Op-ed: New VMC psychiatric facility is a must for those in crisis
A rendering of the planned $233 million psychiatric facility at Santa Clara Valley Medical Center. Picture courtesy of Santa Clara County.

    The Santa Clara County Board of Supervisors voted unanimously to support a new behavioral health building in October 2018, on the grounds of Valley Medical Center. In addition to 77 beds, a new emergency psychiatric services center will replace the current site, which is among the busiest in the nation and provides the only secure psychiatric emergency room in the county.

    The current buildings are derelict with age and cannot be refurbished—they must be demolished. The alternative to a new building would be to shut these services down, which given the existing shortage of beds—particularly for the most acute patients—would wreak havoc on what is already an overburdened psychiatric health crisis in our community.

    We participated on a stakeholders committee to advise the leadership of Valley Medical Center on what should be the range and capacity of services necessary to serve the community needs. We recognized there will remain a shortage of necessary beds, but at least the facility will make a significant impact.

    In addition to providing treatment for adults with serious needs, there will be 24 beds identified for minors in emotional or psychiatric distress. This will include collaboration with the ASPIRE Program at El Camino Hospital, or Families First crisis intervention programs, among others, so care is well coordinated and youth can learn the skills needed to manage stress. There will be additional beds set aside for youth who have concurrent medical and mental health conditions.

    Without question, mental health conditions are far and away the greatest under-met health care need in our country. This is particularly true in Northern California where there are far less than the recommended number of beds necessary for inpatient services. The impact of this shortage can be seen in our streets, with a population of individuals who are homeless and clearly impacted by disorders in their thinking. It can be seen as well in our jails, where an astonishing number of individuals are incarcerated and yet have a serious underlying mental health condition.

    The county is not alone in addressing this need. At the time of the vote by supervisors to move forward on this project, El Camino Hospital was in the process of building what is now a state-of-the-art 36-bed facility, a beautiful place that provides a respectful and dignified environment for treatment and helps address the shortage of inpatient beds regionally. The new VMC emergency psychiatric services facility also addresses the bed shortage need. It is considered a critical entry point for those who arrive in mental health crisis.

    What we find concerning is that now, well into the design phase of this project, politicians running for office have decried the expenditure for addressing these needs. Matt Mahan, candidate for mayor of San Jose, compared the response to the psychiatric health crisis in our streets to valet parking and commemorative statues and monuments. A review of his website makes note that he supports homeless individuals with psychiatric symptoms being brought to treatment centers, a goal that is addressed in this project.

    Johnny Khamis, a candidate for the Board of Supervisors, has posted on Facebook that instead of continuing to provide care for patients at VMC, they should be brought to three area hospitals that are closing down other services. The cost of these refurbishments, to meet the required building standards, would not provide a monetary savings, and from a practicality standpoint of transportation and emergency access to care would not be a functional approach either.

    The time for their input and feedback would have been in the public commentary. They would have heard the many voices of the community who have been calling out for years to invest in treatment. Both of these candidates have supported projects helpful to those with significant needs, but inpatient services in particular have a huge gap in care.

    There is really no substitute for when patients’ lives are in severe jeopardy. Inpatient treatment, especially in a safe environment built to support compassion and healing, offers a respite for patients, their families and indeed the community. A chance for behaviors to calm and to build engagement and trust.

    Individuals running for office can easily portray themselves as fiscally accountable, having not been required to make decisions to address very serious issues. They just say it was too much money without offering realistic alternatives and without having first met with community stakeholders who could have educated them on their experiences and why such an investment is needed.

    While the cost is high, so is the cost of Silicon Valley mansions—a few of which taken together could rival the expense of a state-of-the-art, very much needed facility that will safely offer treatment to thousands upon thousands of people experiencing acute distress over the lifetime of the building.

    Those arguing against government spending may feel the mental health population is an easier target then, say, a new building for pediatric cancer treatment. This project is in fact part of the overall planning for the hospital campus, much of which has already been completed. Separating mental health treatment from other health care services only further stigmatizes what are already highly stigmatized conditions in our society.

    Michael Fitzgerald is an advanced practice registered nurse, retired mental health and addiction services administrator and consultant for Zayante Group. Kathy Forward is a community advocate.

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