Rising hospital costs prompt mental health review in Sacramento County
Sacramento Bee (CA)Mar 30, 2015
The rising costs have led the county to re-examine the way it provides mental health services. When county supervisors approved another budget increase for psychiatric hospitalizations last week, they also directed the Health and
The plan, expected within three months, will include services that help the mentally ill before they reach a full-blown crisis, alternatives for those in a crisis and better assessments to avoid unnecessary hospitalizations.
Preliminary estimates peg the cost of those services at around
Advocates say the changes are long overdue.
"We're throwing good money at bad policy," said
"We're creating more and more hoops for people who are in psychiatric distress. This is unconscionable," said
The increase in hospital costs is for service at three county contractors,
Patient advocates say the cost increase exposes the county's over-reliance on hospitalization and suggests more mental health care should be available that can prevent patients from suffering crises in the first place.
The current budget spike is not due to more people being hospitalized, said
Indigent patients who once received care at no charge from the hospitals now have
Still, Heller agreed that changes are needed. She said the reasons for the system's problems are complex, but the county is committed to providing "prompt access to appropriate care."
An independent expert called for less reliance on inpatient care in 2011, when she reviewed the county's mental health system as part of a class-action lawsuit against the county over proposed cuts to the system.
A majority of clients received outpatient care, according to the report. Yet, in an
By the county's own admission, the mental health system has long struggled to meet the demand for service, and the situation got worse in 2009 when the state cut
Psychiatric admissions at area hospitals increased following the cuts, and emergency rooms remain one of the few options for people in severe distress, according to county officials and medical providers. Patients can wait long periods for placement in a psychiatric hospital.
Efforts to relieve pressure on emergency rooms have led to more psychiatric hospital stays, according to a county staff report.
In a letter to supervisors last week, the
Dr.
The emergency room "is not capable of taking care of the patient," he said.
The county's improvement plan is expected to include more assessments of the mentally ill by county staff. These workers would assess patients at hospitals, the
The plan is also expected to include a proposal for two new crisis residential facilities. The county has one such facility now. By contrast,
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