Santa Clara County mental health system ‘fundamentally broken’

Since Santa Clara County declared a mental health crisis in January, little has changed to combat the problem, supervisors said in a memo to County Executive Jeff Smith.

Local officials are frustrated with the county’s lack of progress in addressing its mental health crisis and are seeking an acceleration of several projects, including construction of a youth psychiatric facility at Santa Clara Valley Medical Center.

Supervisors Susan Ellenberg and Otto Lee are calling for immediate progress on a number of behavioral health programs, projects and services. Since the couple declared a mental health crisis earlier this year, the county has reported 188 residents who have died of drug overdoses and 106 by suicide.

“In just seven months, that’s a loss of nearly 300 of our children, siblings, parents, friends and neighbors, and those are preventable deaths,” Ellenberg said. “This is a public health crisis because our current care system is not equipped to meet the demands.”

She said the county needs to move urgently to meet mental health needs.

“It seems to me that everyone is working very hard, with great compassion within a system that is fundamentally broken,” Ellenberg said.

Santa Clara County’s mental health and substance use crisis has seen a record increase in suicides and drug overdoses accompanied by the COVID-19 pandemic. Schools have seen an unprecedented number of young people and teenagers suffering from severe depression and anxiety. For adults, the issue is further exacerbated by an insufficient number of beds in behavioral health treatment facilities and the overuse of prisons to incarcerate those in need of mental health services.

Supervisors are asking county leaders to begin construction on a 77-bed psychiatric facility serving children and adolescents within the next three months. The project, seven years in the making, will be the first county-run youth psychiatric facility. Some candidates running in the November election have criticized the $233 million project, saying it is too expensive.

“When I hear dates of 2024 and 2025, that tells me we’re not moving fast enough,” Lee said, referring to the estimated timelines for a number of mental health projects.

Smith said the district continues to address the issue, but there is no easy answer to the problem. He added that the county is considering four contractors to build the psychiatric hospital, with plans to report in November. The hospital was scheduled to come online in 2023, but due to delays and cost overruns with XL Construction the contract was terminated. Construction is now scheduled to be completed in December 2024.

“We have the best behavioral health system in the state certainly, and probably in the country,” Smith said. “We clearly have problems, but given the fact that behavioral health and substance abuse problems have been emergencies for well over a generation, we’re at a precipice where we can actually make a difference.”

Dealing with the matter urgently

As Santa Clara County continues to report a shortage of mental health beds, Ellenberg and Lee want to expand capacity to serve patients leaving acute hospitalizations or jails. The extra beds, which provide intermediate care, would free up space for others with greater needs or allow patients to leave the jail, supervisors said.

They also want county officials to expedite a renovation process at a private facility on S. Bascom Avenue to add 28 treatment beds, find funding for 20 readily available beds with a different contractor and create a timeline to an independent long-term mental health facility— with a 90-day deadline.

In response, Smith said the South Bascom facility will begin renovations this week — with plans to finish in April 2023. Officials will update the board on other projects at a later date.

Ellenberg and Lee are also asking the county to add 20 “social detox” beds and implement a medical detox unit in the next three months. Social detox beds support patients with substance use problems entering recovery. Medical detox beds serve those with complex medical conditions. Officials said social detox beds are scheduled to come online next summer.

To address the ongoing worker shortage, Lee and Ellenberg asked for an action plan on how the district would invest in students in the pipeline and recruit new workers by December. Smith said a national shortage of psychiatrists and mental health specialists is limiting the county’s ability to recruit.

“Funding has been allocated and we are willing to fund more,” Smith said. “The biggest difficulty is finding specialized workers who can do this work.”

Supervisors also pointed to $100 million in remaining Mental Health Services Act funding as a county failure and called for it to be put into services.

A number of residents and advocates were called to support the direction by Lee and Ellenberg.

“I call on the board of supervisors to hold the county administration accountable for meeting the needs of people with mental disabilities,” said Sandra Asher, a member of Show Up for Racial Justice @ Sacred Heart. “Many of our neighbors are still falling through the cracks.”

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