County supervisors move forward with mental health proposals

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SAN DIEGO — The San Diego County Board of Supervisors Tuesday directed staff to move forward with a plan that advocates say will allow the criminal justice system to better handle residents with mental health issues.

By a 4-0 vote  — Supervisor Greg Cox was absent — the board directed Chief Administrative Officer Helen Robbins-Meyer to develop a plan that:

— will include timely follow-up care and case management for those in a crisis;

— establish centers providing 24/7 walk-in mental health and substance abuse treatment, including for law enforcement drop-offs; and

— work with school districts and the county Office of Education to develop a school-based crisis response system, including possible expansion of existing psychic emergency response team.

Robbins-Meyer will work with the District Attorney’s Office and the Sheriff’s Department to develop the plan and then return in 90 days with recommendations.

Board Chairwoman Dianne Jacob said the action will allow the county to focus on the individual, not the system.

“If money was the only answer, we wouldn’t have (these proposals) before us today,” she said. “They will strengthen treatment options.”

Last October, the board held a conference on behavioral health treatment, with a focus on the overall system. Supervisor Kristin Gaspar called Tuesday’s vote a “critical first step,” and added that while the county spends $658 million on behavioral health treatment, it must also work with colleagues on both the state and federal level.

Luke Bergmann, county director of behavioral health, said the Public Consulting Group will also help the county by designing services and finding a revenue source.

District Attorney Summer Stephan said that to create plan recommendations, she and Sheriff Bill Gore focused on the deep intersection between homelessness and mental health. She also credited representatives from the National Alliance on Mental Illness, regional court system and city government for their input.

Sheriff Bill Gore said that a third of jail inmates who are released are on psychotropic medications, and many will need support. “I think we’re on the right track, approaching (treatment) in a comprehensive way,” Gore said.

Supervisors Jim Desmond and Nathan Fletcher mentioned concerns over possible residential opposition to crisis centers. Desmond said it’s incumbent upon the county and participating cities to ensure the facilities are accepted in communities. Fletcher said the county plan also must make certain that all participants share relevant data.

Before the board vote, several people spoke in favor the proposal. Gregory Knoll, CEO of the Legal Aid Society of San Diego, told the supervisors that there must be a connection between housing and mental health care.

“You cannot case manage under a bridge,” Knoll said.

Judi Holder, an administrator with RI International, commended the county’s efforts but said the best way to serve people is to bring their voice forward and incorporate their experiences.

“I speak as a person who has experienced the benefits and harms of a behavioral health public system,” she said.

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