Is Sacramento County's New Mental Health Treatment Approach Working?

The Turning Point mental health center in Rio Linda smells faintly of cleaning supplies.

Vacuuming, countertop cleaning and other daily chores are required of all residents, but the routine is about more than just keeping a clean house.

Turning Point is a crisis residential program, created by Sacramento County to alleviate a decade-long shortage in mental health services. It offers  people who are coming down from suicide attempts, panic attacks and other serious mental health episodes a safe place to stay for 30 days.

Crisis residential programs are more intense than drop-in centers, but don’t require psychiatric hospitalization. They’re considered a best practice in the mental health field because they prepare patients to be self-sufficient after release.

Several counties statewide are establishing these programs with grants from the California Mental Health Services Act. Sacramento County opened the Rio Linda facility last year, and plans to launch two more by 2018.

The Rio Linda house isn’t locked - residents can leave and return as often as they like, so long as they attend group therapy three times a day and return by 7 p.m.

George Clark, a 31-year-old Turning Point graduate battling depression and addiction, says the balance of scheduled and unscheduled activities really helped him practice time management.  

“It doesn’t feel strict at all," he says. "It’s structure, and stability. I thrive off of structure.”

Clark was homeless before he arrived at Rio Linda this summer. He landed in the emergency room after a suicide attempt and eventually got a placement at Turning Point.

Hundreds of people like Clark don’t get the services they need to recover, says Susan Gallagher, director of Mental Health America of Northern California. She’s been fighting for Sacramento’s mentally ill since county resources started shrinking during the recession.

In 2009, the county cut half of its psychiatric hospital beds and closed its crisis stabilization unit, which acted as a triage center for people in crisis. Now, people show up at local emergency rooms. But physicians there aren’t usually trained to handle psychiatric cases, Gallagher says.

“We think it’s kind of inhumane that somebody would have to go to an emergency room. If somebody is psychotic or hearing voices, they get looks, they get scorned," says Gallagher. "You don’t want to be in an environment like that, where it’s noisy, you’re not being seen right away, you’re there for hours and days sometimes…It just seems really inappropriate”

There are only about 400 psychiatric hospital beds in Sacramento. In 2015, the county’s grand jury gave the behavioral health services department a scathing report for not adequately serving the mentally ill.

Uma Zykofsky, director of the department, says county staff has responded to that report. They’ve launched two new mobile crisis support teams, who ride along with law enforcement to help people on the street. They’ve added 18 mental health navigators in six local emergency departments, and they plan to open an urgent care clinic later this year.

“I understand when people say it’s taking you too long, but I also believe that if you put in the investment of time, where communities believe the individuals being served belong there, and the programs are part of the fabric of that community, in the long run we’ll have more resilient programs,” says Zykofsky.

The Turning Point facility in Rio Linda served 147 people between August 2016 and June 2017. Of those, eight people discharged to the emergency room, and one had to be diverted to psychiatric hospitalization.

Housing continues to be a struggle for Turning Point graduates. Half of all residents who graduate the program are homeless when they leave.

George Clark is currently at a rehab program and searching for affordable housing. He says the breathing techniques, meditation, and emotion regulation strategies he learned at Turning Point have helped him with his recovery.

When he was at the Rio Linda facility, staff helped him enroll in cosmetology classes at Sacramento City College. He’s hoping to be able to attend them and fulfill is dreams of becoming a hairdresser.

“When I was younger, I used to watch my mother put on her makeup and get ready," says Clark. "I’d sit on the toilet and watch her and say, that’s what I want to do when I grow up’. When I meet a new person, I’m always looking at their hair, thinking in my head, what can I do to her hair to make her look more beautiful?”

The Rio Linda crisis residential facility, combined with a similar South Sacramento program and the two buildings in the works, will provide a total of 72 county mental health beds. Staff say that should serve about 1,000 people annually.