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County Announces High-Intensity Drug Rehab Program for Frequent Mental Health Patients


Read the full article by Paul Sisson in the San Diego Union-Tribune here.

About 500 people with drug and alcohol dependencies who frequently check into the county’s psychiatric hospital on Rosecrans Street will be the first group to receive new care coordination services that the county hopes will eventually revolutionize mental health care throughout the region.

At a news conference Wednesday, county supervisors Greg Cox and Nathan Fletcher announced what they’re calling the “Accelerated Connections to Treatment” program, saying that it is intended to break the cycle of readmission for a relatively small group of residents who often have co-ocurring mental health needs and substance abuse disorders.

Under the new model announced Wednesday, withdrawal would begin at the hospital under American Society of Addiction Medicine guidelines. Each client would be assigned an “addiction specialist” with lived experience conquering the same drug use demon.

That specialist, though, would not be confined to the county hospital but will be empowered to stick with their clients after they’re discharged, even helping them physically make it to the next step.

“The addiction specialist will not just give them a pamphlet and an address to go to; they will drive the patients to drug medical outpatient and residential services and continue to support them afterwards,” Fletcher said.

For too long, the two supervisors said, the county’s psychiatric hospital has been detached from the world of substance abuse treatment.

Fletcher and Cox have worked with the city of San Diego to create a special fund that could help these programs transform buildings that could provide additional space for residential treatment.

Those programs, Fletcher said, will be crucial in making sure that the investments in getting Medi-Cal patients off drugs and into mental health treatment programs don’t end with successful cases ending up back on the streets due to a lack of affordable housing. Though local cities, the county, and many nonprofits are still in the throes of identifying more housing for people in such situations, and the problem is far from solved, Fletcher said that no one should forget that many people are homeless due to untreated mental illnesses.

“A lot of them have family members that are willing to take them in, they have friends that are willing to take them in, but we have to get them in a stable state of mind, and in a stable framework, and have an ongoing treatment program that is working for them,"Fletcher said.

The accelerated connections program is the first concrete example of a new philosophy taking hold at the county that seeks to shift from the current crisis model of care, which often results in involuntary hospitalization by law enforcement, to a more preventive mode. The first 500 patients identified to participate in this new mode of operation are, in some ways, serving as a test case, a proof of concept, of the larger plan to rely on care coordination countywide.