Gaps In Services to our Mental Health Community

by Placerville Newswire / Jun 28, 2017 / comments

[NAMI El Dorado]

NAMI El Dorado County is dedicated to improving the quality of life for people with mental illness and their families through support, education, and advocacy.  NAMI EDC reports the following are gaps in services that are expressed by NAMI members and volunteers as they navigate our systems of care:

1) Our Western Slope, while having a greater number and proximity of services, lacks a facilitated Community Collaborative focused on improving services and supports. This has been of great benefit in South Lake Tahoe. We advocate for a single community directory and care flow to facilitate access to services/supports. Barton Foundation has championed and facilitated the program in South Lake Tahoe. The new EDC Strategic Plan for Health Communities will hopefully address this need.

2) Protective and vigilantly watchful routing of MHSA$ to programs for the seriously mentally ill.   This article captures the essence of the importance of careful spending.   Our county does well in inviting public comment and open review of proposed spend.  Prevention and Early Intervention Funds were designed to go to early intervention and first episode psychosis but are often diverted elsewhere…the goal is to prevent people with mental illness from having it become severe and disabling.    While about 50% show symptoms of mental illness by age 14 most of these cases are not “serious” mental illness.  Serious mental illness is primarily (but not exclusively) an adult disorder.   Our county has an opportunity to demonstrate why protecting funds for the seriously ill (the original spirit of MHSA$) outweighs diverting funds to “all others.”

3) Need for public transparency of the implementation of the Stepping Up Initiative  for reducing the number of mentally ill incarcerated in our local jails. Our Board of Supervisors has signed a proclamation in support of this national initiative in 2015 and the new 2017 Director of H&HS is committed to supporting the initiative. A project timeline to show incremental improvements presented twice a year at the Mental Health Commission meetings along with data supporting these improvements would insure progress toward these important goals.  We need probation officers and jail employees trained in mental health to promptly recognize signs of decompensation and skilled in communicating well with those living with serious mental illness.  The Treatment Advocacy Center is a valuable resource.

4) We need housing options for people living with serious mental illness that they can afford on SSI or SSDI that are also tied into supports and treatments to help maintain their wellness and keep them out of hospitals and jail.   We need housing that heals similar to the needs of larger county’s.  Contra Costa county developed this white paper for their Board of Supervisor which parallel’s our county’s housing needs.

5) Need for implementation of national standard best practices drug testing for those participating in Behavioral Health Court. BHC should be available for those with and without insurance. SCRAM Continuous Alcohol Monitoring systems (ankle monotiring devices) are proving useful to many of our loved ones in helping them in their recovery from co-occurring alcohol addiction. Similarly, drug testing provides the same deterrent in conjunction with treatment.

6) Need for skilled therapists that service moderate-to-severe clients committed and able to follow their treatment plan. We need providers with specific skill in Cognitive remediation therapy (CRT), also called cognitive enhancement therapy (CET), designed to improve neurocognitive abilities such as attention, working memory, cognitive flexibility and planning, and executive functioning which leads to improved psychosocial functioning.

7) Educated therapists and social workers skilled in explaining Brain Science so they can provide the research and evidence about why medication is core to the treatment of first and early episode psychosis. We appreciate the availability of webinars available demonstrating evidence on how anti-psychotic medication helps preserve cognition. Research based information is necessary to combat the misinformation being offered on the internet and in social media. Here is one of several webinars. You can find more at PsychU.org and BBRFoundation.org.
Far too often we see members of the community resistant to take medication feeling they can “work harder” to avoid medication. For many of us medication is core to our ability to thrive even when we are doing everything else we can: healthy diet, exercise, meditation, avoiding stress, knowing our triggers, etc.

8) We need businesses that are for-profit and those that are non-profit to take a greater interest in providing employee development plans that include brain health education and skills in developing resilience. Most employers provide some employee development. We would like to see a greater focus on mental health and substance abuse training from a brain science perspective.   Take the stigma-free pledge and join Mayim Bialik in changing the conversation on mental health and stigma.

9) Greater emphasis on brain health education and skills in resilience in the schools as part of the regular Health curriculum. LTUSD for example has included a Barton doctor as a guest presenter in their freshman science class to help teens understand genetic predisposition matters and why not using alcohol and other drugs are core to healthy brain development. They emphasize appropriately that the brain is not fully developed until approximately age 25 for a woman and 28-29 for a man (and continues neuroplasticity into our older years but at a vastly reduced rate.)   Alcohol and other drugs adversely impact development and damage our brains intensely – especially during adolescent/teen and young adult years.

10) Educate the community about access to services/supports and continue championing mental health and substance abuse awareness all year long – not just in the month of May for “MH Matters” month.

11) Need to find/designate funding for a mobile outreach safety team where a social worker rides along with a CIT officer proactively helping those in the community that may be at-risk.   A family assisted support team as some other larger county’s provide would be beneficial.

12) More proactive approach to identifying AOT clients (Assisted Outpatient Treatment) and educating the community about this program. The county recently provided a press release about this program inviting referrals and we are hopeful and optimistic that AOT services and supports will evolve into a premier program with incremental improvements quarter-over-quarter.

13) Our community will benefit from the acceptance of Medicare/Medi-Cal patients.  Currently only Medi-Cal is accepted by El Dorado County Behavioral Health.  So when residents are moving here from county’s (such as neighboring Placer County) accept both they must find services & supports on their own.  There is a definite cost to the county to accept MediCare patients as well in that additional administration is required to process these claims.  Placer County for example accepts both as many county’s across CA do.  We hear from many family’s eager to have our county accept both.

14) We advocate for premier services without lengthy drives to support family support and prompt care.   Carson Tahoe’s Mallory 24-hour crisis unit and in-patient and outpatient BH services are located in Carson City.   Our community in South Lake Tahoe specifically will benefit if there is a contract between Carson-Tahoe and El Dorado County where Medi-Cal could then be accepted by Carson-Tahoe BH.  Currently Carson Tahoe only accepts Medi-Cal at their hospital (and not by their Behavioral Health unit of operation.)   This is a conversation and contract discussion needed.   Our county contracts with West Hills in Reno, NV (they accept teens and Medi-Cal via this contract.)  We are asking that a contract also be in place for Carson Tahoe so that improved integrated services locally can be provided.   This discussion is in process and we appreciate the collaboration!

We have seen significantly greater transparency in reporting by El Dorado County H&HS new leadership team. We encourage the public to embrace the monthly reports produced by H&HS and made available to the public at the monthly Mental Health Commission meeting.

If you have an idea for an improved service/support in our community, please let us know by clicking here and sending us an email to F2Fnami@gmail.com.