In Northern Calif., local leaders emphasize barriers to improving mental health care

This series of articles examines the fragmented and overwhelmed mental health system in Shasta County and how its failings impact patients and public safety, and contribute to the problem of homelessness. The project was produced through a California Health Journalism Fellowship, a program of the USC Annenberg School for Communication and Journalism.

Other stories in this series include: 

Limited care available for mental health patients in rural Shasta County

Managing mental illness in rural Northern California: Two women share their stories

Untreated, severe mental illness at root of substance abuse and crime problems

Mental health care in rural northern California: Fated for failure?

REDDING, California - As part of its Fragments of Care series on mental illness, the Record Searchlight asked various North State leaders and officials what they think needs to be done to improve mental health services in the area.

In addition to their general ideas, we asked whether a facility similar to the Restoration Center in San Antonio — which most of them learned about at a September presentation in Redding from its founder — would be possible in Shasta County. (See a story about the center elsewhere in today’s Record Searchlight and on Redding.com).

While many of the leaders agreed a one-stop location with an array of mental health services would be a huge asset for the county, almost all of them questioned whether they could find the money for one. Similarly, almost all of the leaders polled said the county needs to stop the revolving-door phenomenon that often sees mentally ill people jailed instead of treated, but few of them described immediate plans to do so.

Supervisor Leonard Moty

Moty said his idea for the time being is to create a mental health collaborative among different organizations and government entities in the county, where each contributes a small amount of money so that there’s a centralized resource for extra mental health services.

“If you do that, you can get a pretty good resource,” he said. “Maybe it’s just a matter of recognizing that each person ... can’t do it alone. Bring it together under one roof. I think that providing these services, in the end, would be cheaper than putting people in jail.”

He said he’d have to do some groundwork before bringing the proposal to his fellow board members, though.

Moty said he’s not necessarily against spending money on a solution, but it has to be a well-planned one.

“I think it’s worth investing money if you’ve got a vision and a plan down the road,” he said. “If you’re just putting money out there to throw money out, I don’t think that’s a good idea.”

Supervisor Les Baugh

Fellow Shasta County Supervisor Baugh said he wasn’t familiar with the Restoration Center model, but noted that certain programs the county is already developing are meant to ease the mental health crisis.

Baugh brought up the county’s recent passage of Laura’s Law, a program that allows for court-ordered outpatient treatment for some mentally ill people, but that the county is only trying out on a trial basis for the year. He also mentioned the county’s recently approved Adult Rehabilitation Center, which aims to give certain jail inmates the services needed to stop them from reoffending when released. That center is not specifically focused on mental illness.

Whatever the solution may be, Baugh said a philosophy needs to change for the county to get there.

“I think you develop a plan and then you follow through and develop the resources,” he said. “If you automatically say, ‘I can’t think ahead because I don’t have the money identified today,’ the answer to everything is no, isn’t it? And it becomes an excuse.”

Assemblyman Brian Dahle

Dahle said he’s always had an interest in mental health policy, and he would be interested in supporting at least a pilot project for a Restoration Center-like facility or a program to treat mentally ill inmates, if someone in another district proposed it.

“It’s not just a problem in my district; it’s statewide,” Dahle said.

Speaking specifically about the Restoration Center, Dahle said it’s a good idea because it has both humanitarian and fiscal benefits.

“My goal is to make people’s lives better and cost us less in the long run, and that’s what they were talking about,” he said. “If the statistics that (Restoration Center CEO Leon Evans) talked about are for real, I don’t know why people wouldn’t get behind that, maybe a pilot project of some sort. If there’s a way to save resources and help people, I think it’s a highly likely possibility that a bill like that would get signed.”

But Dahle said he doesn’t have any immediate plans to bring a mental health-related bill forward, though he does have some general health care ones on his legislative laundry list and will look for bills he can co-author.

In the meantime, Dahle said his hope is that the city or county would create a plan that he could support.

But, he said, “If it were easy to do, it would already be done.”

