WEATHER »

From Dog to Worse

Making Sense of Health-Care Stats


SOUND OF ONE HAND SLAPPING: I wouldn’t know Michael Orozco if he bit me on the ass. But maybe that’s what he’ll need to do to get the help he needs. Michael, according to his mother, is addicted to methamphetamine; he’s also diagnosed as a schizophrenic. For the past nine years, she’s been chasing after Michael’s comet trail, trying to limit the damage. In that time, he’s been arrested more than 20 times, committed six times to various locked-down psychiatric hospitals, and dispatched to countless sober-living warehouses. He spent six months in state prison, reportedly enticed by the prospect of ice cream and pancakes.

Angry Poodle

None of this comes cheap. Michael, in the lingo of social service providers, is the Frequent Flyer and the Million-Dollar Manny all wrapped into one. Catch and release might work when it comes to fishing, but it’s done little for Michael, his mom, or the taxpayers. And he’s only gotten worse. In the past year, cops were called to the Smart & Final parking lot where Michael was waving his knife at the voices in his head. Neither the cops nor his knife did much good. Having no place to put Michael, they let him go. He later punched his brother in the jaw. Hard. He threatened his mom when she was talking with his psychiatric caseworkers. More recently, he was arrested for lewd conduct; charges were not pursued.

It’s a boring story. Unless it’s your son.

A few weeks ago, it appeared Michael finally caught the break his mom had been praying for. A Santa Barbara judge ruled Michael was a 5250 ​— ​that’s 5150 on steroids ​— ​which meant he’d be held in a psychiatric hospital for two weeks, not the customary 72 hours. And the higher-ups at Behavioral Wellness indicated that they, at very long last, would initiate conservatorship proceedings needed to put Michael in a long-term psychiatric facility known as an Institution for Mental Disease. In the acronym-obsessed world of mental-health professions, that translates to IMD, of which, in S.B., there are absolutely none. This, by the way, is precisely and exactly what his mother had been begging for. As such, this hardly constituted a happy ending. But as new beginnings go, it seemed pretty good.

Until, mysteriously, it wasn’t.

Michael’s mom was shocked to discover her son had been mysteriously released from the county’s Psychiatric Health Facility, despite a judge’s order. Yet again, he’d been transferred to a sober-living facility in Boyle Heights near Los Angeles’ Skid Row. It would be the fourth time he’d been dumped there. Every other time, he walked. Within 24 hours. This time, Michael managed to last longer. By only a few days. This time, he was asked to leave. At the time, he was talking with angels and got in an argument with sober-house managers. His mother would discover he hadn’t been getting all his medications. In the best of cases, a sober-living home was not equipped to fix what ailed Michael. This was far from the best of cases. As of this week’s deadline, Michael was still on the loose. A warrant for his arrest has reportedly been issued.

This, too, has become a boring, predictable story. Unless, of course, it’s your son.

I was thinking about Michael a couple of weeks ago as the county supervisors got a progress report from county mental-health czar Alice Gleghorn on the desperately needed changes she was hired to make. Gleghorn was presenting what’s known in government speak as “dashboard metrics,” designed to show ​— ​at a quick glance ​— ​what progress has been made. The dashboard in my car is pretty simple: gas, oil, odometer. If Gleghorn’s metrics were on my dashboard, I’d drive off the road. Anyone would. Her metrics—even simplified—were visually complex and intricately nuanced. Without detailed explanation they defied comprehension.

Boiled down, the good news is that the 80 percent of the people occupying the county’s new short-term crisis care beds did not get committed to the county’s psych hospital within 30 days. The bad news is that it takes 34 days on average before kids with serious problems can be seen by a county psychiatrist; for adults, it’s 24. The bad news is only 11 percent of seriously acute-care patients in Santa Barbara reported improvements after treatment; 66 percent reported that there was no change at all or things got worse. For the first half of the year, the rate of involuntary hospitalizations threatens to set yet another record, nearly twice what it was five years ago. In addition, the number of county shrinks dropped by almost 20 percent while the number of staff assigned to highly inflamed cases dropped from 145 to 120.

While none of that info belongs anywhere near my own dashboard, it’s all useful information. What was glaringly missing were a couple of metrics that would have really told the story. There was nothing, for example, indicating how many people with mental illnesses are now in county jail—like Michael will soon be. Likewise, there was no info indicating how many visits to area emergency rooms were made by people experiencing some form of psychiatric crises. These are fundamental metrics; they require little explanation. They are the gas and oil gage equivalents for mental-health reform. The usual activists from the usual organizations stood up and made that same point. It was the third time they’d done so this year.

In the meantime, I wondered how Michael Orozco fit into these dashboard metrics. Mostly, not at all. Until he gets help the help he needs, he’ll remain a bug splattered by the oncoming windshield of the county mental-health department. Maybe one day I’ll meet Michael. When that happens, I hope he doesn’t bite.



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