Mending Mental Health in Ventura County

5150 hold has problems of its own

 

 

By Lori Denman-Underhill

It is known by many, if not all in Ventura County, that there is a severe lack of services available to those suffering from mental health issues.

The lack of facilities and services available to those persons with mental health issues, specifically under a 5150 hold, is noteworthy and should be addressed and remedied. Especially if this person is truly a danger to themselves and others.One of the latest stories by Citizens Journal  touches upon the subject of a 5150 hold, in an interview  with Oxnard’s Assistant Police Chief Jason Benites, who says there is a “treatment resource issue.”

A 5150 is defined as, “the number of the section of the Welfare and Institutions Code, which allows a person with a mental illness to be involuntarily detained for a 72-hour psychiatric hospitalization. A person on a 5150 can be held in the psychiatric hospital against their will for up to 72 hours.”

Benites said that his Oxnard police officers complain aboutthere being “revolving door” systems. Officers are frustrated because they sit with the person in the 5150 hold for an extended period of time, only to later find out that they are released after a few hours.

“I have an example of what happened yesterday,” Benites said during the prior interview. “There was a 21-year-old male, whose mother took him to a hospital for a mental evaluation. While he was there, he assaulted the staff. He was arrested, booked into jail yesterday, and was released this morning. This morning he approached two of our department’s civilian employees, exposed himself, and nearly assaulted them. He was arrested again. So you can see the amount of resources that were put into that situation, without a seeming result.”

John Shipper oversees the Adult Operations of Ventura County Behavioral Health (VCBH). The areas of his focus include all of Ventura County. Shipper discussed the 5150 hold, how VCBH assists those with this issue and what is needed now in order to help them.

Interview with John Shipper and Citizens Journal:

Citizens Journal: Does your organization work with 5150 holds?

John Shipper: The 5150 hold is one of the tools that we employ. We call upon the police when we are working with someone who doesn’t see the need for services and treatment for themselves. They have gone so far as to make us feel concerned that they are a danger to themselves or others. Or if they are gravely disabled, which is highly controversial. With grave disability, that law is defined as the inability to provide for your own food, clothing or shelter. If a person is gravely disabled, that could become a 5150 hold for three days in the hospital.

The reason why this becomes questionable or controversial is that with a “successful homeless person,” they may be able to provide for their own clothing and shelter and they are eating. A person may say they are not gravely disabled because they are managing those three things – food, clothing and shelter.

The person could be questionably mentally ill. The basis for writing the hold, the 5150, could be somewhat in question. The VCBH staff and the police can do the 5150.

Where is that person on a 5150 hold taken?

When a 5150 is written, it is considered to be an application for a hold. Right now, given the way the system and the resources are structured and available, a person put on a 5150 is taken to the nearest emergency room so they can be medically cleared. So if you are in Thousand Oaks, they take you to Los Robles. If they are in Oxnard, they are taken to St. John’s Regional Medical Center. In Ventura, they are taken to either CMH (Community Memorial Hospital) or VCMC (Ventura County Medical Center).The idea is that in that medical emergency room, it is the medical condition that is determined first. If not, the task of the emergency room is to try and find a psychiatric placement for the person.

Is there psychiatric placement places available for a person on a 5150?

This is where we run into problems. We only have the two psychiatric hospitals in the county. A person who is on a 5150 and put into an Inpatient Treatment, they have to be moved out of County in order to accomplish that. It is less than desirable to have someone in a hospital in Bakersfield, knowing that they live in Oxnard and they need to return to Oxnard. They would probably benefit from being connected to Outpatient Services in Oxnard. Coordinating that care could be difficult, knowing that they have been deserted out of county.

Ventura and Oxnard need more facilities in order to help the number of people with mental issues or on a 5150?

We need two things. There is a level of evaluation or treatment that is called a Crisis Stabilization Unit. You will hear it referred to as a CSU. Oxnard opened a CSU for children almost two years ago, but we do not have a CSU for adults in Ventura County. The rule of a good CSU is to receive people from the emergency room on a 5150. They take on the task of evaluation to see if the person really needs to be in the hospital. Or if there is something that can be done alternatively.

If Ventura County set up a CSU, what good could happen?

A professional at the much needed CSU could sit down and talk to the person in the 5150 to see how they got to the high level of crisis. It could be that the person is in a crisis with a significant other and does not need psychiatric hospitalization. Or it could be someone who has gone off their medication. Then the professional needs to get them back on their medication to let it get to work and chill them out.

The data says that upward between 60 to 70 percent of people that you can evaluate in that sort of setting can avoid going to the hospital. So you could help the person take that step and get them back to helpful resources in the community.

Is there any news of a CSU opening in Ventura County?

We are in the process of getting a couple of CSUs open and online in VC, yes. If we could do that, it would take us a considerable way down the road to being in a better spot. And then if you reduce the amount of people you are taking into the hospital, you don’t need so many beds.

Once we have a good process for determining who we need to take into the hospital, then we would be able to determine how many (or how many more) hospitals we actually need (for mental health). What we need now, however, is at least one CSU for adults and an Inpatient. Those are currently unresolved. That’s really what we need for our services now.

 

Lori Denman-Underhill has been a professional journalist since 1996. She has worked as associate editor for the Los Angeles Daily News TODAY Magazines and has freelanced for LA Weekly, Surfline.com and more. She is now the Ventura reporter for Citizens Journal.


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