Shasta County Health and Human Services Director Donnell Ewert

Ewert said the legal system needs to offer more avenues to get noncompliant addicted mentally ill people into treatment. But until that happens, he said some communities have improved their mental health systems with a sales tax dedicated to those services.

While Ewert said he doesn’t believe such a tax would pass in conservative Shasta County, he said a public safety tax — such as the one passed in Anderson last year — with a mental health component might have a chance.

“So I think that that’s a possibility,” he said. “If someone could provide new money, we’d be happy to provide new services.”

Shasta County Adult Services Branch Director Dean True

True called the Restoration Center a “Cadillac system” that’s to be commended.

“How could you not like it?” he said.

But similar to his county peers, True said the costs associated are a real hindrance.

“What does a Cadillac system like this cost?” he said.

If the cost is unrealistic for Shasta County, True, like Moty, said there needs to be more community collaboration to even get to a place where creating a similar facility would be a possibility.

“A variety of different places ... need to kind of keep coming together and talking about how we could create, even on a small scale, something that’s kind of like that,” he said.

Like Ewert, True also said state laws are too strict to get severely mentally ill people treatment when they may not want it. But he also said changes to those laws would have to be cautious to avoid unjust detainment, and that’s why many patient advocates don’t want to see them changed.

“The bottom line is, you have to be very careful about when and if you’re going to take away somebody’s freedom,” he said. “That’s the challenge of the system. ... There’s a very strong patient advocacy group. They have lots of attorneys who work for them.”

Shasta County Sheriff Tom Bosenko

Bosenko said he supports something like the Restoration Center, but isn’t sure the county could afford it.

Still, he said it’s important not to toss out the idea altogether.

“I think as a community and as community leaders, I do believe that ... concept should be examined more closely,” he said. “I was definitely intrigued by (the Restoration Center).”

As an alternate solution, he proposed a tax-sharing agreement between the county and cities, since the onus for mental health treatment and jail services falls on the cash-strapped county, yet many who use such services live within one of the cities.

Such talks among Shasta County, Redding and Anderson have come up numerous times in the past, but always failed. Still, Bosenko said it’s an idea worth resurrecting.

Shasta County PRESIDING Judge Greg Gaul

Gaul, who also oversees the behavioral health court, said the county would benefit from a mental health facility with more treatment options under one roof.

“If we had ... a one-stop place where they could go and get drug counseling, mental health counseling, get medication, detox. ... If we funneled more money into one place that could serve those needs, we’d probably save a lot more money in the long run,” he said.

Gaul acknowledged the initial investment of such a facility could be steep, but said he believes it would pay off.

“It’s going to cost a lot up front,” he said. “But in the long run, we’re going to save a lot in law enforcement services, court, mental health.”

Gaul said another strategy would be to somehow convince the public to trust mentally ill offenders so they could more easily get jobs once they’re released and rehabilitated.

“If we could find employers who would give people a chance. ... I have people who I know could do a good job, but nobody wants to hire them because they’ve got a felony conviction,” he said. “I think it just takes a whole lot of different approaches. And we’re (behavioral health court) just one little cog in the wheel.”

Redding Police Chief Robert Paoletti

Paoletti said a sobering center might be the first step in easing the revolving-door phenomenon at the jail among untreated mentally ill people, since many self-medicate with drugs and alcohol.

“That would be a huge resource for us. When we don’t have those resources ... it keeps getting worse, and then that intervention from police becomes that much more tragic. Can we, with a solution like this, intervene before it gets to the point where it’s criminal, and then that saves us jail beds, space and cost?”

Paoletti mentioned that a Restoration Center-like facility in his former city, Stockton, was a valuable tool for law enforcement and mentally ill people they encounter.

“Most of them will go (to a voluntary treatment facility), in my experience,” he said.

A sobering facility coupled with a center that offers people housing options would also be invaluable, he said.

“I think there are a lot better places to take them than a jail,” he said. “We just have to build that resource.”

[This story was originally published by Record Searchlight.]