From the North Bay Bohemian
By Lois Pearlman
The Russian River Empowerment Center occupies a simple, two-story house a block behind Guerneville’s Main Street. To reach it from the west corner, you have to step into the narrow roadway to avoid a puddle–inexplicable in the middle of a drought–and the neighbor’s red canoe.
The hand-painted green-and-white sign and the small reception desk by the front door signify that it isn’t a private residence anymore. Otherwise, it seems like a family home. Inside, depending upon the time of day, a couple of people might be sitting on sofas waiting for a class, somebody might be cleaning up the kitchen after lunch or perhaps a small group will be seated around the redwood table on the back deck, enjoying a quiet conversation.
In the middle of a mental healthcare landscape fraught with frustration, controversy and compromises that satisfy no one, the Empowerment Center is an oasis of serenity.
“Everyone who comes here says, ‘Oh, it’s so calm,’” agrees Jess Wolfe, one of three staff members who run the center.
Wolfe, like colleagues Mary Black and Deanne Rocchietti, is a current or former mental healthcare consumer. Wolfe is a child-abuse survivor who has healed herself through a combination of traditional and alternative therapies. Her position as program coordinator at the center, she says, suits her perfectly because she has a lot of hard-won expertise to share.
The center is open Tuesdays through Fridays, offering a full schedule of support groups, dance, writing and stress reduction workshops, potluck lunches and beach hikes. There are also little self-guided stations set up with materials and suggestions for drawing and painting, writing and deep-breathing exercises. But mostly it is a safe place to spend some time, prepare a snack or meal in the fully supplied kitchen and cut through the isolation that surrounds many people who live with mental illness.
“A lot of what we do here is about relationships,” says Wolfe, her face beaming with happiness. “I’ve been homeless. I’ve been on welfare. We can all offer each other a different perspective or a way out of the mess we’re in.”
One of the regular members, Russian River resident Leah Clark, agrees.
“It’s about changing life’s stories. We’ve had some real breakthroughs,” she says.
The operating premise at the center is that people with mental illness are more than just their condition. And the center’s goal is to help people live full, productive lives.
There are 55 regular members of the center with an average of about 12 participating each day. All of the activities are free to anybody who wants to participate, whether or not they have an official diagnosis of mental illness. There are monthly meetings and basic rules of conduct to ensure that everyone is safe.
At What Cost Health?
Of course, all of this comes at a cost, which is currently covered by a grant from the state Mental Health Services Act (MHSA), approved by voters in 2004 as Proposition 63.
The act, funded by a 1 percent tax on Californians earning more than $1 million annually, poured $3.5 million into Sonoma County mental health services during the 2006-2007 fiscal year. Statewide, the total is about $1.2 billion per year, more than originally anticipated.
That might seem like peanuts considering that Sonoma County budgeted $47 million last year for its mental health programs, but as state and federal budgets get tighter every year, it is still significant.
In its first phase, the MHSA has provided Sonoma County with money for two peer-operated wellness centers, outpatient treatment for 50 offenders with mental illness through the county’s Mental Health Court and additional services for children, teens, families, adults and seniors, homeless people and substance abusers. Under the act’s provisions, at least 50 percent of the money has to be spent on partnerships with nongovernmental agencies.
In addition to the cash infusion, which cannot be diluted by budget deficits, the act also sets out other provisions that make it unique. The framers of Proposition 63 included a requirement that all of the programs funded with the money must be new. That means that counties can’t use the money to supplement existing standard programs, potentially opening the door to new ways of doing things.
The MHSA also provides money to fund a planning process for each phase, a process that is open to the public. The first chunk of the money is designated for services; the second phase for prevention and early intervention. Smaller portions of the money are designated for innovations, capital facilities and technology, education and training.
Beginning in 2004, the county held dozens of meetings to determine how to spend the services portion of the money. Currently, it is in the middle of planning sessions for the prevention and intervention phases.
“The hard part of this is that the community is going to have to identify priority groups and priority approaches,” says Mike Kennedy of the Sonoma County Mental Health Department. “The trick is, do you want to go a mile wide and 12 inches deep, or do you want to really focus?”
It’s a tough question when there are so many gaps in the county’s mental health services. One of the big holes already identified is the lack of intervention programs for youngsters who exhibit early signs of mental illness.
If a program were already in place, it’s possible that Sebastopol teen Jeremiah Chass might still be alive. His family might have had the resources to help him before he had a March 2007 episode of mental decompensation and was shot to death by sheriff’s officers in his own driveway.
With at least two other police killings of mental health patients in less than a year, the county is experiencing a mental health crisis of its own. Families of two of the victims have filed suit in federal court. Chass’ family is suing the Sonoma County Sheriff’s Department, and both the wife and mother of the late Richard De Santis, a bipolar man killed by police in September 2007, are suing the Santa Rosa Police Department.
Point Arena resident Valerie Barber, whose mentally ill son Jesse Hamilton was killed by Santa Rosa police in January, says that he had been released too soon from a halfway house into a group home with minimal supervision and was unable to take care of himself. Hamilton had stopped taking his medication and was allegedly wielding a knife when police shot him.
“[The halfway house staff] said he had graduated,” she explains. “They told me, ‘Why are you trying to hold him back?’ They belittled me for being concerned. They told me there wasn’t any more funding [for him] for that level of care. They don’t pay for ongoing care in a halfway home if you’re not sick enough to be in a hospital.”
Nowhere to Go
Sonoma County’s mental healthcare system made headlines recently over the closures of two acute psychiatric inpatient facilities. Last June, the county shut down Santa Rosa’s Psychiatric Emergency Services, known more familiarly as the Norton Center, saying it was losing $2 million to $3 million a year because the average daily population had dropped to less than half the facility’s capacity. And this February, Santa Rosa Memorial Hospital closed its psychiatric hospital on Fulton Road, claiming $22 million in losses.
That leaves the county with no inpatient care for people facing acute mental health problems. The county provides emergency care at Norton for 23 hours or up to three weeks in a six-bed halfway house. After that, it sends patients to Marin General in Greenbrae and two Seventh-Day Adventist-run hospitals in St. Helena and Vallejo.
To fix the problem, the county has initiated roundtable discussions with representatives from local hospitals. The two alternatives being considered are a 60- to 84-bed regional hospital at the Fulton Road facility, which would be run by a private company, Psychiatric Solutions, or a 16-bed hospital at an undetermined location, which would be shared by Kaiser Permanente and the county. Norton is too costly to retrofit, says Art Ewart, Sonoma County’s director of mental health.
Sonoma County isn’t alone in facing a broken and bleeding mental healthcare system, says Rosemary Milbrath, director for the National Association on Mental Illness Sonoma County, who estimates that California has lost 700 mental health beds in the last year. And, she adds, it is a nationwide trend.
Part of the loss can be attributed to new, noncustodial ways of treating those with mental illness, but a lot of it comes down to lack of money. Ewart says that the state’s mental health budget is underfunded by 50 percent. Locally, that means one worker is generally responsible for 30 to 40 clients. Ideally, Ewart says, it should be a 10-to-1 caseload.
“The people we serve in the community are not getting sufficient treatment,” he says.
According to retired county mental health worker Marty Gerber, mental health services in California were at their peak in 1982. Since then, it’s all been downhill, with clients and overworked clinicians paying the price.
The remainder of this article can be found here, or by visiting: http://www.bohemian.com/bohemian/06.25.08/cover-healthcrisis-0826.html
