughter was raped several times beginning as a young teen and began to self medicate with drugs, which landed her in jail.

“There have been many times when she has reached out to help,” Aceves said, but a lack of insurance complicated the search for treatment.

“Our county ADMHS system should have been there for us,” she said, urging them to create a system that can heal instead of punish.

Dave Saunders, who spoke on behalf of District Attorney Joyce Dudley, said that the DA supports moving forward with the Laura’s Law pilot program.

“We respectfully suggest that it’s time to use those funds,” he said.  

“Implementation would send a strong message to family members of our community.”

Noozhawk staff writer Lara Cooper can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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