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County Notes: Mendo’s Backward Mental Health System

There’s a common misimpression out there in our crumbling world that the mental health 911 calls that cops are responding to are criminal or otherwise violent or dangerous. Mostly, that’s not true. In fact, the cops are typically called because of family tumult, such as mom, dad, bub or sis or all of them are talking crazy and throwing stuff. 

Not that “domestic disputes” are without their hazards. Police officers have been killed or seriously injured on calls that seem relatively routine. 

But many domestic disturbances don’t require police muscle to sort out. That’s why Mendo’s long-delayed Crisis Van (aka Mobile Crisis Response Unit) is such an important part of the local response to 911 call response system. The helping professionals do not get involved in these cases until after the “crisis” has been dealt with and the “patient” is under some control, either by the cops or, better and when available, the crisis van. And even after that first response, the “help” — aka “services” and “resources” from the helping professionals is frequently refused by the patient or their family.

The impression given by the promoters of Measure B was that millions and millions of dollars must be spent on layers of bureaucrats and architects and buildings and property and psychiatrists and drugs and case managers, and therapists and on and on. But as the call logs for the Crisis Van show, most of the time the early response to the 911 call by a person of understanding and knowledge who can handle that initial difficult encounter, does more good for the person involved, and significantly reduces the law enforcement burden as well as reducing the need for all those follow-on expensive layers of ancillary staff.

But in Mendo, especially in Mendo, most of the money goes to Camille Schraeder and her $30 million a year Helping Industrial Complex, a complex that hides its effectiveness (and Mr. and Mrs. Schraeder’s personal annual take) behind “patient confidentiality,” recently further expanded when Mendo spent $5 million for a $1 million four-bedroom house next door to Ms. Schraeder’s admin HQ in Ukiah, thus significantly reducing her costs (without reducing the cost to the County) because, for the individuals involved, her staff can simply walk across the parking lot to meet with their “clients” — after they’ve calmed down and been brought there by the cops and/or the crisis van.

Most of the real response has already been done by then, and anyone who does not meet the technical 5150 criteria (a danger to himself or others or gravely disabled) and accepts a ride to the $5 million“crisis residential treatment” home on Orchard Street in Ukiah is already much less of a problem. All the helpers have to do is feed and house them for a few days, offer them some sympathetic chat time and maybe some new drugs — at hundreds of dollars per hour.

According to sources close to the crisis van operation, the main difficulty in staffing the crisis van and bringing it to more areas of the county for more hours of the day is that the Schraeders, with their millions of County funds, hire almost every likely crisis van candidate that comes along, and, because they’re a private company, they can hire people much more quickly than Mendo can — recruitment and hiring for Mendo takes months and months, during which time qualified candidates have to wait around for an unspecified start date, during which time they are likely to take another non-County job that will employ them now. And there’s no limit to the number of people the Schraeders can hire because whatever they do at whatever cost will be reimbursed by the County and the state — albeit delayed at times — as long as they prepare the bill correctly. And they make all the administrative decisions once the person has been accepted as their client.

Not once has official Mendo asked for a report on the crisis van, its effectiveness, its cost, its recruiting, its staffing, its protocols, its impact on reducing the number of 911 emergency calls, its level of reduction in emergency room visits, etc. Instead, Official Mendo, in particular an ill-conceived ad hoc committee of Supervisors Ted Williams and Maureen Mulheren, is working with the Schraeders to come up with yet another repackaging of some service numbers which, of course, will report that all those millions Mendo gives them, uncompetitive, sole-source of course, are well spent. We’ll get charts and graphs with disembodied out-of-context data which is nothing but a slicing and dicing of the raw numbers, not a measure of whether anyone is actually helped.

But as obvious as the Crisis Van benefits are, prioritizing and ramping it up has never been important to Mendocino County. Official Mendo prefers to waste millions on homeless “services” and mental health office staff instead of focusing on the incidents that push people into personal difficulty, and sometimes homelessness, when they really need help.

In the next few days we will summarize the kinds of calls that the crisis van has been called to in the last few months. Almost every one of them is an example of how Mendo’s expensive helping bureaucracy has its priorities backwards. 

PS. Also unheard from regarding the Crisis Van is Mendo’s small but loud horde of cop-haters who should be thanking local law enforcement for embracing and implementing the crisis van which in turn reduces and de-escalates cop-citizen encounters, thus reducing the chance of an unfortunate incident of the type we read about in the News From Elsewhere. Instead, the last we heard from them, they were calling for an audit of the Sheriff’s Department even though the Sheriff’s department is the most transparent operation in the County and they couldn’t identify a single thing they thought the Sheriff was wasting money on.

