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Area mental health services wrestle with growing demand

County, private providers adapt to meet needs
By: Andrew Westrope, Staff Writer
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MENTAL HEALTH RESOURCES

PlacerCounty adult crisis hotline: (916) 787-8860 or toll free 888-886-5401

PlacerCounty child crisis hotline: (916) 872-6549 or toll free 866-293-1940

National Alliance on Mental Illness (NAMI) of PlacerCounty: (916) 554-0554

Sierra Summit Behavioral Health IOP: (530) 845-4602

 

 

Demand for mental health care services is on the rise in and around Placer County, and providers are struggling to find new ways to meet it.

Serving an estimated 2,500 people a year and roughly the same number through its crisis hotline, Placer County Health and Human Services has recorded a growing number of people entering into the public health system, particularly through crisis services and without insurance.

Director Maureen Bauman attributed many of these cases to the economic crisis of 2009, which caused many people to lose jobs, housing or investments, and subsequently their insurance. She said the mental health crisis hotline’s most common calls are from people with suicidal thoughts or from people concerned about a friend or family member.

In addition to the hotlines, the county offers several options for healthcare: outpatient therapy, which includes medication and a variety of therapy groups; two treatment centers with peer-led support, The Welcome Center in Auburn and Cirby Clubhouse in Roseville; a 16-bed psychiatric hospital in Roseville; a crisis stabilization unit as a transitional step between a hospital and a residential facility for patients returning to the community; and more intensive services with help from Turning Point for individuals who cannot stay in a hospital. The county also does outreach with homeless shelters and other institutions to get people out of care facilities and back into the community.

Bauman said the only significant cut in the past few years has been the consolidation of the county’s outpatient programs into a single location.

“We used to have an outpatient office in Auburn,” she said. “We still have some services in Auburn. We have The Welcome Center, and we got a little more creative about the way we do services, but our outpatient therapy and medication clinic is in Roseville only.”

Not everyone is satisfied with those services.

Sharen Neal, an advocate from a support group called the National Alliance on Mental Illness (NAMI) of Placer County, accused the county of wasteful spending, outsourcing too many of its programs without overseeing their cases properly, using an assessment team instead of case workers and not communicating enough with families. She said administrators failed to answer her questions in public meetings and sometimes don’t return calls for weeks.

“When you call, how many people have six weeks to wait to get an appointment? If you need services, you need services now,” she said. “Most of our clients are ending up in the legal system because they’re not getting mental health help.”

Bauman gave no direct response to these criticisms, though she said the crisis hotline is an access point for services and offers a live response to any case or question, urgent or not. And anyone with an emergency, she said, should walk into the Placer County Psychiatric Health Facility on Cirby Hills Drive in Roseville, with or without an appointment. Bauman added that the county supplies grievance forms in the lobby for anyone with complaints or concerns.

One area care provider, Sierra Summit Behavioral Health in Grass Valley, has identified a major gap in services and started a new program in January to fill it. The clinic opened an intensive outpatient program (IOP) as an alternative to inpatient psychiatric hospitalization and traditional outpatient therapy. For many clients those offer a choice between too much care and too little, and for them, the new program offers an intermediate level of service to avoid unnecessary hospitalizations or jarring transitions.

Sierra Summit’s IOP is three days a week, three hours a day of intensive group therapy in the evening, plus weekly individual or family therapy sessions. The clinic will also host free monthly aftercare groups to check on clients’ progress.

Clinical Director Talal Alsaleem said he started organizing the program about a year and a half ago as other local outpatient providers like psychiatrists, therapists, social workers and hospitals confirmed the need for one.

 “The consensus was that there are a lot of people in the community who don’t really fit regular outpatient or hospitalization … but often end up going to Sacramento or the Roseville area to get the services there,” he said. “Intensive outpatient is for people in between – people who are in traditional outpatient therapy, but they’re just not seeing progress yet, and they don’t quite fit the need to be in the hospital.”

Alsaleem said he wants the program to be accessible to everyone 18 or older with any type of affliction, from common mood disorders to schizophrenia and psychotic disorders.

“A lot of people think intensive outpatient was designed for people in crisis. Well, yes, we do take people who are in crisis, but sometimes it’s somebody who’s not really in crisis but just tried outpatient therapy and got stuck with treatment,” he said. “You don’t have to be referred by a physician or a therapist. You can just call up and schedule an assessment, and if it’s the right program, you’ll be enrolled, and if not, we’ll connect you to the right services at no charge.”

Alsaleem also intends to organize quarterly forums for local healthcare providers to discuss the community’s needs. The first of these will be on April 16 at the clinic, followed by public forums hosted by guest speakers in the future. The clinic will also start a weekly, public bipolar support group meeting at 6 p.m. on March 27.

Well aware of the community’s lack of options for patients who could use IOP-level care, Dr. Daniel Binus of Beautiful Minds Medical in Auburn said “a tremendous amount” of mental health needs go unmet in the area. He attributed much of this problem to a shortage of mental health providers nationwide, but even more of it to a lack of prevention efforts like education on lifestyles and mental illnesses. Binus named anxiety disorders, major depression and bipolar disorder as the most prevalent mental health issues he sees in the Auburn area and felt many of his own clients would benefit from intensive outpatient therapy.

“These are people that need intensive monitoring, because they could get very quickly ill to the point of being a danger to themselves or others, or having an inability to care for themselves, and what an intensive outpatient program allows people to do is to come to a place where they can be safe, they can learn good coping skills, and they can get better much more rapidly,” he said. “It’s even a win for insurance companies, because they’re having to pay less reimbursement, so it decreases the amount of overhead that Medicare and other insurance companies are having to dole out.”

Binus has been considering starting his own IOP for the past year or so, if demand and community support warrant it. He said his program would integrate physical, emotional and spiritual health instead of compartmentalizing them the way too many treatments tend to do.

“The big question in my mind is now, ‘If this one is starting up in Grass Valley, is it going to be too much to start one in Auburn?’” he said. “I doubt it, because there is just such a huge mental health need in general.”

For those who are on the fence about seeking treatment, Bauman recommended free online education sites, such as the “Know the Signs” campaign at www.suicideispreventable.org, and a rational attitude about taking care of oneself.

“The biggest message for us is that mental health is just like physical health, and people need to take care of it,” she said. “Lots and lots of people have a mental illness, so we want people to be aware that there are resources, there is help and treatment, and it’s not something to be embarrassed about.”