Guest Column

Policy Clears Way For Mental Health Treatment Options

Soon, Orange County people experiencing a mental health crisis may have new options for immediate, expert help. That’s thanks to a recent clarification of state policy that clears the way for important initiatives designed to improve crisis mental health services in Orange County and save taxpayer dollars in the process.

The clarification appears to be prompted by former Orange County supervisor and now state Senator John Moorlach’s Bill 1273. The bill confirmed that counties may use Mental Health Services Act (MHSA) funding to provide crisis stabilization services to clients on an involuntary basis. Orange County officials had previously held that the funds were, by statute, for voluntary services only. This clarification, then, clears the way for Orange County to use MHSA funding to develop and establish mental health urgent care centers and to use those centers to treat people compelled to receive services when they are unable or unwilling to seek those services on their own. Importantly, this would include people placed on a “5150” psychiatric hold by law enforcement or other authorized professionals.

This is good news for all of us. Here in Laguna Beach, the closest option for helping a person in a mental health crisis is a hospital emergency room. That’s not ideal for anyone. Emergency rooms are, by their nature, primarily set up to handle a physical health crisis. And, they must triage and treat first the most life-threatening cases. This sometimes means that a person placed on a psychiatric hold – as well as the police officer that authorized the hold – must wait hours before the patient receives stabilization care. That’s no one’s fault; emergency rooms are right to prioritize. But it’s not an effective intervention for the patient and it’s not an efficient use of the ER or law enforcement efforts.

Instead, Orange County is exploring a network of mental health urgent care centers specifically set up to deal with the particular needs and challenges of patients having mental health emergencies. These centers promise to improve care while reserving ER beds for medical emergencies.

This kind of flexibility in the use of public funds to accomplish the funding’s intent in a more effective and efficient manner is encouraging. Senator Moorlach’s insight and understanding of this issue is informed, I’d venture to guess, by his time as an Orange County supervisor and as chair of the Orange County Commission to End Homelessness. One doesn’t have to spend much time working within our homeless services system to understand how interdependent it is with our mental health system. Whenever and wherever we can improve our ability to be creative, thoughtful and responsive to acknowledged best-practices with funding to meet the needs of our most vulnerable, we’re better off.

There are other important changes in the use of MHSA funds that would create similar efficiencies and improvements. Currently, none of Orange County’s MHSA-funded permanent supportive housing units are participating in the county’s new coordinated entry system, which assesses homeless individuals and then places them in supportive housing based on their vulnerability – with the most vulnerable individuals placed first. Opening up the county’s MHSA units to the coordinated entry system – and prioritizing the use of those units for our county’s most vulnerable, would have a similar impact that the urgent care centers are expected to have. By taking the most vulnerable homeless people off the street, we will decrease the use of other systems – police, fire, ambulance, emergency rooms, etc. – to care for them.

Friendship Shelter has experience with both coordinated entry and MHSA housing. When coordinated entry was initiated last August, Friendship Shelter staff were among the first to administer assessments and help individuals receive housing. That effort housed 44 individuals from the Laguna Beach ASL emergency shelter in just six months. And, Friendship Shelter is proud to have recently opened 14 units of MHSA housing in San Clemente for transitional aged youth, ages 18-25, who face homelessness and mental health challenges.

Our experience shows us that both coordinated entry and permanent supportive housing work. We look forward to a time when vacancies in our own MHSA units – and the other MHSA-funded units across Orange County – can be filled through the system designed to ensure that the neediest are housed first. Like the welcome clarification prompted by Senator Moorlach’s bill, those changes would promote effective and efficient use of these much-needed public funds.

Dawn Price has been executive director of Friendship Shelter for eight years. Friendship Shelter operates homeless shelter programs in Laguna Beach and housing services in south county.