The San Diego County Board of Supervisors on Tuesday weighed the merits of a plan to create thousands of mental health treatment “slots” by 2030.
As presented by county health officials, the Substance Use Disorder Optimal Care Pathways calls for:
- doubling residential treatment capacity from 4,978 slots now to 8,851 slots in five years;
- increasing outpatient treatment capacity from 9,332 slots to 18,390 slots, as way to ensure earlier intervention and long-term care, and
- expanding housing resources linked to behavioral health treatment, from 2,627 slots to 5,033 slots.
According to board Vice Chair Terra Lawson-Remer’s office, a slot is “an episode of care,” such as access to a patient bed or group therapy session or having an appointment with a clinician who can administer medication.
The board voted 3-0 to receive the presentation, and directed Chief Administrative Officer Ebony Shelton to return with updates in August.
According to a statement from Lawson-Remer and Supervisor Monica Montgomery Steppe, the county “has already made major strides” in improving substance use disorder services by adding more than 5,100 treatment slots since 2021.
Both supervisors added that other highlights are the opening of four crisis stabilization units and more mobile crisis response teams, as an alternative to residents ending up in an emergency room, jail or on the streets.
The county has progressed in shifting from a crisis model of care to one of chronic care methods and prevention, said Dr. Luke Bergmann, director of the county’s Behavioral Health Services department.
“We know that catching people earlier in their behavioral health journeys increases the likelihood of connecting them to treatment before they reach a crisis,” he said. “We want episodes of crisis be the exception, rather than the norm.”
Dr. Nicole Esposito, also with Behavioral Health Services, said nearly 20% of California residents need treatment for substance use disorder, but just 11% get the help they need.
“Our system has long lacked a cohesive treatment strategy to identify and engage people in treatment and keep them engaged throughout their recovery,” Esposito said. “We recognize that each person’s journey to recovery is unique,” requiring multiple avenues to treatment and other support in every phase of life.
She added that the county has identified several key strategies, including partnering with hospitals, prescribing medication, reducing the stigma around treatment and increasing willingness to get help.
Supervisors also heard the perspective of county law enforcement and criminal justice representatives. Cmdr. Jim Emig of the Sheriff’s Office stressed the need to maintain Psychiatric Emergency Response Teams, noting that someone in a behavioral health crisis is also a public safety concern.
Rachel Solov, chief deputy district attorney, said that there’s a strong prevalence of people suffering from substance use or mental health issues in the criminal justice system. There is a need to increase substance treatment, and safely respond to those deemed incompetent to stand trial, Solov said.
“If we can keep people out of the justice system in the first place, we are far better serving the public,” she said.
