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March of the Mutt-Mitted Zombies

Re-branding Effort Underway for County Mental Health, but What About Puff Unit?


WHAT’S IN A NAME: The first, second, and third thing any get-shit-done organization absolutely must have is a catchy acronym. Otherwise, you’re DOA. Ideally, such acronyms should be no more than three letters long and spell something pronounceable that calls to mind the organization’s core mission. In this context, the cruel and chronic dysfunction that’s plagued Santa Barbara County’s Alcohol, Drug and Mental Health Services the past 30 years seems all but inevitable.

Angry Poodle

ADMHS?

That’s not a name. It’s a semi-random cluster of capital letters that induces sudden dyslexia in most readers. It defies physical articulation. Anyone who tries sounds like they’re suppressing a cough and a sneeze simultaneously. But for an organization that’s attempted to treat the mentally ill and the addicted as if they magically occupied separate planets — with no overlap — that perhaps makes perverse sense.

My sources tell me the ADMHS officials are working hard behind the scenes to “re-brand” themselves. The organization’s top dogs have spent the past two years reconfiguring their structural DNA. As they prepare for a massive reboot, they’re looking, naturally, for a new name. One candidate is Department of Behavioral Services. Department of BS? Don’t. Personally, I like MAD — Mentalhealth, Alcohol, and Drugs — but that’s dangerously Old School, and no doubt Mothers Against Drunk Driving would sue for trademark poaching.

Whatever new name is adopted, the powers that be must still confront one of the most stubbornly intractable acronyms of all time: PHF. That stands for Psychiatric Health Facility and is pronounced “Puff.” It’s where people are held involuntarily after they’ve been deemed an imminent threat to themselves or others — memorialized in the California Welfare and Institutions Code as section 5150. When first built, the Puff unit could hold 25 patients, but for a myriad of reasons, federal regulations would later restrict the unit to no more than 16. For a county of 400,000, that’s certifiable. If we merely met the statewide average of psych beds per capita, we’d have 70. For all the howling, the crowding only gets worse. In recent months, the Puff unit has been mysteriously inundated with individuals deemed “Incompetent to Stand Trial” — ISTs for short — on misdemeanor charges, but not necessarily sick enough to qualify as 5150. At times, eight of the Puff’s 16 beds are occupied by ISTs. At other times, it’s four. Whatever the number, ISTs tend to stay as much as five times longer than most 5150 patients. When the Puff is full — it always is — the IST population can’t be sent to Vista del Mar in Ventura County; Vista Del Mar won’t accept individuals facing criminal charges even if only for intentionally spilling Mountain Dew on a CVS store floor. In fact, Vista del Mar is so often full that Santa Barbara County is now negotiating with a facility in Pasadena — even further away for family members seeking to maintain contact and provide support. Despite all the talk in recent years, Cottage Hospital’s ERs remain slammed by 5150 traffic. In 2012, Cottage diagnosed 367 individuals as 5150. Last year, it was 739. As of this October, we already hit 718. The average length of time spent chilling in the ER? Twenty-three hours.

The good news is that the county appears poised to announce it will soon open a 23-hour-and-59-minute “crisis stabilization” holding facility capable of a maximum population of eight people. Nobody ever got better in 23 hours, but maybe a person could decompress sufficiently to not Puff. Likewise, the county is searching for a spot to open a desperately needed 30-day residential crisis facility — such as the one now operating in North County after successfully working out a host of embarrassing kinks. But the real estate market being what it is, several deals have reportedly crashed and burned before the dotted line could be signed. Not only is the need acute, but millions of dollars in state grant money that’s been set aside for just this purpose will disappear — evaporate — this June if that money’s not spent.

Lastly, Pennsylvania Republican Representative Tim Murphy — the only clinical psychologist in Congress — has authored a sweeping, ambitious, and, yes, controversial mental health bill in response to the many mass shooting involving the mentally ill in recent years. Among its key features, the Murphy bill would abolish the 16-bed limit on Puff units throughout the nation. For Santa Barbara, that’s enormous. Congressmember Lois Capps was asked to cosponsor the bill — as have 31 other Democrats — by area mental-health advocates, but she declined to do so. Capps is troubled by provisions deemed too coercive and insensitive to privacy considerations by some mental-health advocates. Murphy’s bill has been attacked because it relies heavily on court-mandated outpatient treatment, or else. I get it, but sometimes you just have to pick your poison. Without that coercive leverage, hundreds of thousands of mentally ill people will not voluntarily seek treatment. But they most definitely wind up behind bars instead. Capps, we are told, has hitched her wagon to an alternative mental-health bill sponsored by Democrat Ron Barber of Arizona. His bill, however, is conspicuously MIA on the 16-bed limit. Barber, it turns out, was wounded in 2011 by mentally ill gunman Jared Lee Loughner, who we have since learned was determined to go out in a 165-round-a-minute blaze of death. Luckily for Barber, Loughner only got to 30. But, unluckily, Barber is now 161 votes away from defeat in a bitterly contested recount battle with his Tea Party opponent. He probably won’t make it back next year, and neither will his mental-health bill. Capps, it turns out, just happens to sit on the same Energy and Commerce Committee as Murphy. It remains unclear to what extent — if any — they’ve ever spoken.

Lois, meet Tim. Tim, meet Lois. Do something.

The alternative, of course, is simultaneously FUBAR and SNAFU. If you aren’t familiar with these acronyms, I’d suggest looking them up. I’d tell you, but this — I’ve been informed — is a family newspaper.

Editor’s Note: This column was corrected to indicate Section 5150 is part of California’s Welfare and Institutions Code, not the Penal Code.

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