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Mental Health Care Finally Got County’s Attention in 2019


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

For decades, San Diego’s individual health systems have largely handled the issue on their own, building facilities sized and staffed largely to meet their own needs. But 2019 truly found a new era of cooperation across organizations that often compete with each other for business.

The most visible symbol of this new “we’re in this together” spirit is a dismal county-owned property on Third Avenue in Hillcrest that used to house the county’s child protective services department. The county had planned to put the derelict property up for sale to be turned into high-priced condos. With a sweeping view of Mission Valley and across Mission Bay, there is no doubt that whatever development deal came out of the property would have been particularly sweet for county coffers.

But newly-elected supervisor Nathan Fletcher had a different idea. Noting that the property is situated within walking distance of Scripps Mercy Hospital and UC San Diego Medical Center Hillcrest, Fletcher floated the idea that the property would better serve as a mental health hub than as another high-rise rent repository.

The rest of the board quickly agreed to explore the idea and UC San Diego Health, which has to replace its existing Hillcrest mental health unit due to impinging construction plans, followed suit. In October, a favorable feasibility study in hand, Fletcher assembled a group of health care executives, including from Scripps Mercy Hospital, at the weed-choked parking lot of the property where all embraced his vision of cooperating on a facility that is to offer a broad range of services from outpatient consulting and medication management to quiet respite for those in immediate crisis.

Later that month, the county announced that it plans to quickly convert part of its existing Live Well center in Oceanside for a similar kind of development, offering a range of comprehensive services designed to keep medical professionals in regular contact with those who need help. The goal is to reduce the need for expensive inpatient beds by treating lower-level psychiatric problems more immediately and thoroughly and preventing such situations from escalating to the point where multi-day stays in locked hospital units are necessary.

It’s a major shift toward prevention that has drawn applause from many, including Cathryn Nacario, chief executive of NAMI San Diego, the local chapter of the National Alliance on Mental Illness.

“For sure, 2019 has been an absolutely transformative year, because we have seen nothing like this,” Nacario said. “I think finally the message is getting out that there is no health care without mental health care.”

She credited the county Board of Supervisors for listening to the recommendations not just of professionals but also of those who receive services in reshaping the system’s very underpinnings under the guidance of Dr. Luke Bergmann, director of county behavioral health services. Fletcher, she added, has been a true change agent not just for speaking on the issue in public, but for holding numerous planning meetings behinds the scenes where so many gathered to discuss how the system should change toward prevention.

“He has been, I think, just very passionate about this issue, and he has been very vocal in a way that has brought people together,” Nacario said.