Will The Real One Sided Reporter Please Stand Up

Mendocino News Plus is the reboot of the late Paul McCarthy’s locally famous and popular Mendocino Sports Plus facebook page, but with Paul’s son presiding. They repost most of our County coverage the day it appears. We don’t mind because we still like the page and it gets our coverage before a few facebook readers who would never see it on our website, and it generates some local feedback which is always good to get.

After MNP reposted our article about the crisis van on Thursday, a woman named Josie Drake commented: “Unfortunately there is so much information not put into this article! But that is the way AVA does it one sided!”

According to her facebook page Ms. Drake works for Redwood Community Services in Fort Bragg. She is described on line as “a counselor in Fort Bragg, CA. She currently practices at Integrated Care Management Solutions.” 

Another on-line bio says: “Josie Drake is a top Case Manager/Care Coordinator in Fort Bragg, CA. With a passion for the field and an unwavering commitment to their specialty, Josie Drake is an expert in changing the lives of their patients for the better. Through their designated cause and expertise in the field, Josie Drake is a prime example of a true leader in health care. As a leader and expert in their field, Josie Drake is passionate about enhancing patient quality of life. They embody the values of communication, safety, and trust when dealing directly with patients. In Fort Bragg, CA, Josie Drake is a true asset to their field and dedicated to the profession of medicine.”

MNP asked Ms. Drake for more info.

Ms. Drake replied: “I can go on and on, but at the RCS web page there is a lot of useful info on what they do for Crisis and follow up!”

We looked at that webpage:

“Crisis Response Services, Mendocino County — Finding the way to wellness and recovery during times of crisis is not always easy. Available 24 hours a day, 7 days a week, Redwood Community Crisis Services is the sole provider of emergency crisis response in Mendocino County. RCS provides crisis intervention services to all persons regardless of insurance. This includes emergency mental health, evaluation, assessments, intervention, aftercare and follow up services. These services are often the first step in a person’s journey, as we evaluate psychiatric symptoms and refer you to additional services if needed. Services are provided to children, youth, adults and their families.”

The RCS webpage describes RCS’s crisis services in the usual generic way with no numbers, no measures of effectiveness. There’s no way to argue their service claims. We assume they’re doing some good for their clients; they’re certainly paid well enough for it. But boilerplate service descriptions stop well short of the kind of incident reporting we get from the crisis van call log. It’s kinda like watching those glowing PG&E ads where they tout their crews and their responsiveness, but never mention their many failures and crimes. 

RCS’s fancy data dashboards are just numbers of this and percentages of that. You could cut them in half or double them and nobody would know the difference. They don’t mean much. And they never mention the public money they’re getting.

Using the word “unfortunately,” Ms. Drake complains that our coverage of the crisis van (and other AVA stories she presumably has read) is “one-sided.”

Let’s have a look at “balanced” reporting on mental health practices in cash and carry compassionate Mendoland. 

Karen Rifken at the Ukiah Daily Journal and Stacey Sheldon at KZYX covered the Crisis Residential Treatment Center Grand Opening, leaving out several key pieces of information like the fact that it cost $5 million when it shouldn’t have cost more than $1 million, thus depriving mental health patients of about $4 million in services or other facilities. Or that the only reason it was built and built where it was built (next door to Ms. Schraeder’s HQ) was that the state told the Schraeders and the County that if they didn’t spend over $4 million of Measure B money on it and get it open by the end of 2021 they’d pull their half million contribution to the cost. Otherwise, it would have suffered the same fate as nearly every other Measure B project: Endless bureaucratic delays. But that didn’t stop Mendo from bragging about being forced to build it at way to high a cost and Ms. Rifken and Ms. Sheldon from writing glowing stories about it.

Ms. Schraeder and her high level friends in County Government also get nearly unlimited time singing their own praises in public before the Supervisors (and the Behavioral Health Advisory Board) without providing even the minimum of useful outcome data such as the number of release plans and the frequency of relapse.

It works too. Supervisor Mulheren joined the happy talk parade on Thursday via her Supervisors Website: “[Last] Thursday was a very important day, it was the Crisis Residential Treatment opening tour. Although the licensing is not yet complete the construction is done. This will be an opportunity for our local residents to have a place to stay either before or after needing a 5150 hold. They can stay for up to 30 days as a transition. It’s a home like facility. I have photos on my Facebook page @ Mo4Mendo” 

From where we sit these typical propagandistic reports as described above are never denounced as “one-sided.” But nooooooooo, the meany faces at the AVA point out a few of the realities and we are dismissed as “one-sided.”

