Officials work to create integrated health model, new housing and services
NORTH BAY – Faced with budgets “cleaned to the bone,” North Bay county mental health care directors said this year will mark a distinctive transformation of the system.
Sonoma, Napa and Marin officials are moving forward with new strategies for doing more with less and said intensified collaboration with community partners and integration with physical health is central to the change.
“With the recent round of budget cuts and dramatic anticipated loss of sales tax, Mental Health Services Act and vehicle tax revenue, those are three big hits. At this point it feels like there is nothing left to adjust,” said Jaye Vanderhurst, mental health director for the Napa County Health and Human Services Agency.
“We are really facing dramatic programmatic changes and in a lot of ways we are back to the beginning; we will have do adjust completely how we do business.”
Napa was recently host to a forum of the California Mental Health Directors Association that focused on adaptive new strategies for adjusting to economic turbulence. The two-day event included directors from across the state and a presentation by the president and chief executive officer of the California Institute for Mental Health. Central to strategies for transforming the system is better focus on preventative care as a method for reducing expensive hospitalization.
With expansion of pre-emptive care in mind, local mental health departments are in various stages of implementing integrative health programs meant to coordinate physical and mental care and catch issues early. These programs are organized in different models, including mental health staff stationed in local health centers and primary care doctors making visits to county mental health care facilities.
“We have been looking for opportunities to redesign the system, and now is definitely a time of transformation,” said Sonoma County Mental Health Director Mike Kennedy.
To absorb the immediate budget cuts, all three counties have left unfilled positions vacant or made small staff reductions. Others have collapsed programs and reduced the number of individual visits or transferred to a completely group-visit format. At the same time, new programs and services will come online this year through increased work with community partners.
Napa is in the beginning stages of forming an integrative physical and mental health program with federally qualified health center Clinic Ole. Last year, the county’s medical director participated in a psychiatric medication forum at the clinic meant to help doctors become more comfortable with prescribing. Soon the department would like to co-locate county staff with clinic providers.
In Sonoma, the county already funds mental health professional hours within the Southwest Community Health Center system and officials are piloting a drop-in psychotherapy program in Petaluma.
“Demand for our mental health services has continually increased, and we are working to offer more services, but right now our waitlist continues to grow,” said Southwest Director of Mental Health Services David Anglada-Figueroa.
Also, the county is collaborating with partners to offer new services to children and families, trainings for law enforcement, a wellness and empowerment center and new mental health housing. Mr. Kennedy also reorganized outpatient teams to better fit the recovery model of care, including staff for dual-diagnosis patients, the homeless and transitional-age youth.