Mental health emergencies don't belong in the ER

When I meet political candidates, I always ask them about their campaign issues. The usual answers are “good government” or “wanting to give back.” When I press for actual issues, many candidates give me a blank look.

Not Patrick Kennedy. Early last year, when I talked to him about his candidacy for the Sacramento County Board of Supervisors, he had plans to tackle numerous issues. And he was particularly passionate about improving mental-health services in the county.

He was also very knowledgeable about these issues. And this was before he won his seat. Since June, he has spent considerable time working with hospital groups, the county health department and the fire department to improve mental-health services.

Mental-health problems are not simple and cases vary widely. What we need is a continuum of care, with a variety of approaches. This is critical both for improving mental-health services and also for controlling costs.

Health-care experts agree that we need alternatives to hospital emergency rooms for treating people suffering from mental-health problems. Hospital Council of Northern and Central California Regional Vice President Brian Jensen told me that Sacramento’s four hospital groups estimated that 1,700 patients a month could be diverted from emergency rooms if there were alternative medical facilities specializing in this type of care.

Earlier this year, with support from the other county supervisors, Kennedy convened a meeting of the county staff and other health stakeholders, primarily the four hospital groups, to discuss options.

Over a recent breakfast at Old Soul at 40 Acres in Oak Park, Kennedy told me how the county staff and the hospitals were initially distrustful of each other. But now they meet weekly to work out the details of creating drop-in locations, providing more beds and offering more supportive services.

Kennedy is full of praise for the county staff, particularly Sherri Heller, director of Sacramento County’s Department of Health and Human Services. And he praises all four hospital systems, which have been coordinating with each other as well as the county to create an effective plan.

This plan will not only keep people out of the emergency room, but will also help to prevent mental-health breakdowns and emergencies. This plan is only possible because of the Affordable Care Act. Previously, many people went to the emergency room because their mental condition had gone untreated. Their only option was the emergency room, which by law has to accept everyone.

Now, thanks to the Affordable Care Act, many of these people now have health-care insurance for the first time. They can get treatment. And the emergency room will no longer be their only option.

Having the county staff and health-care organizations cooperating, combined with new resources becoming available through the ACA, will hopefully only be one of many positive changes enabled by the ACA. It’s exciting to see that the vision that Kennedy articulated to me, early in 2014, before his successful campaign for the board of supervisors, is now starting to come to fruition.