SANTA BARBARA COUNTY GRAND JURY 1997-1998
HOUSING THE MENTALLY ILL
Released May 11, 1998
The Grand Jury received complaints regarding two businesses which house the mentally ill. In addition, the Jury received letters from relatives complaining that mentally ill inmates have received little or no treatment while in jail. Since the Department of Alcohol, Drug and Mental Health Services (Mental Health Department) has not been reported on for 10 years, the Grand Jury decided to see if the complaints were justified.
The Grand Jury interviewed the following:
Site visits included:
The Grand Jury had a number of talks with the Director of Mental Health Department and staff. They provided lists of housing facilities that contract with the department to aid the mentally ill. The Grand Jury received copies of the Mental Health Commission meetings documenting decisions which encourage "clients" (patients) to work and live outside of mental health shelters. This development (sometimes called "mainstreaming") is the result of closing former state mental hospitals which did little to rehabilitate the mentally ill and were very expensive to maintain. Camarillo State Hospital closed in 1997 which increased the burden on county treatment facilities. Recently, new drugs have become available which better control the symptoms of mental illness and allow many patients who stay on these medications to live a more self-sufficient life outside of institutions.
There is a countywide shortage of suitable housing for the mentally ill. "Suitable" means not only safe and clean, but a place where counselors are either available on site or welcomed for regular visits with clients.
There are a number of non-profit organizations such as Work Training, the Mental Health Association, and Phoenix House, which can support a dozen or fewer clients in group homes. These organizations run programs to help stabilize clients and get them out of group homes and into the community. In addition there are larger businesses (Telecare in
North County and Sanctuary in South County) which contract with the county to provide greater numbers of clients with similar support.
Only the Psychiatric Health Facility (PUF) is set up specifically to handle mentally ill persons in crisis. The population at PUF fluctuates from 16 (the number that Medi-Cal will pay for) to a maximum 25 patients. Because this hospital must also take clients referred from the jails by a psychiatrist from the Mental Health Department, the PUF facility is frequently overcrowded. This overcrowding necessitates sending mentally ill clients who are not jailed to other facilities, such as the Vista Del Mar psychiatric hospital in Ventura. Help for an additional 20 patients will be provided by Cottage Hospital when the new 5th floor space for the seriously mentally ill opens in May 1998. At present, Cottage Hospital can take only one or two such cases.
Last year the Mental Health Department was given responsibility for the Drug and Alcohol programs. Several key managers have voluntarily left the department or have been terminated. This reorganization and personnel change has created additional work for department employees. They indicated that morale is low and that these changes are at least partly responsible.
In mid 1998, a state-funded pilot program known as "Mental Health/Probation Program" will also be implemented. Initially, a small group of mentally ill law breakers will be assigned to the program. The Probation Department, Courts, Sheriff’s Department and Mental Health Department will be collaborating to treat and monitor chronic offenders. The objective is to stabilize mentally ill clients, stop their destructive patterns, and allow these people to live safely on their own.
The Grand Jury was astonished by the complexity of the job facing the Mental Health Department, and was favorably impressed by the way the department deals with its thousands of clients. Confidentiality laws which protect the rights of mentally ill persons often work against their best interests by obstructing freer flow of information between county agencies, family members and/or caretakers. There continues to be an overwhelming need for a short term holding facility for patients whose failure to take medication causes disruptive behavior which requires police to put them in jail. This treatment exacerbates their problems and reinforces society’s intolerance toward the mentally ill. There were few complaints about the department from mental health counselors and workers in contracted facilities. Non-profit and larger businesses that house and counsel the mentally ill were well run and competently supervised by the department.
REHABILITATION INSTITUTE OF SANTA BARBARA
6. The Director of Mental Health should find and hire competent managers in order to be relieved of some of the burdens of increased departmental responsibilities. In addition the director should:
c) Publicize the need and encourage public support for facilities to house the mentally ill and addicted members of our county. [Findings 4,5, 7 and 8]
Department of Alcohol, Drug & Mental Health Services
Findings: 3, and 8
Recommendations: 3, 4. 5, and 6
Probation Department – Recommendation: 5
Board of Supervisors – Findings: 1,2,3,4, and 5
Sheriff’s Department – Findings: 5 and 7
Recommendations: 2, and 5
We want to advise you that California Penal Code Section 933.05 require that comments to Grand Jury findings and Recommendations be made in writing to the Presiding Judge of the Superior Court and the Grand Jury Foreperson within 90 days (Governing bodies) or 60 days (Department heads).
Therefore the Grand Jury requires that you respond to each of the Findings and Recommendations that applies to your agency.
Please send your response to:
Honorable Judge Frank J. Oachoa
Presiding Judge, Santa Barbara County Superior Court
1100 Anacapa Street
Santa Barbara, CA. 93121
Grand Jury Foreperson at the same address.
Responses to the Grand Jury should be submitted on a 3 ½ inch computer disk (preferably in Word) along with the printed response.