In a move described as groundbreaking by its chair, the San Diego County Board of Supervisors Tuesday approved $23.8 million to expand mental health and substance abuse care, including emergency response and crisis centers.
The unanimous vote supports more patient beds, expanded psychiatric emergency response teams (PERT), community-based mental health crisis stabilization centers, more resources for schools and an increased standing contract with Palomar Health.
Board Chairwoman Dianne Jacob praised the county's Health and Human Services department, the District Attorney's Office and law enforcement for their efforts.
"When have you ever in this chamber seen our Health and Human Services, the DA and the sheriff working together on an issue that's the most prevalent issue of the day," she said. "We're marrying our Health and Human Services agency with our justice system for a bold approach. I have never seen this before."
A coordinated system will also reduce the time law enforcement officers have to spend responding to calls involving a mentally ill person, proponents said.
Luke Bergmann, director of San Diego County Behavioral Health Services, said Tuesday's action was not about filling gaps in the system.
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"We need to fundamentally reshape the health care continuum," he said, adding, "More than $10 billion is spent annually by various health care providers just to hospitalize people with mental illness in San Diego County. We need to shift from a crisis care system to a chronic care system. We need to evolve the system methodically and deliberately."
Referring to her colleagues, District Attorney Summer Stephan credited "200 stakeholders that worked very hard" to strengthen mental health care.
She added that every region of the United States is facing mental health care issues.
"Today's solutions are concrete and everyone is excited about them," Stephan said.
While there may be some pushback from communities about expanded mental health facilities, if people were better educated on how they work, they would be supportive, Stephan said. It's better to have people who are mentally treated in a humane manner, rather than them "ending up in a cold jail cell," she added.
Stephen said she has received letters "mostly ... from moms that describe the anguish they go through (with children) in severe mental health crisis.' The parents' only option is to call 911, but many officers aren't trained to handle these types of cases, she added.
"These moms were asking for what is happening today," Stephan said, adding that one in three people in the criminal justice system struggles with a mental health condition.
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Supervisor Kristen Gaspar said prevention is the key to improved mental health care.
"We should not sit around and wait until people are vulnerable and in a state of crisis," she said.
Gaspar also urged health care providers to advocate for better mental health care at the municipal level.
Supervisor Nathan Fletcher praised regional health care systems for wanting to play a role in improved care.
"We know these things are difficult, and appreciate that you're willing to find a way," he said.
During the meeting, several mental health care professional supported the board's vote.
Diane Hansen, CEO of Palomar Health, said because of the county, her profession "can do a better job of taking care of our patients."
"You are truly making a difference in the lives of others," said Hansen, who also thanked Gaspar and her colleague Jim Desmond for their help with securing more care for North County residents.
PERT Director Mark W. Marvin said that because mental illness varies depending on the person, hospitalization isn't needed for everyone and he supports alternative methods, including crisis stabilization centers. He added the centers should treat substance abuse, as well.
