Contemplating crises

Listening to a presentation about mental health services in Butte County, Jim Burfeind found he had something to say.

The talk—put on by the county’s Department of Behavioral Health, drawing 14 to the Chico branch of the Butte County Library last Thursday (April 26)—had just shifted from background information to “notable changes” made by the county affecting its plan for programs under the state Mental Health Services Act. That legislation, stemming from Proposition 64 in 2004, constitutes roughly a third of the department’s $60 million budget.

The change that moved Burfeind, and others, to speak was the mobile crisis unit. A Behavioral Health counselor responds with Chico police officers to calls in which a person with mental illness is suspected to be involved. (See “Mobile crisis team introduced,” Downstroke, March 29.) Between the two counselors, whose salaries are grant-funded, at least one is available every day.

Day being the operative word: The mobile crisis unit shifts go 8 a.m. to 6:30 p.m.

MHSA Administrative Analyst Celeste Cramer explained that data tracking of calls to the department and hospital-based clinicians influenced the hours, and that nighttime incidents often require law-enforcement intervention due to drugs and alcohol.

Burfeind noted that, because Behavioral Health’s business hours fall during the day, the agency would receive more calls during the day. The data, thus, is “self-fulfilling … probably skewed.” A retired teacher who belongs to the support and advocacy group NAMI Butte County—a local chapter of the National Alliance on Mental Illness—he added that he speaks with a lot of families who experience difficulties at all times.

“This really needs to be 24 hours,” he said of the mobile crisis unit. If that’s not possible due to funding limitations, “it’s almost better to start at 6:30 [p.m.] and end at 8 in the morning.”

Others concurred, including NAMI board member Colleen Phipps—known for championing Laura’s Law, which lays out a program for treating mentally ill individuals posing a threat to themselves or others. (See “Help in crisis,” Newslines, March 1.)

“The mobile crisis team, they don’t even have to do it during the day, in my opinion,” she told the CN&R afterward. “[They’d] get better response, because they’d help more people that way…. Over the years, 90 percent of the people [in crisis] I’ve encountered, it’s been after 6 at night.”

After the meeting, Burfeind stressed to the CN&R that he appreciates the program. He just sees room for improvement.

“I think it actually would save the county and the city money to have more behavioral intervention with the police at those [night] hours,” he said, “and reduce the amount of incarceration and bigger problems.”

The NAMI attendees expressed optimism that the input may prompt a change. After all, the mobile crisis unit owes its existence to feedback from sessions such as this.

State law requires counties to craft three-year plans for MHSA-funded programs, then issue annual updates. Butte County’s current plan runs 2017-20. The process includes public comment, which Behavioral Health gathers from surveys and direct feedback.

Holli Drobny, the department’s community service program manager, organized 12 gatherings in a 29-day span, capped by last Thursday’s meeting in Chico. She conducted six at county library branches, six at service sites such as the Stonewall Alliance Center and Iverson Wellness & Recovery Center. Total attendance surpassed 100.

“The idea behind going out into the community is that community collaboration is a big part of the Mental Health Services Act,” Drobny told the CN&R. Across the meetings, “the main consensus I’m finding is that people are really shocked when they’re finding out all the different programs that are funded through MHSA and Behavioral Health. We do a lot of work on these plans, planning out these programs, so to be able to inform the public is really awesome, really gratifying.”

Nearly two-dozen programs across a dozen facilities fall under the MHSA umbrella. They include the Crisis Stabilization Unit and Iris House, the neighboring crisis residential facility; “wraparound” support services for youths and adults; housing assistance; and vocational training.

Along with the mobile crisis unit, Behavioral Health this year launched Strengthening Families, a 14-week course (starting in the spring and the fall) to bolster parent-child bonds.

Drobny, whose responsibilities include serving as the county MHSA coordinator, explained during the meeting that the county will receive nearly $11.8 million in MHSA money this fiscal year. Add in funding brought in as a result of these programs, most notably Medi-Cal health insurance payments, and the sum reaches $20 million.

Drobny and Cramer, the MHSA analyst, had another colleague at the meeting: Assistant Director Joel Chain. No question, Behavioral Health heard the feedback about the mobile crisis unit. The department will collate all public responses for the next iteration of the plan update, which Drobny said should be available for public review by early June.

“It will definitely be something that’s reviewed by the leadership team,” Droby said after the meeting. “I can’t say what decisions will be made because of it, but hearing the community voice advocate for it will be an important part.”

The suggestion came up previously, she said.

“Unfortunately, it does come down to resources.”

Behavioral Health will expand its mobile crisis footprint, however. Drobny told the assemblage that the county received a grant for a second pilot program, in which counselors and part-time peer advocates will accompany sheriff’s deputies in Oroville and Paradise. That will launch sometime this fall, pending hiring and other logistics.