Score: -3
(0/2/3)
San Luis Obispo County Grand Jury
• 2022-2023
San Luis Obispo County Mental Health Services:
⚠️ Aviso de traducción: Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 5 findings
F1
SLO County has failed to create and maintain a safe, orderly, effective and efficient means for ensuring that persons experiencing mental health issues receive the care they need, when they need it. The average and sometimes extended time periods Held persons spend in local emergency rooms prior to placement in an appropriate treatment facility is unacceptable as demonstrated by records from multiple emergency room encounters.
Related Recommendations (1)
R1
SLO County should commit to creating a single, integrated and unified mental health services center that houses the PHF, the CSU, the MHET, outpatient coordination, juvenile mental health services, and that includes a medical health triage and screening facility where all Held persons, regardless of age, categorization or insurance status, can be medically cleared prior to placement in an appropriate section of the mental health facility.
F2
By relying on the four private hospital emergency rooms as the primary point of intake for persons experiencing mental health issues, SLO County has created a situation in which the quality and capacity of other emergency medical care within our county is at constant risk of degradation due to a variety of factors all relating to the requirement that those hospitals provide psychiatric services as primary care facilities for which they have little or no dedicated expertise or resources.
Related Recommendations (1)
R2
SLO County should relieve the four private hospitals in our County of the responsibility for warehousing Held persons.
F3
SLO County does not provide adequate resources to ensure the safety and security of both County and contractor staff who work in mental health services facilities and hospitals based on documented incidents.
Related Recommendations (1)
R3
SLO County should seek the financial resources needed to hire and retain outpatient mental health services professional staff in sufficient number to allow for reasonable and customary caseload management ratios.
F4
Despite an almost dizzying array of scheduled interagency, inter and intra-departmental meetings, teams, and working groups, SLO County fails to provide the kind of unified, integrated, and “single” voice leadership needed to ensure that espoused policy regarding the delivery of mental health services in a manner that meets the needs of our community while simultaneously respecting and appropriately protecting the professionals who strive to provide such services.
Related Recommendations (1)
R4
SLO County should seek the financial resources needed to hire and retain mental health services professional staff in sufficient number to meet the needs of Held juveniles within our county.
F5
SLO County is entirely dependent on private service providers located outside of our County to provide beds and treatment for all Held juveniles and for those adults who don’t fit the criteria for acceptance at the PHF.
Related Recommendations (1)
R5
The SLO County Sheriff’s Office, SLO County Behavioral Health Services, and the SLO County Board of Supervisors should jointly devise and implement a plan to ensure that properly trained and certified correctional officers are assigned in sufficient number to provide for the safety and security of all staff and Held persons when such persons are in the County’s care and custody no matter which facility is responsible for the patient.
Conclusions 1
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CL1Persons experiencing mental health issues in SLO County who are placed on involuntary holds are facing a challenge to be treated in a timely, safe, and effective manner when they enter the County- managed mental health care system. There is a demonstrable risk that both their mental and physical conditions may suffer due to a number of issues that are identified in the Findings section of this report. Against that backdrop, the Grand Jury found numerous examples of dedicated County employees who are committed to providing the best possible care under often exasperating circumstances caused by the County leadership’s unwillingness or inability to provide the appropriate number of professional staff and facilities required to meet the needs of those among us who experience mental health issues. To date, County leadership has failed to ensure that espoused policies and stated goals are appropriately funded and properly managed and executed. As referenced earlier in this report, the Grand Jury initially focused its investigation on the manner in which local law enforcement agencies interacted with SLO County mental health services while dealing with Held persons. That focus underwent fundamental change when we discovered what happens when a person enters the County system through a hospital emergency room. The issues proved to be extraordinarily broad and complex, leaving little time for the 2021-2022 Grand Jury Submitted July 26, 2022 16 to conduct the kind of far-reaching, comprehensive investigation this important topic deserves. The Grand Jury, was, however, able to examine and report on several critically important issues after conducting 16 interviews with key stakeholders from the executive to the line level across many of the involved agencies, both public and private, and reviewing hundreds of pages of documents and numerous county, state, federal, and private websites. But many issues remain unaddressed with respect to the manner in which SLO County provides services to those experiencing mental health issues. Therefore, the 2021-2022 SLO County Civil Grand Jury strongly recommends that as soon as it is impaneled, the 2022-2023 Grand Jury use this report as a jumping off point to continue with a new and more comprehensive investigation into this topic with a deeper examination of the issues raised herein as well as a suggested emphasis on the human and financial costs of the current County approach to the delivery of mental health services. For example, the Grand Jury may want to conduct post-exit interviews with professional staff who have voluntarily separated from County employment over the past three or four years to determine the factors that influenced their departure. The Grand Jury may also want to examine factors affecting the cycle of re-admittance for people who have been subject to more than one Hold. It also may want to interview mental health patient rights advocates and prior mental health patients.
Agency Responses 1
Government agencies' official responses to this report's findings and recommendations. Click on a response to see the structured breakdown.