City of Chico and Butte County are failing to deal with mental health issues that complicate the homeless situation

19 Jan

 I read a promising article in the News and Review a couple of weeks ago, with everybody fretting over all these police shootings across the nation, about a new local program “that addresses situations in which officers respond to those with mental problems.”

I’ve been trying to follow  this conversation for a couple of years now. At several meetings I attended, including a Police Advisory Board meeting and a local governments joint session, former Chief Kirk Trostle, lieutenants Linda Dye and Jennifer Gonzales, and other members of Chico PD described problems in dealing with the “homeless” and “street people” who are deemed “unsafe for themselves or others.”   When officers are called by a citizen or citizens who have an incapacitated person laying in the middle of the sidewalk in a puddle of their own making, or somebody who is standing in the middle of a local business screaming at the customers, Chico police officers have to make that determination – is this person at risk either of their own injury, or at risk of injuring others? These officers receive training in dealing with the indigent, including a week at Butte College for a sort of mental health cram course.

During the “normal” business day – Monday through Friday 9 to 5 – these people are transported to Enloe Hospital Emergency Room, I assume checked over by a medical doctor, and then handed over to a “support” employee from Butte County Behavioral Health, for transport to the facility on Rio Lindo Avenue here in Chico.  But, after hours and on weekends, there is no “support,” and these folks are simply handed over to the staff at Enloe ER. The police won’t arrest them, because then they’d be responsible for the bill, so these people are free to wander out on their own after the police have deposited them in the ER, leaving hospital staff to clean up. And the bill is left to the taxpayers.

Last year Butte County supervisors received over a $1 million-plus grant for county Behavioral Health. At a subsequent meeting, I watched them parcel most of that grant to two doctors, one of whom will not even set foot in the county. He will administer patients via computer.  Their salaries and benefits took up about half the grant, the rest was supposed to be used to secure those “support personnel”, at salaries of $30-35,000. The last time I talked to Supervisor Maureen Kirk about this, she forwarded an e-mail from a Behavioral Health Department staffer saying they were having trouble filling those support positions. No kidding?

 Lake County received a similar grant, but got more money because they have more poor people there. Here’s an article about how they parceled that out:

BOS approve three-year contract, eight positions for behavioral health

By J.W. Burch IV

jburch@record-bee.com @JWBurchIV on Twitter

UPDATED:   01/08/2015 09:10:14 AM PST
 

LAKEPORT >> A three-year contract for substance abuse services was unanimously approved by the Lake County Board of Supervisors at this week’s meeting.

Totaling a little less than $2 million, the contract be effective from July 1, 2014 until June 30, 2017.

The objective is to make substance abuse treatment services available to Medi-Cal beneficiaries, the contract states. State and federal funds will be used for service reimbursements, which were decreased for the county.

“It is possible that amount will change again,” Lake County Behavioral Health Director Linda Morris said.

District 3 Supervisor Jim Steele asked if funds are equally distributed to all counties in the state.

According to Morris, funds are distributed based on a county’s needs.

“So there is a chance for us to change our position,” Steele said.

In other business, the board also unanimously approved a resolution that would add a total of eight positions in the behavioral health department.

Positions include one clinical psychologist, one full-time and six part-time client support assistants.

According to Morris, a clinical psychologist is needed to provide competency and secondary conservatorship evaluations.

Additionally, the clinical psychologist would work in the mental health, as well as the alcohol and drug divisions.

The full-time client support assistant will arrange vehicle maintenance, coordinate departmental transportation schedules, as well as schedule drivers for client transportation.

Enhancement of services to existing Wellness Centers and supporting SB 82 grant services will be the role of the six part-time client support assistants.

Grant services through SB 82 involve diverting potential crisis clients away from local hospitals to centers for peer support, resource planning and referrals.

The expansion “will allow for a reduction in services being provided,” Morris stated. It will also alleviate some of the time spent by local law enforcement agencies on such services.

While the client support assistant positions were planned in the department’s budget, which is expected to range between approximately $5,886 and $7,159, the clinical psychologist position wasn’t.

