[Noozhawk’s note: This article — part of a Noozhawk special project in partnership with the USC Annenberg Center for Health Journalism — is the second in a series investigating the shortage of acute care psychiatric beds for people experiencing a mental health crisis in Santa Barbara County. Click here for the first story.]
Susan Ayer’s eldest daughter, Claire, suffered from a serious mental health condition when she was 17 and was first put on hold in the spring of 1999, shortly after graduating from college. high school in his hometown of Santa Barbara.
The only bed available for her was at Aurora Vista del Mar in Ventura, where she stayed for three weeks.
“During the three weeks she was there, I drove 35 miles and 35 miles a day to visit her after work while taking care of her two sisters and their needs,” Ayer told Noozhawk.
“She was lucky that she only went to Ventura, it could have been Pasadena or San Diego, and I don’t know what would have happened then.”
In just six months, Santa Barbara County sent 160 acute mental health patients to 29 different hospitals outside the county.
Santa Barbara County is ranked sixth among California’s 58 counties for having the largest gap between its existing number of acute mental health inpatient beds and the number of needed beds, according to a 2021 assessment by the California Department of Healthcare Services. .
Santa Barbara County’s single mental health facility has 16 beds available for the county’s approximately 375,000 people over the age of 18.
Noozhawk spoke with several people who gave high marks about the quality of staff and care at the County Psychiatric Health Facility at 315 Camino Del Remedio in Santa Barbara. But they were frustrated that there weren’t enough beds for themselves or their loved ones to receive that level of care here in their home county.
When the 16-bed Santa Barbara County Psychiatric Health Facility reaches capacity — which is almost every day of operation — the county attempts to secure placement of patients at its contract psychiatric hospital in Pasadena, Aurora Las Encinas.
When that hospital does not have beds available, patients are sent all over California to receive the critical acute care they need.
Not only are patients being sent hundreds of miles from home to receive adequate care, but sending patients out of county comes at a significant cost to the county itself.
Between August 2020 and January 2021, the county had 160 out-of-county hospital placements, resulting in nearly 1,000 bed days, according to data obtained by Noozhawk.
Of those patients, only 25% were referred to the county’s contract hospital in Pasadena, which is nearly 150 miles north of Santa Barbara County and more than 100 miles from the south coast.
The county’s contract with Aurora Las Encinas in Pasadena is for $2.1 million over three years, from fiscal year 2019-20 to fiscal year 2020-21, according to the Department of Behavioral Wellness.
When there are no beds available in Aurora Las Encinas and the county must send patients to an unconventioned hospital, the price per day ranges from $523 to $1,575 depending on the region of the state and the type of institution to which they are transferred.
At the lower end of that spectrum, in the six months between August 2020 and January 2021, the county paid more than $500,000 to send its 160 patients to non-contract facilities.
At the furthest end of that spectrum, the county paid nearly $1.6 million — about 75% of the cost of the county’s three-year contract with Aurora Las Encinas — in just six months.
While the length of stay in out-of-county hospitals varies from person to person, sometimes people only need inpatient intensive care for a few days. This leaves another problem with transportation, family visits and providing resources to patients when they return home.
Alice’s son Jim was in ER on hold 5150 for almost 10 days in the winter of 2021.
After being sent to a mental hospital in Ventura, transferred to the Santa Barbara County Crisis Stabilization Unit, and finally released to his brother, he experienced another psychotic episode.
Jim’s brother called the County Mobile Crisis Team, who came to take him to Marian Regional Medical Center in Santa Maria until they found a closed psychiatric hospital to send him to.
Because the county could not guarantee his placement at the psychiatric health facility or his contracted hospital, he was sent to a facility in Sherman Oaks – at least 2 1/2 hours from his home in Orcutt.
“It was a nightmare,” recalls Alice, Jim’s mother. “It was a real nightmare.
“They kept moving him further and further, and as soon as he was admitted to a hospital they tried to figure out where they could send him back next.”
What’s next in the series
This report is the second in Noozhawk’s series analyzing Santa Barbara County acute care beds for patients in mental health crisis. Noozhawk recognizes that mental illness and the challenges of navigating the mental health system are vulnerable experiences to share. Alice and Jim are pseudonyms used to identify two of the local residents in this story, at their request.
The next article will be published on April 28 and will explore the development of Crisis Stabilization Units in Santa Barbara County, and why they are not being used as often as expected.
Click here to read the first article discussing the local shortage of psychiatric treatment beds.
This series is produced as part of a project for the 2021 USC Annenberg Center for Health Journalism Data Fellowship.