Stanislaus County leaders approve more services for emotionally disturbed children

Stanislaus County’s Mental Health Services Act plan will add services and supports to reduce hospitalizations for children and adolescents who struggle with severe emotional disorders.

The Board of Supervisors approved the amendments Tuesday evening. A crisis intervention program will attempt to provide alternatives to hospitalization for children and teens in crisis, who often are held for days in hospital emergency departments because of a statewide shortage of psychiatric beds.

When a bed is available, the young patients are taken by ambulance to facilities in the Bay Area, Sacramento, Bakersfield or farther away. The added stress and separation from family can worsen the mental health crisis, a county report said.

Madelyn Schlaepfer, director of Behavioral Health and Recovery Services, said the county hopes to lease space for a crisis unit near Doctors Medical Center in Modesto, where an intervention team could work with patients and their families in a quiet setting.

“We want to bring the patient and family to the center and spend some time to figure out a plan that does not include hospitalization,” Schlaepfer said.

Up to four clients, age 6 to 17, will be served in the crisis intervention unit at a time. The pilot program serving 80 to 100 minors will cost about $630,000 the first year. Besides lessening the pain for patients and their families, the county hopes to see a cost savings from fewer hospitalizations.

A crisis intervention program for adults with mental illness has been effective in reducing hospitalizations, and BHRS officials are confident the same will happen with young people.

Although the county will give priority to clients eligible for Medi-Cal, it will make the program available to minors regardless of insurance coverage, based on need and capacity, Schlaepfer said. Funding from the state’s Proposition 63 millionaire’s tax can be spent on mental health treatment for the underserved whose insurance does not include those benefits.

Supervisor Bill O’Brien said a program limited to those with Medi-Cal benefits would not make sense. The county will expand a contract with Aspiranet, which runs an episodic crisis service, to make crisis intervention available at all times.

The county was responsible for costs of 160 hospitalizations for suicidal teens and children in psychiatric emergencies last year, a sharp increase from 114 the previous year. More than 200 hospitalizations are projected before the end of the current budget year on June 30.

Another addition to the county’s plan will provide intensive mental health services for children and adolescents who have been hospitalized, so they don’t continue to need inpatient care. What’s known as a full-service partnership will combine outreach, case management, counseling, assessments and psychiatric services for up to 24 minors the first year.

The services are expected to cost $811,740 over 12 months. The number of clients served could double in a year.

The services aim to build resilience in young clients, so they learn to deal with stress and life’s challenges as they near adulthood, Schlaepfer said. Program staff will respond to difficult situations at home or meet families in crisis at the emergency room to see if a hospital stay can be averted.

According to statewide data, fewer minors with psychiatric conditions are hospitalized if they and their families receive help managing the illness. As an example, Los Angeles County reported almost a 40 percent reduction in hospitalizations among the 7,000 children in its program.

By coordinating mental health services for young people in the juvenile justice system, Stanislaus County has seen a reduction in homelessness, incarceration and hospital stays among that population, a staff report said.

Supervisors are expecting a review on the first-year results of the full-service partnership program.

Tuesday’s unanimous board action also approved expanded supportive employment services for mental health clients.

This story was originally published December 16, 2015 at 2:48 AM with the headline "Stanislaus County leaders approve more services for emotionally disturbed children."