“However, it will be funded by anticipated savings from other vacant positions,” Morris said.

Contact J. W. Burch, IV at 900-2022.

See that – “ six part-time client support assistants.”  Would you want your son or daughter to be one of those “client support assistants“? With a budget “between approximately $5,886 and $7,159“? Are you getting that – that’s $6 – 7,000 to pay all six assistants! To provide escort for mental patients?

The article I read in the News and Review involved handing out cards to homeless people who have a hard time verbalizing to police. Here’s the full story from California Health Report:

By Lynn Graebner, California Health Report

http://www.healthycal.org/program-aims-ease-encounters-mental-health-consumers-law-enforcement/
When law enforcement and people experiencing a mental health crisis intersect, it’s often not clear to either of them what they are dealing with or how to proceed. A new program in Butte County seeks to make those encounters safer for everyone.

 The Butte County affiliate of the National Alliance on Mental Illness (NAMI) and local law enforcement are offering cards to consumers of mental health services that can contain any information the consumer feels would be important for a first responder to have. That may include their diagnosis, emotional triggers and emergency contacts.

The back of the card carries the emblems of local law enforcement agencies that support it.

“It invites the officer to step out of an enforcement mode and into a public service mode,” said Andy Duch, a captain at the Butte County Sheriff’s Office.

 “When mentally ill people are approached by law enforcement, just like anyone else, they get incredibly anxious,” said Jason Tate, program manager for the Iversen Wellness and Recovery Center in Chico. “Anxiety and fear can lead to a more challenging time.”

And symptoms of mental illness can appear to police as drug abuse. A manic episode, for instance, can look like methamphetamine use and slurred speech can often be mistaken for drunkenness, Tate said. So a white card explaining unusual behavior may change the interaction with a police officer.

 A successful pilot project with cardboard cards was done three years ago. So in April NAMI Butte County started rolling out more substantial plastic ones. Close to 100 have been distributed, said Cathy Gurney, president of NAMI Butte County.

 Some leaders in the mental health community fear the cards will increase stigmatization of the mentally ill, painting them as incapable of speaking for themselves or even dangerous.

 Duch and Gurney anticipate it having the opposite effect. They liken the card to a medic alert bracelet.

 “It legitimizes their crisis,” Duch said.

 “And it opens up a whole new line of conversation,” Gurney said.

 No record is made of who gets a card or what’s on it. The consumer dictates the information to the person producing the card which can even be issued blank with just the law enforcement emblems on the back.

 Shannon Patterson got one for safety reasons. She has bipolar depression and has been homeless for three months. A doctor prescribed her medication that caused her to become deeply depressed. When police took her to a social service department for help she was turned away because she was homeless and staff thought she just wanted shelter, she said.

 The next day she attempted suicide. She had to be resuscitated three times, spent 10 days in the hospital and still suffers hand tremors from the overdose.

 “The system really failed me,’’ she said. So when the white card program emerged she decided to get one.

 “I felt it would be better for me to have that,” she said.

The card lists her name, diagnosis and triggers, such as confinement and loud noises. It also lists numbers for her mental health provider and emergency contacts and her medical conditions including multiple knee and back surgeries and a heart murmur.

 She’s hoping the card would legitimize her medical conditions to staff if she ever had to seek help at an emergency room.

 James Freeland, who is staying in a Chico homeless shelter with his wife after their house burned down, said he thinks the card is a great idea. He has paranoid schizophrenia and post traumatic stress disorder.  “I’ve been in prison most of my life and this card shows that there are issues on top of issues,” he said.

NAMI Butte County is gradually rolling out the program, wanting it to spread by word of mouth, Gurney said. Her organization will print cards for clients of the Iversen Wellness & Recovery Center in Chico every two weeks and cards will also be printed at the Torres Community Shelter in Chico and the Butte County Behavioral Health Department. The City of San Diego has also expressed interest, Gurney said.

 So far the cards have been well received. The Iversen Wellness and Recovery Center has had about 35 people opt to get one.

 Tate hasn’t spoken to anyone who has used a card with law enforcement yet but said his members seem to really like having them and he has not heard any negative opinions.

