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Supervisors Fletcher & Cox Announce County Adds Substance Abuse Treatment to Psychiatric Hospital


Substance abuse treatment is now being made available at the San Diego County Psychiatric Hospital, a move that bucks standard industry practices by co-locating mental health and substance abuse treatment.  

Supervisor Nathan Fletcher, joined Chairman Greg Cox, Councilmember Jen Campbell and County Behavioral Health Services Director Dr. Luke Bergman during a press conference Wednesday to announce details of the new Accelerated Connections to Treatment (ACTT) program. Other participants included the CEO of the National Alliance on Mental Health Cathryn Nacario, and representatives from the Office of City Councilmember Chris Ward and the Midway neighborhood.    

“We are taking bold action and changing how we operate to ensure better outcomes for the patients who visit our psychiatric hospital. By taking the unprecedented step of co-locating mental health and substance abuse treatment we are better equipped to provide vital services to a hard to reach group of people, many of whom are experiencing chronic homelessness,” said Supervisor Fletcher. “This is a better way to connect people to the treatment they need.”  

By expanding the network of resources available to people experiencing homelessness and in need of behavioral health services, with the Accelerated Connections to Treatment program the County is taking active measures to combat the root causes of our region’s homelessness crisis.

“Difficult problems require creative solutions, and this is a program that offers a new way of helping this population of homeless individuals,” said Chairman Cox. “This is a great start and we will continue to find ways to enhance the system of care for those suffering with Substance Use Disorders.”

About 500 individuals each month are frequently brought to the County Hospital on Rosecrans Street without being admitted. Many of these individuals’ symptoms are mistaken by law enforcement or other entities as psychotic, when in fact certain drugs (including methamphetamine) have side effects that mimic psychosis. Due to the fact that they do not have a serious mental illness, but instead are struggling with a substance use disorder and are intoxicated they are given a referral for a local facility, often without any follow-up.  

The Accelerated Connections to Treatment program will use a hands-on approach by linking patients directly to the providers and treatments they need using a four step process, which is expected to cut down on the recidivism we see on our streets, and to improve public health outcomes by helping individuals gain a wider support system in their battle against addiction and substance abuse.

"With the County stepping up to invest in programs such as ACTT, it not only has positive impacts in the Midway District but also with those seeking help in all our communities,” said Councilmember Campbell. 

To implement the  Accelerated Connections to Treatment program, the National Alliance on Mental Illness is partnering with the County, and work will with patients who volunteer to participate. 

“This new model of providing services will advance care integration across other emergency and crisis care systems in our community,” said Cathryn Nacario, CEO of NAMI San Diego. “This linking of services is critical, because too often we see a fragmented health delivery system that prevents doctors and care-givers from providing treatment efficiently and patients from receiving the most appropriate care throughout their experience.”

The four- step substance abuse disorder treatment process is as follows:  

  1. An addiction specialist, ideally someone with lived experience,  will engage patients with primary or secondary substance use disorder and encourage them to participate in the program. They will build a relationship, earn their trust and become their support system throughout the process. 
  2. A team of medical professionals, alcohol and other drug treatment counselors and peer support specialists will help the patient manage their withdrawal on site at the hospital using  the American Society of Addiction Medicine Guidelines
  3. The team will assess the patient after their detox period to determine the most appropriate level of ongoing care needed, and help make a direct connection to the service provider.  
  4. The patient’s addiction specialist will not just give them a pamphlet and an address to go to -- they will drive the patient to the facility that will provide ongoing care and continue to support the patient afterwards. The addiction specialist will become their support system to help them get to appointments, connect them to other social services and keep them motivated to turn their life around.  

“San Diego emergency personnel spend thousands of hours each year responding to homeless individuals experiencing an overdose or psychiatric crisis. We have to focus on the underlying mental health and addiction issues that lead to repeated emergency room visits,” Mayor Kevin L. Faulconer said. “I applaud the County, including Supervisors Cox and Fletcher, for taking action to focus resources on the problem, increase bed capacity, and connect people to services that end the cycle of homelessness."

The Accelerated Connections to Treatment program will begin in May 2020.