Can Mendocino County get a handle on huge unmet mental health needs?

After a first failed attempt, Mendocino County voters approved a measure in November 2017 that would add a tax to generate millions of dollars to go toward mental health programs and facilities.

It was a relief to the county sheriff who had been advocating for Measure B, the Mental Health Tax, for the past two years.

More than 83 percent of voters approved the measure, allowing the county to impose a small tax increase, about a half cent in the first five years and an eighth cent thereafter, on sales taxes.

This money will go toward mental health services for diagnosis, treatment, a mental health facility, and an oversight committee, among other things, all aimed at improving the mental health of Mendocino residents.

Mendocino County has estimated the new tax will bring in $33 million dollars. But the county’s current 5th District Supervisor, Dan Hamburg, due to retire this year, believes it’s not a silver bullet, though it will help improve the situation.

According to Data USA, which uses data from the American Community Survey conducted by the US Census, there is only one mental health clinician for every 497 people in Mendocino County. That’s compared to one mental health clinician for every 389 people in Sonoma County, and one mental health clinician for every 357 people in Humboldt County.

Mendocino County has one of the highest rates of suicide, according to the California Department of Public Health’s 2017 County Health Status Profile report. It also has one of the highest rates of drug-related deaths.

My project for the 2018 California Fellowship will focus on how rural Mendocino County is struggling to address mental health in a county that desperately needs proper treatment.

According to Sheriff Tom Allman, the Mendocino County Sheriff’s Department has become the de facto agency to deal with mentally ill persons on nights and weekends. Allman believes having more funds for mental health support would lead to better training for deputies in the field. I’d like to follow up on this, and find out whether the Sheriff’s Office is using the new funds to bolster training for deputies on how to respond to mental health needs while on duty.

The county is already beginning to set up its 11-person citizens’ oversight committee, and has hit early snags. The five citizens on the committee, representing each of the five districts, were announced in January. Most have no experience in mental health care. How effective will the committee be, and what will be its priorities? Will it emphasize diagnosis and treatment, or management of the psychiatric facility?

And who will the county take its cues from? Sonoma County, just next door, has been hailed as the fifth best county in California in overall health outcomes. What is Sonoma County doing that is making them so successful? Money is one obvious answer, but what programs are they using and how are they using public outreach tools?

Finally, the project will look at how rural counties are dealing with mental health issues among local youth. How are problems being identified in the classroom, and what kind of resources are available to students?

Catching mental health issues at an early stage is often the best way to prevent larger problems, so tracking how it’s being done in schools could be a way to measure future successes and failures. Are students getting the support they need from teachers, staff and school districts?

Finally, for a rural county which has far fewer mental health care providers, what methods and programs can address the problem?

Telemedicine is on many people’s radar as a potential solution, especially in rural counties where getting to the doctor is an arduous task. According to local registered nurse Bonnie Noble, 80 percent of telemedicine is used for behavioral issues. What are the pitfalls and potential benefits of such technology?

While my project will focus specifically on Mendocino County, I’ll be asking the larger question of how mental health can be effectively addressed by local governments. What programs have been shown to be effective through trial and error, and what will it take to bring those programs to rural areas, where even some basic necessities are unavailable to residents?

[Photo by Tom Hilton via Flickr.]