SLO County lacks mental health care facilities for seniors, children and the privately insured
Tribune (San Luis Obispo, CA)Oct 12, 2015
Local photography adorned the walls, with a recurring ocean theme designed to inspire calm.
"Even though it's not optimal with what we have, we want to provide a home," Atwell said on a recent afternoon.
The 16-bed inpatient Psychiatric Health Facility, or PHF, provides care for people suffering from a host of mental illnesses. The small hospital, which is licensed by the state, is run by the county's
In addition to the inpatient care at the psychiatric hospital, the county provides outpatient mental health services at five clinics around the county and through partnerships with local nonprofit groups. A county mobile crisis team responds to emergency calls, making assessments and referring people to the appropriate services.
The PHF, or "puff" as it's called, is the only psychiatric hospital for the general public in
Patients with insurance may be evaluated and, if they require hospitalization, transferred to a psychiatric facility out of the county.
"For people with private insurance -- there's no place for them currently," said
The facility
The county Psychiatric Health Facility opened in 2003 after the county's
The PHF is housed inside part of the old
The 1,800-square-foot hospital offers bedrooms, a group treatment room, common area, an inter view room for patient-doctor interactions and a fenced patio. It doesn't have a cafeteria, so the county contracts with
A locked entry door opens into a long hallway that leads to an activity room where, on a recent afternoon, a few patients sat at a table and worked on brush strokes and watercolor paintings.
"Art segues into other conversations, like how they're feeling today," rehabilitation therapist
Off that room is a common area with chairs, newspapers and reading materials. Brightly colored inspirational sayings fill the walls. Nearby, county employees work in an office area bustling with activity, including someone working the telephone looking for available psychiatric hospital beds around the state.
Another hallway is lined with doors to patient rooms -- two to a room -- each with plastic book shelves and beds, designed for safety.
Through another locked hallway door is the wing for minors.
A special state waiver allows the county to use four of its 16 beds, if available, for children ages 8 to 18.
"But the unit is teeny-tiny and not an adequate treatment space," Robin said.
She described the youth area as "nothing more than a couple of bedrooms ... in a hallway separated from adult services with no recreation space."
As such, the county can only use the area to stabilize children for "maybe a day or two," Robin said. Then they must be transferred to psychiatric hospitals better suited for children, such as Aurora Vista del Mar in
Personal experiences
Because the PHF doesn't meet the needs of seniors or kids, those patients usually have to travel hundreds of miles away for care. Some families never seek inpatient care or can't seek continued care because the distance creates insurmountable problems.
"We know in working with these children and their family members (that) it's very difficult for families to travel to have to go see them, or figure out how to keep their continued care with their primary care physician here," said
For
Her mother was diagnosed with bipolar disorder in her 40s and had been doing well with treatments until her early 80s when she began to have delusions.
"She was in a state of high anxiety and she felt like she wanted us there all the time," Parker-Kennedy said. "So I moved her from a big a city to here (where we later found out) there were no support services and a doctor shortage."
It took awhile to find a local psychiatrist, and even then, they said they weren't equipped to treat elderly patients with mental disorders, Parker-Kennedy said.
"She died very sad and depressed" in 2012 at age 85, she said. "I feel like if we could have had someone who analyzed her in a hospital setting she would have had a better chance."
Patients at PHF
In fiscal year 2013-14, the most recent statistics available, the PHF had 1,246 admissions with an average daily patient count of 14 1/2 people.
Robin estimates the county transferred between 275 and 314 patients to out-of-county mental health hospitals statewide annually from 2012 to 2014.
"We put a lot of effort into locating beds," said
"The transfers out are children, elderly who would be better served in a (gerontology) facility and adults and elderly with private insurance or
PHF patients generally come from emergency rooms, schools and neighborhoods after being assessed by a county mobile crisis team. Some also come from the courts and
A little less than half -- about 40 percent -- of people who undergo a mobile crisis evaluation remain at their home with outpatient care, Robin said.
No expansion plans
The county has no current plans to expand the 16-bed psychiatric hospital because a 1965 federal regulation doesn't allow
The rule doesn't apply to psychiatric facilities tied to a general hospital, or to patients younger than 22 or older than 64.
The county has applied for a state grant to open a four-bed outpatient crisis stabilization unit in a modular building next to the PHF, where patients could stay for up to 23 hours while they await a bed opening.
Outpatient services
The county's
It also partners with the county's social services and probation departments, as well as with local schools and colleges.
General county services include medication support through a medical evaluation and ongoing monitoring; individual, group and family therapy; case management; day treatment programs for youth; the 24/7 mobile crisis team; behavioral modification services for youth at risk of losing a home placement; and specialized services for youth involved with the
In addition, the
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--Wilshire Community Services to provide similar programs for the elderly.
WHO IS ADMITTED TO THE
The PHF admits four types of patients*:
--Those on a 72-hour involuntary hold because they are a danger to themselves or others. (Called a 5150 hold under the state Welfare and Institutions Code).
--Those on a 14-day involuntary hold because they are deemed a danger to themselves or others or are gravely disabled. (Called a 5250 hold). This follows an initial 72-hour hold and requires an informal court hearing.
--Those who have been deemed gravely disabled due to mental illness under state codes and are awaiting placement at a residential care facility, which may take months.
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* Other patients, including those on private insurance, can go to the PHF for an assessment and then may be referred elsewhere for care. Children and the elderly can be admitted but then transferred due to inadequate space for their age groups.
THE FOUR-DAY SERIES AT A GLANCE
Day 1: Proposed mental health facility poses many questions.
TODAY: A closer look at the county's Psychiatric Health Facility.
Day 3: Arguments for and against the proposed facility in
Day 4: Meet the psychiatric hospital's landowners and operator.
Stay connected with
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