[Noozhawk’s note: This article — part of a Noozhawk special project in partnership with the USC Annenberg Center for Health Journalism — is the second in a series investigating the shortage of acute care psychiatric beds for people experiencing a mental health crisis in Santa Barbara County. Click here for the first story.]
Susan Ayer’s oldest daughter, Claire, was afflicted with a severe mental health disorder when she was 17, and was put on a 5150 hold for the first time in the spring of 1999, shortly after she graduated high school in her hometown of Santa Barbara.
The only available bed for her was at Aurora Vista del Mar in Ventura, where she stayed for three weeks.
“For the three weeks she was there, I would drive 35 miles down and 35 miles back daily to visit her after work while also taking care of her two sisters and their needs,” Ayer told Noozhawk.
“She was lucky that she only went to Ventura, it could have been Pasadena or San Diego, and I don’t know what would have happened then.”
In just six months, Santa Barbara County sent 160 acute mental health patients to 29 different hospitals outside of the county.
Santa Barbara County is ranked sixth among California’s 58 counties for having the largest gap between its existing number of acute mental health inpatient beds and the number of beds needed, according to a 2021 California Department of Healthcare Services assessment.
Santa Barbara County’s single Psychiatric Health Facility has 16 beds available for the county’s roughly 375,000 people over the age of 18.
Noozhawk spoke with multiple people who gave high marks about the quality of staff and care at the county’s Psychiatric Health Facility, at 315 Camino Del Remedio in Santa Barbara. But they were frustrated that there weren’t enough beds for themselves or their loved ones to receive that level of care here in their home county.
When Santa Barbara County’s 16-bed Psychiatric Health Facility reaches full capacity — which is nearly every day of operation — the county tries to secure placement for patients at its contracted psychiatric hospital in Pasadena, at Aurora Las Encinas.
When that hospital does not have any beds available, patients are sent far and wide, throughout California, to receive the critical acute care that they need.
Not only are patients sent hundreds of miles away from their homes to receive adequate care, but sending patients outside of the county comes with a significant cost to the county itself.
Between August 2020 and January 2021, the county had 160 placements at out-of-county hospitals, resulting in nearly 1,000 bed days, according to data obtained by Noozhawk.
Of those patients, only 25% were sent to the county’s contracted hospital in Pasadena, which is nearly 150 miles away from northern Santa Barbara County and more than 100 miles from the South Coast.
The county’s contract with Aurora Las Encinas in Pasadena is $2.1 million over three years, between fiscal year 2019-2020 and fiscal year 2020-2021, according to the Department of Behavioral Wellness.
When there are no available beds at Aurora Las Encinas and the county has to send patients to a noncontracted hospital, the price per day ranges from $523 to $1,575 based on what area of the state and what kind of facility they are transferred to.
On the lowest end of that spectrum, in the six months between August 2020 and January 2021, the county paid more than $500,000 to send its 160 patients to noncontracted facilities.
On the farthest end of that spectrum, the county paid nearly $1.6 million — roughly 75% of the cost of the county’s three-year contract with Aurora Las Encinas — in just six months.
While the length of stay at hospitals outside of the county ranges from person to person, sometimes people only need acute inpatient care for a few days. This leaves another issue of transportation, family visits and providing the patient resources when they return home.
Alice’s son, Jim, was in the emergency department on a 5150 hold for nearly 10 days in the winter of 2021.
After being sent to a psychiatric hospital in Ventura, transferred back to Santa Barbara County’s Crisis Stabilization Unit, and finally released back home to his brother, he experienced another psychotic episode.
Jim’s brother called the county’s mobile crisis team, which came and took him to Marian Regional Medical Center in Santa Maria until they found a locked psychiatric hospital to send him to.
Because the county could not secure his placement at the Psychiatric Health Facility or its contracted hospital, he was sent to a facility in Sherman Oaks — at least 2½ hours away from his Orcutt home.
“It was a nightmare,” recalled Jim’s mother, Alice. “It was an actual nightmare.
“They kept moving him farther and farther away, and as soon as he was admitted to one hospital, they were trying to find out where they could discharge him to next.”
What’s Next in the Series
This report is the second in Noozhawk’s series analyzing Santa Barbara County’s acute care beds for mental health patients in crisis. Noozhawk recognizes that mental illness and the challenges of navigating the mental health system are vulnerable experiences to share. Alice and Jim are pseudonyms used to identify two of the local residents in this story, at their request.
The next article will be published on April 28 and will investigate the development of crisis stabilization units in Santa Barbara County, and why they aren’t being used as often as expected.
Click here to read the first story addressing the local shortage of psychiatric treatment beds.
This series is produced as a project for the USC Annenberg Center for Health Journalism’s 2021 Data Fellowship.