By the way, we’ve heard some good things about RCS’s services in Fort Bragg from several independent sources, and that probably includes Ms. Drake’s services. As we said in our title, the issue isn’t the individual service providers (well, ok maybe a few of them) but the “backwards” priorities that the local bureaucracies and outfits have that are not focused on early prevention and assistance or cost effectiveness, but instead on reimbursable clients and grant money and wasting large chunks of Measure B sales tax money on things that are the equivalent of what CEO Angelo once described as a $50,000 kitchen.

We see our “one-sided” coverage as a necessary part of the mental health services picture, the other side if you will, the side that isn’t included in the self serving, one-sided happy talk that comes out of the Continuum of Care and the data dashboards and the rest of the system’s press releases and uninformative, aren’t-we-wonderful reports.

Mendo’s Crisis-Outreach Unit Pilot Program: Half a year of helping Mendo’s mentally ill and their families

Since mid-June of this year, Mendocino County’s relatively new Crisis Van has responded to more than forty crises, operating 40+hours per week mostly out of the Ukiah Valley area with a few calls responded to in Willits, Laytonville and Anderson Valley. A second psych tech has been hired and is expected to be deployed early in the new year. Several more positions are funded but are still vacant, one of which is expected to serve on the Mendocino Coast. 

Two vehicles have been assigned to the program in recent days; previously the psych tech responded with law enforcement officers in patrol vehicles. With the introduction of their own vehicles, the crisis units are expected to be able to do more outreach.

For the six months that the single Crisis Unit has been in operation, it has averaged about six calls a month.

Although the function of the Crisis Van is somewhat different, these numbers are about the same order of magnitude as those reported for the short-lived Mobile Outreach Unit that operated in 2016-2017 before it was disbanded when the psych tech retired.  Although this original crisis effort was funded, official Mendo made no serious effort to re-start it or even ask any questions about it.

Only four of the calls since June involved a person found to be “5150,” a threat to self or others or gravely disabled. 15 calls  involved people who had been arrested before or, as they are designated by police, "known to law enforcement.

Given the circumstances most Mendolanders live in — precarious housing and low income (almost half of Mendocino County’s population is on one kind of aid or another, mainly food stamps), crisis calls are surprisingly low, yet Mendo manages to spend almost $30 million a year on mental health services, if the combined privatized Schrader’s sole-source contract with the 40-plus employees with the County’s mental health administrative office staff.

After we reported on the Crisis Van status last week, AVA commenter and former Mendo social worker James Marmon wrote:

“I’ve never been a big fan of the crisis vans because I think they are a waste of money. What I’ve always felt was necessary and more cost effective is ‘Outreach Teams.” I worked on an outreach team in Sacramento in the late 90s. Getting out to people before they reach a crisis state is much more beneficial for all involved. If family members are concerned that their loved one is falling apart they can call the outreach team for an intervention. Law enforcement can be called in for backup if warranted. Street Outreach works well too. We used to go out to where the homeless were, get to know them, and offer services. By doing so you don’t want to  come across as adversarial in order to gain their trust. Dragging a cop around with you can be counter productive in most cases. The biggest issue with setting up teams like this is funding. The Schraeders can’t bill MediCal unless a person is really in Crisis. CEO Angelo, who now controls the Measure B purse, would do everyone but the Schraeders a favor if she would look into and consider turning these crisis vans into pre-crisis vans staffed with outreach teams.”

But as we pointed out to Mr. Marmon, the crisis van is not sitting around idle waiting for 911 calls. Crisis Response and Outreach Services are overlapping and not mutually exclusive. 

To confirm that we asked Sheriff Kendall about the operation of the crisis van when not responding to crisis calls.

Sheriff Kendall replied: 

“Of course, they are doing outreach as well. They have several clients they make a strong connection with and basically provide them with ‘maintenance.’ They also respond with my deputies when there is a serious issue, not involving a 911 call. You have to remember sometimes it’s feast or famine. Although there may not be an emergency every moment, they have plenty of work to keep them busy by taking a proactive response with folks who have been frequently needing the services.”

Most of those people who “have been frequently needing the services” are already known to both the Sheriff’s staff and as experience accumulates, the Crisis Van tech(s).

We previously summarized the Crisis Van response log for the first couple of months a few months ago. 

“We Are Not Saying ‘Let’s See What Happens’”

By a 4-1 vote on Tuesday, the Board voted to adopt the ordinance consolidating the Auditor-Controller and Treasurer-Tax Collector into one combined elected position. They did so despite having no analysis or plan and against the recommendations of the officials involved and everyone else who commented on the subject. The Supervisors don’t need data or analysis because this change is about personalities, not policy. 

