By: Jodi Nerell
Sutter Health Director of Local Mental Health Engagement
At Sutter Health, we believe mental health is human health. We understand that mental wellness impacts total wellness. We know support is not accessible or available everywhere.
And we realize that we can be part of the solution, working with communities and like-minded organizations like the Steinberg Institute to provide continuous care. This is not an easy charge. There is no “one size fits all” answer. It requires a localized approach and going into communities we serve to find the root cause of any access or disparity issues impacting mental health and addiction care services.
A new approach to crisis care in Placer County demonstrates our commitment to collaborative solutions. A Sutter community health needs assessment found that too many people in Placer County were falling through the cracks, not getting the care they needed. Using that information, Sutter teamed up with Placer County to participate in the Crisis Now Academy, a 10-month learning community designed to support California counties in optimizing their behavioral health and substance use disorder crisis system.
Just this month Placer County opened the Lotus Behavioral Health Crisis Center, a voluntary urgent care center for residents experiencing a mental health crisis. The Lotus Center is one of the core elements identified by the program as a systematic approach to effective crisis care.
Funded by Placer County with community health investments from Sutter Health and others, the Center offers county residents a short-term place to stay where they can decompress for up to two days in a calm environment. With the help of trained clinicians, clients work to address the immediate crisis and create a plan to access needed wrap-around services before discharge.
Can this innovative approach work elsewhere? We are committed to finding out by working with our partners and sharing what we learn. We are focused on solidifying the continuum of care for mental health and addiction through data, technology and partnerships.
To do this, we continue to work to understand the barriers to care, among them:
The bifurcation of mental and physical healthcare. Historically, mental and physical health were separately addressed, distinguishing between mind and body.
- The challenge with early detection. A lack of access to screening for mental health concerns like anxiety and depression can mean later diagnoses, presenting a risk for greater challenges longer than necessary or suicide.
- A fragmented network of care, fraught with significant gaps. Access to early intervention, treatment and wrap-around support services are highly variable, based on patient geography, resource availability, insurance coverage and socioeconomic status.
- The lack of adherence to evidence-based training, practices and treatments. Patients are predominantly served with traditional medical approaches rather than progressive, culturally based care approaches that take unique needs into account.
- A lack of equity in mental healthcare coverage. While mental health parity statutes mandate some insurance companies provide mental healthcare at the same level they cover physical healthcare, this coverage is unevenly implemented and enforced.
- Policies that challenge mental health financing and reimbursement. The public and private sectors have long funded mental health differently and separately, creating challenges when it comes to access.
- Catastrophic budget shortages in the public sector. The decrease in funds will result in further loss of services, putting mental health and addiction care in a reactionary mode focused on rationing services.
Across the state, we’ve worked to increase access to mental health and substance-use treatment services. We have supported community-based organizations, helping to expand access to support services under the new California Advancing and Innovating Medi-Cal initiative (Cal-AIM). We’ve added substance-use navigators to 20 of our emergency departments, making 4,000 connections to care in 2021 in one of the most critical access points for medical intervention. This has allowed us to treat immediate needs and help our patients find the longer-term road to recovery.
In Placer County and throughout the state, local government plays a critical role in the design and access to care. Sutter Health consistently supports policies that call for expanded access to care, more robust coverage and increased reimbursement for mental health and substance abuse services. We partnered with counties and a statewide organization to pilot the implementation of standardized 5150 training. We also support regional efforts to implement the new three-digit dialing code 988, which routes callers to the National Suicide Prevention Hotline.
None of this work could happen without local government, community advocates, people with lived experiences and organizations like the Steinberg Institute. As the needs for mental health awareness, early prevention and intervention, equal access and greater quality care continue to escalate, we need to continue to focus on our communities. We need to keep sharing information and best practices. We need to expand access through local partnerships and strategic community health investments.
Only then can we begin to scale mental health care across the state, bringing better access to quality and compassionate mental health care to all Californians.