Santa Clara County is officially in a mental health and substance abuse crisis, according to the county Board of Supervisors, who this week called for a better coordinated effort to respond to the crisis.
The supervisors’ unanimous action asked county staff to begin “systemwide planning” to address mental health issues and shortages in the mental health care workforce.
The supervisor action did not include any new money or specific legislation at this time.
Instead, the board seeks to outline a process for establishing a comprehensive treatment plan to be presented in April.
The action was proposed by Supervisors Otto Lee and Susan Ellenberg. In a statement outlining the reasons for declaring a public health emergency, Ellenberg said, “The current crisis of people with untreated severe mental illness, and its intersections with the housing crisis, substance use and the criminalization of mental health, has left jails as the provider of last resort.”
“This trend has been decades in the making and will require large-scale, innovative and coordinated responses across levels of government, the private sector, community organizations and residents to resolve.”
The San Jose Downtown Association, which has been confronting issues of mental health among San Jose’s unsheltered residents, sent a letter to supervisors this week, strongly endorsing renewed action to address public mental health issues.
“There is a mental health and substance abuse crisis in Santa Clara County,” wrote Scott Knies, executive director of the downtown association, on behalf of his business members. “We see it everyday in downtown San Jose with individuals suffering from psychosis and addiction in our doorways, sidewalks, parks, creeks and trails. And their numbers continue to grow.”
“Decades ago, the state abdicated its responsibility for its most vulnerable citizens by turning over mental health services to counties without the dedicated funds for implementation, he wrote. “Our cities have suffered ever since.”
“Declaring a public health crisis is a bold step forward only if it leads to the massive changes hinted at in the proposal,” Knies wrote. “Nibbling at incremental improvements to the status quo efforts will not cut it.”
Lack of adequate mental health resources and increasing burdens on county jail staff to deal with mental health issues were cited last August by Sheriff Laurie Smith in her response to the supervisors’ no-confidence vote. Smith in December was accused of willful misconduct over jail conditions and faces possible removal in court proceedings that begin Friday.
“It is unacceptable to wait for the state to take the long-overdue action to remedy the impacts of shifting people with serious mental illness out of state hospitals as they began to close in the late 1960s and 1970s,” Ellenberg said in her statement.
“While the intent of community-based care was laudable, the implementation has been inhumane for residents too unwell to care for themselves, and untenable for cities and counties not provided with – or lacking the necessary resources to meet the needs of their residents at scale.”
She said that while the county “continues to increase general fund investment in behavioral health and has added many new program components just within the last three years including a mobile crisis response team, a crisis stabilization unit, additional contracted treatment beds, embedded providers with law enforcement agencies, youth wellness centers, expanded school-based behavioral health services, and intensive outpatient treatment programs… too many of our residents are disconnected from care, our systems are too difficult to navigate5, and the need for services outstrips our available capacity.”
“We recognize that a resolution is largely symbolic – but our aim is to move away from piecemeal discussions of the needs in our behavioral health system, or adding ‘one more tool to the toolbox’ as has been the narrative with other individual program expansions, and instead to charge the board and administration to take the same kind of proactive, urgent and collaborative leadership to solve this pressing need as we have done with COVID-19 and other emergencies in the past,” the supervisor said.