The CEO, the District Attorney and Supervisor Gjerde (the current Chair and longest serving Supervisor) don’t like the current Interim Auditor-Controller. They don’t like her because she has denied reimbursement for travel claims that were not in line with county policy. She’s also denied the use of county funds to pay for such things as hot tubs for personal use. The problem? She was saying “no” to a trio of powerful people who don’t think the rules apply to them and who are used to getting their way. 

Supervisors Williams, McGourty and Gjerde cited specious and irrelevant complaints about travel reimbursement delays, decades old retirement system problems, allegedly uncollected taxes on vacation rentals, unnamed and unquantified “efficiencies,” and mischaracterizations of the objections that have been raised. They didn’t ask the individuals involved about these allegations, just made unsubstantiated claims.

Supervisor Haschak was the lone dissenter, noting he hadn’t seen anything describing how the consolidation would save money. He also pointed out there wasn’t enough analysis (none, as a matter of fact) and it would be better to have buy-in from the officials involved. 

Supervisor McGourty (who has ignored the well informed comments of the current incumbents and others with direct knowledge of County finances) arranged to have a “real expert,” make a presentation to the Board. Pat Blacklock, CEO of Rural County Representatives of California (RCRC) and former CAO of Yolo County was on hand in an obvious attempt to make up for the lack of analysis. Unfortunately, Mr. Blacklock made a presentation on the “Yolo Model”—- which was not the model Mendo’s Supervisors voted for. 

The offices of Treasurer-Tax Collector and Auditor-Controller were already consolidated before Blacklock got to Yolo! For that reason, he offered no information on how the offices were consolidated or how they functioned, either before or after. Not one Supervisor pointed out this apples to oranges comparison.

The Yolo Model turned out to be the creation of a Department of Financial Services with an appointed (not elected) Chief Financial Officer (CFO). This may be the ultimate goal of the Supervisors, but under current conditions the voters would never support a CFO appointed by the Supervisors. It took three tries to get voter approval in Yolo.

Before the CFO was approved, finance staff in Yolo were scattered among the already consolidated Auditor, the CAO and the departments. The efficiency they observed was from taking some finance staff out of the CAO and departments. If the Board wants efficiency they would take the 8 or 10 finance people who work in the CEO’s office and put them in the understaffed Auditor’s office. Instead, the CEO’s office keeps adding staff while the Auditor-Controller and Treasurer-Tax Collector are perennially understaffed. 

Blacklock emphasized (twice) that consolidation (into a CFO) succeeded in Yolo because the Auditor was "an absolute superstar" who was committed to culture change. Have the Supes identified Mendo’s superstar who will lead Mendo’s conversion? Do they think consolidation will happen on its own? Do they expect staff (whom they’ve just snubbed) to add this to their already heavy workload? 

Supervisor Williams cautioned against the risk of inaction solemnly intoning, “I see problems with the status quo.” Which could be said of any county department. During Supervisors reports Williams lamented the hundreds of millions it would take to fix county roads, saying it was time to decide which ones will revert to gravel. Isn’t that a problem with the status quo? Why not combine the Transportation Department with General Services? 

Williams also said he hadn’t heard from any employees or department heads who were against the consolidation. Which only shows he isn’t listening. Howard Dashiell, Director of Transportation wrote a letter cautioning the Board against consolidation. He made a point of saying he sticks to transportation issues and never takes sides on political issues, leaving that to the Supervisors. Yet he chimed in on this one.

Without citing any information to support his claims, Williams said consolidation would lead to more efficiency and improved staffing levels. The letters of opposition from the incumbents explain why the opposite is more likely to be true.

McGourty described the current system of two elected officials as being “not truly a democratic process” because an incumbent could resign mid term leaving a vacancy to be filled by appointment. Supervisor Mulheren (who managed not to say a single word during the discussion) used the same ludicrous argument when the Board introduced the ordinance at a previous meeting. Neither McGourty nor Mulheren explained how creating a single elected position would prevent the single incumbent from resigning mid-term and magically create more democracy in the process. Or how this would be any less democratic than having two elected officials, either of whom could resign, thereby creating a vacancy. 

The most telling remark of the discussion was Supervisor McGourty’s weak attempt to wrap up the discussion and refute the critics: “We are not saying, ‘Gee, let’s see what happens.’ We can make a plan to make this work.”

Actually, “Let’s see what happens” is exactly what the Board has done, as McGourty’s next sentence — “We can make a plan to make this work” — admitted, i.e., there is no plan. McGourty closed by saying, “Eventually we need to look at how our finances are organized for this county.” The time to do that would have been before blindly voting to combine the two key financial offices in the county, not after. But in Mendo there is no plan, no planning process. Instead, they’re working on a “strategic plan” that their own employees say is a “waste of time.”

One Comment

  1. Prismonic February 7, 2022

    Thank you.

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