BAD NEWS: It was yet another Zoom meeting. On the line was the mental-health brain trust for pretty much the whole South Coast — high-ranking administrators from Cottage Health and the county’s Department of Behavioral Wellness, a smattering of frontline workers who deal intimately with those in the throes of crisis and despair, and, of course, the usual coterie of mental-health advocates. These advocates are the unsatisfied customers of a system even the most bureaucratically savvy find impossible to navigate. It was one of many such meetings regularly held to ensure that everyone experiencing a psychiatric crisis is enveloped in the comforting embrace of “wrap-around services” — in the lingo of the profession — and that all “hand-offs” are unfailingly “warm.”
The meeting — held about a month ago — started out bumpy enough. Cottage Emergency Room workers were really frustrated and upset. During the pandemic, the ER has been overwhelmed by the high number of involuntary mental-health holds called 5150s — patients deemed a potential danger to themselves or others. They wanted answers to some critical questions. Who was the Behavioral Wellness person they should contact when releasing people whose acuity had subsided just enough to no longer qualify as 5150? What about people who relied on CenCal or MediCal for their insurance — in other words, poor people? What were they supposed to do with people whose 72-hour holds had expired?
The meeting got bumpier still when Isabell Nava joined the meeting. Her 25-year-old grandson had checked himself into the Cottage ER five times in psychiatric distress back in October, she said. He was paralyzed by crippling anxiety. He was hearing voices telling him to hurt himself. He got prescribed medications. On one visit, he was sent to the county’s Crisis Stabilization Unit but then sent back to the ER for medical attention. But what he did not get was placed in a qualified facility treating people needing acute care. There’s not much room in that inn.