Comstock's magazine 1118 - November 2018 - Page 53

cent of a typical day dealing with mental health issues with their patients, but many aren’t trained for that, says Dr. Robert McCarron, vice chair of ed- ucation and integrated care in UC Irvine’s Depart- ment of Psychiatry and Human Behavior. So why not combine training programs for psy- chiatry and general care? “When I asked that question 15 years ago, I re- ceived tons of pushback,” McCarron says. “People said, ‘You’re either a psychiatrist or a family medi- cine doctor, you can’t be both.’” But tunes have changed with more health sys- tems taking an integrated approach. Four years ago, McCarron created a fellowship to train pri- mary care providers for one year on how to screen and diagnose common psychiatric issues, such as mood, anxiety, psychotic and substance misuse disorders. The program received $1 million from the state’s general fund to pay tuition for medical students in underserved areas. The fourth class, expected to have about 110 fellows, begins in January 2019. November marks the one-year anniversary for Sacramento County’s Mental Health Urgent Care Clinic, touted as a first-of-its-kind alterna- tive to emergency rooms and psychiatric hospi- tals. Funded by the Mental Health Services Act, this five-year program with a $2.5 million annual budget operates with a multidisciplinary team of psychiatrists, social workers and peer navigators. The walk-in clinic sees about 350 individuals per month. Approximately 30 percent of them are self-referred while others come from mental health outpatient community clinics, emergency rooms, law enforcement, schools and friends, says Kelli Weaver, division manager for Sacramento County Behavioral Health. “There is not a one-size-fits-all model,” Weaver says. “The goal is to have a continuum of services to address the needs of the community at all lev- els. Individuals live productive and fulfilling lives in the community and manage mental health con- ditions just the same way individuals of all ages manage and live with other chronic illnesses.” By early spring, Dignity Health expects to open its behavioral health crisis collaborative, a new center on the campus of Mercy San Juan Medical Center. Established in partnership with Sacramento County to treat patients with men- tal health issues, the center will provide “access to integrated emergency medical and emergency mental health crisis and intensive services” for pa- tients by psychiatrists, behavioral health nurses and mental health technicians trained in special- ty trauma-informed care, says Rosemary Younts, Dignity Health’s senior director of Behavioral Health Services. Time will tell if these initiatives deliver the Sac- ramento region from its neglectful past, but any chance of recovery demands that entities, public and private, work together, not alone. “To address the needs we have, you have to work together and be creative and collaborative,” Younts says. “Nobody can solve the problem and provide all of the services on their own.” n Russell Nichols is a freelance writer who focuses on technology, culture and mental health. His work has appeared in The Wall Street Journal, The Boston Globe, Governing Magazine and Government Tech- nology. On Twitter @russellnichols. November 2018 | 53