Today marks the first day of 2024’s Mental Health Awareness Month, a time when all who are committed to helping those living with mental health conditions can pause to reflect on the meaning of their work, and foster greater empathy and understanding for those in need of care.
There are millions of these individuals in California. Almost one quarter of adults with a mental illness are unable to receive the treatment they need — a number that has not improved over the past decade.
Hospitals are integral to the shared efforts to combat mental health disorders, with one-third of all inpatient hospitalizations and one-fifth of all emergency department visits involving patients with behavioral health disorders.
That’s why it’s critical that as stakeholders come together with a shared purpose, we align efforts and resources. Everyone is trying to solve the same problems, but without a comprehensive, meaningful, and collaborative path, the challenges will only continue to grow.
Take, for example, the recently passed Senate Bill 43, which went into effect in January (both San Diego and Imperial counties have temporary extensions for implementation) and expands the definition of “gravely disabled” for purposes of placing a person on an involuntary psychiatric hold or a conservatorship.
This means that any peace officer or county-designated professional could place a broader group of individuals on an involuntary hold and transport them to a facility, including hospitals, for assessment, evaluation, and treatment.
This is seemingly a good thing. We all want to make sure vulnerable people are safe and protected. The question is not whether this is the right thing to do, but how to do the right thing effectively and efficiently.
For hospitals, bursting at the seams with patients and facing massive financial challenges, this will mean thousands upon thousands more people with mental health needs arriving at already crowded emergency departments. Without additional resources and regulatory and financial relief to ensure the resources are there to meet patients’ needs, this new change will further strain an already depleted health care workforce.
There are signs of hope. Prop 1’s passage in March will bring billions of dollars for behavioral health housing and treatment infrastructure, as well as deliver key updates to existing law that help focus finite resources where they need to be for patients. Here in San Diego County, another 16 psychiatric care beds are expected to come online this year, but many more will be needed. In our 2022 Community Health Needs Assessment (CHNA), 70% of electronic survey respondents identified behavioral health as a top health need. As we begin our research for the 2025 CHNA, we will continue to delve deeper into the behavioral health challenges faced by our community. Hospitals continue to stand ready to do their part, and that commitment must be matched by all stakeholders if southern California is to make real progress on the shortage of mental health and substance use disorder treatment professionals, as well as the shortfall of beds for patients in need.