A mayoral candidate’s criticism of a planned psychiatric facility has drawn strong rebuttals from mental health advocates.
The Board of Supervisors revealed a plan in February to build a 77-bed hospital building at Santa Clara Valley Medical Center. The proposed facility, which is expected to be completed by the end of 2023, would include county-run pediatric psychiatric units for children and teenagers—a first for Santa Clara County.
Councilmember Matt Mahan recently criticized the county Board of Supervisors for alleged financial mismanagement. One example he cited was the facility, noting its hefty price tag of $233 million.
“The county isn’t moving quickly or efficiently enough to address mental illness and addiction,” Mahan told San José Spotlight. Citing statistics from U.S. Department of Housing and Urban Development, Mahan said Santa Clara County has 2,328 people with severe mental illness and 1,668 experiencing chronic substance abuse living on the streets.
“Proposing to add 77 treatment beds at a cost of over $3 million per bed isn’t good enough,” Mahan added. “The public deserves a plan that addresses the scale of the crisis.”
Mahan isn’t the only politician who has attacked the plan’s cost. Former Councilmember Johnny Khamis, who is running for a county supervisor seat, told San José Spotlight he supports the idea of building a mental health treatment facility, but he thinks the number of treatment beds is too small for the price tag.
“Why only 77 beds for $233 million?” Khamis said. “Like, what are they constructing it out of?”
Mental health advocates and other lawmakers say Mahan and Khamis are misinterpreting how the money is being used on the project. Supervisor Joe Simitian, who led the drive for the psychiatric facility, told San José Spotlight the cost is consistent with what other municipalities have spent on modern psychiatric and medical facilities. El Camino Hospital in Mountain View opened a new $96 million behavioral health facility in June 2020. But it only treats patients 18 and older.
“We’re not building a Motel 6 here,” Simitian said. “If you’re looking at the nature and extent of the services in the facility, the number of beds, and the level of acuity that the facility is designed to address, a sharper analysis would conclude the costs are consistent with current construction costs.”
A worsening problem
Michael Fitzgerald, former director of behavioral health for El Camino Hospital, provided some guidance on the VMC project. He said the arguments raised by Mahan and Khamis seem to ignore the fact that the average patient stay in a treatment bed is about a week, which means each treatment bed hosts dozens of patients throughout the year.
“It’s not just the cost of beds,” he added, discussing the various expenditures necessary to create a modern psychiatric hospital. “You’re providing a whole treatment environment.”
The dearth of psychiatric treatment beds is a growing concern in Santa Clara County. In 2017, the county reported 12.69 acute psychiatric treatment beds per 100,000 people, according to a study. The study stated 969 more beds would be needed to meet demand. The problem is worse for children.
There are no psychiatric acute care hospital beds in Santa Clara County dedicated to children and adolescents under the age of 18. Simitian said each year approximately 600 children with severe psychiatric needs require hospital stays, and they must be transported to counties all across Northern California as far away as Sacramento.
Kids will ‘end up lost’
Diana Pohlman, a resident of the Silicon Valley region, experienced the lack of services firsthand in 2007 when her 7-year-old son suffered the onset of a rare autoimmune disorder that caused severe psychiatric symptoms. He experienced hallucinations, talked to himself, ran in front of cars and struggled to eat.
She told San José Spotlight that medical staff at Stanford University said there was nothing they could do, and in desperation she went to the police who said they could put him in foster care or a halfway house. Pohlman’s son eventually received help once his disease was diagnosed, but she said the experience made her acutely aware of the lack of behavioral health facilities dedicated to psychiatric care for minors.
“If they don’t do this hospital, there will be hundreds of people who will just end up lost,” Pohlman told San José Spotlight, “and they won’t have the beds to keep them in.”
Mary Nelson’s son, Paul, suffered from the same disorder. Bizarre symptoms appeared overnight: he tore up the floor of his bedroom, stabbed his door with a knife and tried to pull his teeth out. Nelson told San José Spotlight she had to transport her son from their home in Half Moon Bay to Vallejo to a psychiatric hospital. Because Paul required psychiatric and medical services, he was shuffled between facilities–a stressful ordeal.
“The benefit (of VMC) is having the specialists in one place, being able to treat both their underlying medical condition and their physical condition,” said Nelson, who also testified about her experience before the Board of Supervisors.
Without adequate psychiatric facilities, many mentally ill residents are getting warehoused in jails which puts them at risk. According to Sheriff Laurie Smith, approximately 25% of the county’s jail inmates have a serious mental illness, and the wait time for treatment beds can stretch out for months.
Kathy Forward, former executive director of the National Alliance on Mental Illness (NAMI) in Santa Clara County, told San José Spotlight the need for effective psychiatric care has grown during the pandemic, especially for younger people.
“There’s been a lot of suicide attempts, kids thinking they don’t want to live anymore,” Forward said. “COVID is really exacerbating that in children and adolescents.”