Hospital’s new burden: “It’s like something out of Dickens”

The Sonoma Valley Hospital is not alone in its troubles. At the board meeting last week, the news that raised eyebrows was not about the cash flow (doing better) or the review of what the $45 million bond measure will buy (unchanged since last report), but Santa Rosa Memorial Hospital is closing its mental health center, and budget cuts have forced similar closures in Guerneville, Petaluma and Cloverdale. “Will this impact us?” asked board member Arthur Riebli.
“This is a crisis that’s already here,” said Dr. Dick Kirk, psychiatrist and chair of the Sonoma Valley Health Care District. “We need to respectfully press the county to get information as to what the situation is, and the county should hold public and private entities accountable to provide mental health service,” he said, emphasizing that the problem is not limited to a few unfortunates. “Half of the people who come into primary care have a mental health problem,” Kirk said.
“A good many cases are, I would assume, people who are despondent,” Riebli said. “They’ve given up. They may be homeless, without a job.” But Kirk said, “Actually, some might think mental illness affects people on drugs, or the homeless, but in fact, recent studies show that 50 percent of us will suffer major depressive illness at some time in the course of a lifetime.” Often the mental health aspect will underlie a presenting problem, which is physical.
“And now, the hospitals don’t know where to send their patients,” Kirk said. “Some people are saying, ‘Don’t even try to get them admitted, because it’s impossible to get them in anywhere, because there are just no beds.’ Others say, ‘No, we need to go on record trying to get them admitted–somewhere.’ But the bottom line is, the mentally ill will present an added problem for the hospital.”
Board member Mike Smith, recounting a recent episode, said, “One of those patients ended up having to have a person sit with the them the whole time [while staff tried to arrange for a transfer] and that runs up our cost. That’s going to happen more and more.” Without mental health facilities, they all seemed to agree, the burden on the hospital will be severe, and the state cuts could make the situation all the more dire. “The best analogy I can come up with,” said board member Michael Nugent, “is that it’s like something out of Dickens.”
When asked how closing Memorial Hospital’s mental health facility would affect the county, Rita Scardaci, director of the Sonoma County Department of Health, said that the mental health center is not owned by the hospital, but is leased and run by Psych Solutions, Inc., a national for-profit company. She acknowledged the challenges within the system. “One psychotic person in your emergency room can create a real problem,” she said, and the county is not leaving anyone without emergency help. “We have a facility here called Psychiatric Emergency Services, and clients can stay there for 23 hours. We’re open 24/7, 365 days a year.” The facility can admit someone who’s having their first psychotic episode, after a doctor has medically cleared them. Then the patient would go through an assessment, and if they’re in an acute state, needing hospitalization, they would be transferred to Marin General or Saint Helena, or wherever they can be admitted. She said the county is looking for a way to develop a freestanding psychiatric hospital. “In Sonoma we believe one in five lives are touched by mental health issues,” she said. ”There are a lot of concerned health and human services [organizations] in the community working toward hopeful solutions for the future.”