The Santa Cruz County Behavioral Health Division (BHD) is underfunded and understaffed, which hinders its ability to provide services to low-income patients, young people and jail inmates with mental health needs.
A lack of bilingual staff, furthermore, makes delivering mental health services to Latinos challenging.
That’s according to a report released June 12 by the Santa Cruz County Grand Jury, which among other things recommends increasing salaries for mental health providers, streamlining the hiring process and turning to universities for recruiting new employees.
The report found that four out of 10 director positions were vacant, and were filled by interim employees who were still responsible for their own jobs.
The findings come as no surprise to Kirsten Juel, who works in the county’s Integrated Behavioral Health Program. She joined more than two dozen colleagues Tuesday to address the Board of Supervisors during the public comment portion of their meeting.
She says she has been working on the issue for more than a year, during which hiring new employees has stalled. The report, she said, underscores their points.
According to Juel, her department is facing a 54% vacancy rate, a number supported by the findings of the report, which shows an average 30% understaffing, including management, clinicians and support staff.
“We’re here today to address the behavioral health crisis we’re having in the county,” she said.
The shortage—and the fact that no qualified candidates are on a hiring list—stems from the rising cost of living that is not being addressed by the lower-than-average wages, Juel says.
“We are not offering a comparable wage to our neighboring counties,” she says.
In addition to a raise, the workers are asking for a reduction in the hours they are working.
“We’re working so hard, we’re doing the work of way too many,” Juel says.
The report recommends increasing the availability of the county’s Mobile Emergency Response Teams to round-the-clock coverage. Currently, the teams that offer services to adults and youth do not work on the weekends and are around 50% understaffed.
A lack of beds for mental health patients frequently delays care, and leaves many continuously cycling through the system, the report states.
Because of the lack of capacity, new patients are frequently diverted to hospital emergency rooms, which taxes those systems and leaves mental health patients underserved, with some waiting up to 24 hours, the report shows.
The county’s behavioral services are also bedeviled by a shortage of beds in its Psychiatric Healthcare Facility (PHF). According to a report by the nonprofit Treatment Advocacy Center, the center has just 16 beds, far short of the 135 it needs based on the county’s population.
Because the PHF is only for adults, minors must be transferred to out-of-county facilities.
That could change as early as late 2024, when the county opens a facility in Live Oak specifically for young people. But the county plans to close the current Crisis Stabilization Program aimed at patients under 18 after June 30. A “smooth transition plan” is therefore needed to fill the gap, the report shows.
There is also a lack of “step-down facilities” geared at helping patients transition out of intensive behavioral health programs, the report shows.
The BHD should also offer hiring bonuses, loan repayment, public service loan repayment and workforce tuition, the Grand Jury recommends.
Santa Cruz County spokesman Jason Hoppin says that county officials agree with many of the findings in the report, but said they are still analyzing the Grand Jury’s discussion of vacancy rates.
“While the numbers may look alarming, they may not be that exceptional given normal employee churn and the time it takes to recruit employees given Civil Service rules, the difficulties we have bringing new staff into the most expensive rental market in America, and many other factors,” Hoppin says.
Under state law, organizations typically have 90 days to respond to grand jury reports. They are not, however, required to implement any of the suggested changes.
