By Ann Donahue
Right now, a person having a mental health crisis in California’s Santa Maria Valley will have a difficult journey. In the midst of personal upheaval—be it suicidal ideation, post-partum depression, post-traumatic stress disorder or extreme anxiety—the first stop will be a trip to the emergency room. If the individual requires additional care from that point, they will likely be forced to travel as far as Ventura or Los Angeles to receive critical and potentially life-saving in-patient treatment. That’s a trip of more than 200 miles away from their support system at the precise time they need to be held close by those who love them.
This isn’t just a hypothetical situation. The doctors, nurses and staff at Marian Regional Medical Center can provide real-world examples: the nurse who after several emergency room visits had her post-partum depression descend into post-partum psychosis and she started entertaining thoughts of harming her baby; the recent widow kept in the emergency room for 18 hours after suicidal thoughts before being transferred to Ventura via ambulance; the young schizophrenic woman held in the ER for 58 hours before an in-patient bed was located for her in Pasadena. Soon after she was discharged from the Pasadena facility, her auditory hallucinations recurred.
“We’re doing everything we can—I don’t want to give you the impression that we’re ignoring them,” said Dr. David Ketelaar, an emergency physician at Marian who is past President of the Center’s medical staff and leads the behavioral health effort at the hospital. “But the right setting for them is private, where you’re addressing the mental health concerns, not in a chaotic emergency department where trauma is happening around them.”
For emergency room doctors and nurses, it’s obviously a heartbreaking, frustrating decision to move a patient hours away when what they need most at the time is consistent, comprehensive local care, with access to their family and ongoing neighborhood mental health resources. As things stand now in Santa Maria, there is no standalone unit that can provide stabilization to those in mental health crisis. A minimum of 50 inpatient beds are recommended to serve every 100,000 people; Santa Barbara County has only 4 for every 100,000.
But all of that is about to change. Thanks to the fundraising and advocacy efforts of several Western Growers members, Dignity Health’s Marian Regional Medical Center is about to open a 24-hour Crisis Stabilization Unit to support those with mental health needs that can be managed by 18-24 hours of intensive evaluation, therapy and support.
“What happened over the years was that the number of persons in crisis and not getting beds in a timely fashion just kept gradually growing,” Ketelaar said. “We needed a different solution to get more in-patient beds and capacity. My ER colleagues across California and across the country are dealing with the same thing.”
And so a solution was developed: establish a short-term crisis care unit that treats the immediate mental health issue and lays the groundwork for long-term community-based health. The hospital anticipated that once a center was built at Marian, instead of sending patients out of the county, 50-75 percent will be safely discharged home after one day of treatment by specially-trained psychiatrists, psychiatric nurses and support staff in the Crisis Stabilization Unit.
The effort to build the center at Marian was led by Western Growers Board Member George Adam, President and Owner of Innovative Produce and a member of the Marian Foundation Board of Directors, who rallied the agricultural community in the area to raise funds for this critical asset to the region.
“As we go through different economic times in ag, it’s always tough because you don’t know what’s around the corner,” Adam said. “But I think everyone saw the need for this. It wasn’t really a tough sell. It was a great response, especially during the pandemic when this particular need is acute.”
Among those Western Growers members who answered the call were: Beachside Produce, Bonipak, Main Street Produce, Central West Produce, Durant and Rancho Laguna Farms. In total, the group raised $2 million to help establish the center.
“George’s help has been instrumental,” Ketelaar said. “We were so appreciative of how he helped rally the community. The work he did provided a boost to our ER staff when they heard about the support.”
Cortney De Lotto, the Manager of Philanthropy and Philanthropic Gifts at the Marian Regional Medical Center, said the push to fundraise for the Crisis Stabilization Unit came on the heels of a campaign for an expansion of the hospital’s emergency department. “As soon as that [expansion] was built and opened we were running to the same issue,” De Lotto said. “It was just this really bad cycle.”
To break that cycle and build the CSU, outside financial help was needed—and is still required to this day. According to the Vice President of Philanthropy for the Foundation, Jessa Brooks, the need for community financial support for the Crisis Stabilization Unit will be ongoing. For those who are truly indigent, there is adequate insurance reimbursement to medical professionals for the care they provide, she said. But for those not living in poverty, medical treatment for behavioral health issues is provided at a loss to the hospital.
“Mental health is going to be a priority for our organization, not only clinically, but also philanthropically,” Brooks said. “We know that services are dire in this community, and we need them. But we also know the reimbursement is not desirable. It’s really horrible. The hospital takes a hit on providing these services. We run in the red in that area. Insurance has not caught up with the need. But this is, as our hospital president says, just the right thing to do. So we’re going to do it.”
A blessing for the Crisis Stabilization Unit was held on June 8; as soon as inspection is complete by state and county agencies, it will open. And as mental health needs cross all socio-economic boundaries and close to 1 in 5 people will suffer from an acute psychiatric illness during any given year, Ketelaar said the formal go-ahead cannot come soon enough.
“The one thing George recognized very early on in talking with us is that mental health is ubiquitous,” Ketelaar said. “Everybody from the CEOs of companies and their families down to the farmworkers to the people who are just doing the daily work in our community—you do this kind of care for everybody. I can’t tell you how appreciative we are of the leadership that George Adam showed and how he helped us in linking us to key persons in the community.”
For Adam and his Western Growers colleagues, the chance to give individuals going through mental health struggles a chance to regain a productive place in society is, simply, invaluable. “We just try to make the most impact where we can,” Adam said. “It’s what we would do with any of our employees. We try to give everyone the best opportunity we can.”
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