(2520) Mental Health

San Benito County Behavioral Health (SBCBH) Mental Health Division (MH) delivers specialty mental health treatment services and programs that are accessible to the County’s population.

Services are available primarily in English and Spanish, and are delivered at our outpatient clinic, in the schools, and at Esperanza, our drop-in center.

Services are also delivered in the community and at individual’s homes to support them to achieve positive outcomes.

Typical services available are:

• Clinical Assessment,

• Outpatient Counseling Services

• Individual, Family, and Group Counseling,

• Medication Services, including telepsychiatry,

• Case Management,

• Crisis Intervention and Stabilization,

• Inpatient Psychiatric Hospitalization (delivered at regional hospitals),

• Behavioral Health services also deliver services to clients referred from other County departments, including onsite at the Adult and Juvenile Detention Facilities,

• Mental Health Treatment evaluations – referrals from the Superior Court for evaluation for outpatient or treatment facility commitment,

• Mental Health Diversion and Re-Entry Court for criminal offenders and other Justice Involved individuals affected by mental illness,

• Domestic violence victims counseling program,

• Client behavioral health treatment services for clients referred by Health and Human Services Agency – Child Protective Services,

• A variety of treatment, prevention and early intervention and housing projects with services funded by Mental Health Service Act (MHSA)

• The Pandemic has brought about the necessity for the most challenging system level operations and service delivery changes we have experienced due to the many restrictions and precautions caused by the COVID-19 Pandemic. It is significant to note that throughout the Pandemic duration SBCBH MH treatment and prevention services have continued with no cessation of service delivery, nor clinic office closure. It is commendable and deserves recognition of the staff as essential workers who have provided our community the safety net of mental health treatment and prevention services. Staff and clients have had to navigate through flex scheduling of clients to minimize in person in the clinic service delivery and adjust to many of the services provided through virtual platforms. MH treatment services for individual and even family and group sessions have been provided through and tele-video and telephone conferencing. Clients and staff have adjusted through these alternative means of communicating remarkably well as indicated by measuring units of services delivered. The transition was at first difficult as indicated by the beginning 2 months of the Pandemic and experiencing a corresponding reduction of services delivered to 40% of normal, but then progressing to units of services delivered at pre-Pandemic levels and greater. It should also be noted that our staff continued to respond in-person throughout the Pandemic to our local hospitals Emergency Room for the evaluations and interventions and stabilizations of individuals in acute psychiatric crisis.

• SBCBH MH has designed a new Crisis Response Team. We have negotiated utilizing a Hollister Police Department (HPD) Officer in tandem with one of our MH Case Managers. This is a Mental Health Services Act Prevention service in its pilot program phase. There is heightened state and national level concern expressed that in the field response to individuals experiencing a mental health acute crisis should receive a non-law enforcement level of first response. It is anticipated that through our HPD and MH team response that some of the concerns regarding a systemic level first response to individuals with mental illness through law enforcement can be mitigated. It is also expected that the implementation of the MH-HPD Crisis Response Team will have a significant impact on reducing the need for HPD to implement involuntary detention holds, commonly referred to as 5150 involuntary detentions.

• It is a continuing concern that SBCBH MH must deliver culturally competent and linguistically appropriate services. The threshold language for our county is Spanish and so we must become more capable of having our monolingual and preferred first language Spanish speaking clients have access to an adequate number of MH service providers who have bilingual/bicultural proficiency in English and Spanish. We currently have available one psychiatrist, M.D. who is fluent in Spanish and another who has a remedial level of proficiency. We have numerous non-professionals and paraprofessional Spanish speakers, but it is still difficult for us to recruit and retain fluent Spanish speaking Mental Health Clinician staff. Utilizing a trained intermediary for translation is a technique we utilize when we cannot provide a direct service provider that is fluent in a clients preferred language.

• On an almost daily basis the State Department of Health Care Services has been issuing their state to counties Behavioral Health Information Notices. The Information Notices (IN’s) convey new requirements and regulations as related to the operations and services delivery for both our SA and Mental Health Divisions. It is an ongoing challenge to keep the pipeline open for acquiring the skilled and degreed professional and credentialed staffs that are equipped with the abilities to help us remain in compliance with the requirements. We must also keep an ongoing flow of other levels of direct service delivery staff who we train to meet the changing and challenging MediCal reimbursement claiming and audit requirements. Small counties, such as San Benito are the staff development and training systems that have the most difficulty with retention of staff after they have achieved their professional licenses and other credentials that allow them to then move to more attractive career opportunities in larger counties and higher paying private network provider entities.

• Population growth in the County continues to rise and pose current and future impact to County Behavioral Health Services (Mental Health and Substance Abuse Treatment Services). The recovery from the pandemic caused economic downturn, relocations of a more remote telecommuting workforce and even local business and industry expansions point to continued population growth in San Benito County. Population growth and emerging trends in society portend for more demands for the availability of Behavioral Health Services. County Behavioral Health Services are funded to provide a safety net behavioral health care system for individuals with serious mental illness and children and youth with serious emotional disturbances. We are, however, seeing trending to a broader defining of public perception of the conditions that meet the criteria as requiring public funded mental health services. SBCBH needs to be prepared to fund more services that previously were defined as mild to moderate conditions that were not expected to be supported through government funding dedicated for public safety net treatment for acute and serious mental disorders provided for indigent populations.