 But the cards aren’t for everyone. Corey Chambers is staying at the Torres Community Shelter in Chico while he pursues an internship in the solar industry. He has friends with white cards but does not intend to get one himself. He’s been homeless since May and takes Zoloft for depression. He’s afraid of being classified as mentally ill and thinks the card may add to the stigma he already suffers as a result of being homeless.

 “I’m trying to stay as functional as I can,” he said.

 Leaders in the mental health community have similar concerns.

 “The white card initiative, while well intentioned, is extremely problematic,” said Leah Harris, director of the National Coalition for Mental Health Recovery. “It borders on psychiatric profiling, and also reinforces the assumption of dangerousness,” she said.

 Yana Jacobs, senior program officer for the Foundation for Excellence in Mental Health Care, feels white cards are another way of keeping people disabled.

 “It creates a picture of someone who is so out of their mind they don’t know where they are,” she said. “Suddenly someone might go from being a PhD at Johns Hopkins to a psych patient who can’t speak for themselves.”

 She contends that people with mental illness are already afraid to call for help when they have a physical health problem for fear they will be shipped off to a psychiatric hospital, she said.

 “If [responders] see psych meds in their possession it invalidates them,” she said.

 Instead of white cards Harris would rather see more mobile crisis teams with peer support specialists and clinicians who can de-escalate situations and connect people with the appropriate care.

Efforts in that direction are underway as well, said Gurney. NAMI California, the California Highway Patrol and the Behavioral Health Directors Association held a summit in November. They are discussing the possibility of standardizing Crisis Intervention Training for law enforcement across the state to improve interactions between police and those living with mental illness.

For now Patterson feels a little safer carrying a white card to help her navigate any potential confrontations with law enforcement or county health services in the future.

The News and Review hadn’t printed the whole article, or even a link to the whole article, I had to ask for it.  That was unfortunate, and evidence that people here don’t seem to care about this problem beyond a sound-byte. Notice the criticism – Leah Harris of the National Coalition for Mental Health Recovery agrees with me, “would rather see more mobile crisis teams…”   But in Butte County, as in Lake County, the mobile crisis teams are staffed part-time and paid less than poverty level income, with no benefits.

The News and Review also printed this editorial the other day:

 Consider a day center

Chico needs a daytime safe space for homeless individuals

This article was published on 01.15.15.
The barriers homeless individuals face to get off the streets are complex and numerous, but when mental illness factors into the equation, things become infinitely more complicated.

As you’ll read about in this week’s cover piece by Assistant News Editor Howard Hardee, mental illness often prevents those in the homeless community from receiving services from Behavioral Health and other public agencies and nonprofit organizations. Those individuals often have an extremely hard time advocating for themselves. But there also are many practical reasons that the aid this population needs is out of reach.

For example, as reported in the story, homeless people have no safe place to store their belongings. Nor do they have transportation to make appointments or a way to keep track of them to begin with.

That’s where the idea of a day center comes into play. Chico is home to many wonderful organizations, such as the Jesus Center, which feeds the local destitute and offers them an opportunity to clean up, and the Torres Community Shelter, which provides a roof for those who don’t have one of their own. However, there is no place for local homeless folks to go during the day. Those who stay the night at the shelter must leave early in the morning, and the Jesus Center is not a place for people to hang out.

Ideally, a local day center would have experts in public health and housing, among others, who would help connect individuals in need with wellness information, housing referrals and job counseling. Lockers for storage, voicemail and message services, and transportation to medical appointments would also greatly benefit this vulnerable population.

The day-center model has been successful in many cities and it’s long past time that Chico’s leaders consider it as an option here, especially since the local homeless population is on the rise. Such a center is a vital part of the long-term efforts needed to help this portion of our community.

I have to ask the editor – would she staff such a center? Would she take a budget of $5 – 7,000 to run it? People are so quick to expect others to make do.

The system in Chico has broken down. We have all these ideas, but nobody wants to do the actual work of dealing with the mentally ill. The money seems to be there, but our “leaders” don’t seem to have any sense in spending it. 

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