Santa Cruz Grand Jury releases report on understaffed county BHD
SANTA CRUZ - A new Santa Cruz County Civil Grand Jury report highlights the need for additional staffing in the county's Behavioral Health Division (BHD).
Mental health struggles and rates of substance use disorder have been dramatically escalating for more than two years in Santa Cruz County, according to the report. The county's BHD is the primary provider of mental health care for low-income adults and children who lack private health care coverage.
The report released Monday investigates how the BHD, part of the county's Health Services Agency, handled the additional demands on their services caused by the COVID-19 pandemic.
The Civil Grand Jury, a panel convened in each county around the state annually to investigate and report on local government operations, found the BHD to be significantly understaffed with around a 30% staff vacancy rate, which includes management, clinicians and support staff.
At the time of the investigation, four out of the 10 director positions were vacant, filled by interim employees who were performing the tasks of at least two positions, the report says.
Critically low staffing levels have harmed access to and quality of treatment across many programs. The jury found that the programs providing community and field-based crisis intervention and evaluation services like Mobile Emergency Response Teams for adults (MERT) and youth (MERTY) are frequently understaffed and are unable to expand their services to weekends for lack of staff, even though they have the necessary funding. These programs serve people experiencing a significant mental health crisis and who are gravely disabled or at imminent risk of harm to self or others.
An estimated 37% of BHD's clients are homeless, according to the report. About 67% of homeless residents in the county have chronic substance abuse and 43% of BHD's substance use disorder clients are involved with the criminal justice system.
The report notes several other problems, including inadequate capacity for crisis stabilization, described as services needed for people who are experiencing an acute mental health crisis; lack of continuing care capability and insufficient outreach to the Latino/a community; and that BHD can only be expected to improve with significantly more staff.
The jury made an urgent recommendation to increase BHD's staffing to meet the overwhelming demand for mental health services in the county. Additionally, it recommended increasing the capacity of the crisis stabilization program and transitioning the MERT and MERTY programs to 24/7 availability. It also recommended improving service to marginalized populations, especially people experiencing homelessness, those involved with the criminal justice system and the Latino/a community.
According to the report, a response is required from the county Board of Supervisors and invited from county administrative officer Carlos Palacios, the Mental Health Advisory Board, BHD director Tiffany Cantrell-Warren, county Health Services Agency director Monica Morales and county personnel director Ajita Patel. Responses from those county officials were not immediately available.
The report is available at https://www.co.santa-cruz.ca.us/Portals/0/County/GrandJury/GJ2023_final/2023-6_BHD_Report.pdf.
