San Mateo County officials talk mental health programming, improving services

“This topic has come up in the community a lot and the more that I learn the more that I realize how complex it actually was and how, depending on where you are, you have different access to different kinds of services,” Corzo said during Tuesday’s Board of Supervisors meeting who dedicated the session in the honor of former Supervisor Don Horsley, a major advocate for modernizing mental health resources, who died in late November.

In Half Moon Bay, there’s the Crisis Assistance Response and Evaluation program. Since launching in 2022 in partnership with the nonprofit El Centro de Libertad following the deaths of two coastside residents experiencing mental health crises, officials say they’ve seen great success in reducing escalated emergency calls and increasing stabilization rates.

“There’s often this perception that this response is only a homeless response team and it’s not. This response is available and necessary and utilized by businesses, public facilities, homes, families, schools and our unhoused residents,” Matthew Chidester, Half Moon Bay city manager, said.

Daly City, San Mateo, Redwood City and South San Francisco have joined forces with the nonprofit Starvista and the county’s Behavioral Health and Recovery Services Department to pilot the Crisis Wellness and Crisis Response Teams program. The co-response model deploys a mental health clinician to emergency calls in which someone is having a mental health crisis.

San Mateo Police Chief Ed Barberini lauded the program and clinicians who are embedded in departments, noting the mental health professionals have become a resource for officers. On average, clinicians respond to about 20 calls a month per department.

“We’re not here to advocate that the CWCRT Program is the end all and we’re not here to advocate that it’s better or worse than any other program. We just know that it’s made our department a better department and enhanced our level of service,” Barberini said.

The county Sheriff’s Office has its Psychiatric Emergency Response team, launched in 2015 also in collaboration with the Behavioral Health and Recovery Services Department as a co-response model. Sheriff Christina Corpus said she aims to expand the reach and availability of the program in part by hiring more PERT clinicians.

“PERT is not only meeting in our patrol actions but also in our wraparound follow-up actions, which we’re very well known for. Most of our success comes from working with our clients and their families,” PERT program director Lt. Mike Tabak said.

By the start of next year, the county is expected to have implemented a new Mobile Crisis Response program as part of a MediCal mandate by the state Department of Health Care Services. The program, funded largely by federal dollars, calls for enhancing an existing youth mobile crisis response into an all-age response model for anyone, anywhere in the county at all times.

A required single crisis hotline will be managed through Starvista’s crisis line that integrates the national crisis line, 988, that launched in 2022. Supervisors are expected to approve a contract with a service provider before March, a timeline that confused the electeds who noted the program must be implemented by Jan. 1, 2024.

The two-member mobile teams will include a behavioral health clinician and peer support specialist, both of whom will receive extended state-mandated training on how to respond to people from various backgrounds, will be tasked with providing face-to-face crisis assessments, de-escalating situations, recommending temporary holds and providing warm handoffs, providing referrals to ongoing community services, and conducting follow-ups.

Looking ahead, Supervisor David Canepa said he’d also be interested in considering a mental crisis urgent care facility. He also showed interest in learning more about a response model adopted in the county of Denver called the Support Team Assisted Response Program that was also presented on Tuesday. The model largely centralizes calls for services within the Denver 911, unlike models in San Mateo County that are divided by jurisdictions.

The county’s Behavioral Health Commission also proposed two recommendations of its own: for the county to develop a mental health integrated dispatch system with clinicians embedded in the dispatch department who can help resolve crises over the phone, and to launch a countywide unarmed mental health crisis response unit.

Chief of Health Louise Rogers also recommended the county focus on implementing the new MediCal Mobile Crisis Response program and developing stronger coordination between existing services before hiring a consultant to conduct further review of potential gaps. Corzo suggested staff return with an update in March on various programs.

“We’re doing a much better job trying to work together. … There’s more work to do, but, more and more, I think we’re getting some clarity of some of the gaps,” Dr. Jei Africa, Behavioral Health and Recovery Services Department director, said. “Over time, these programs were created depending on what was coming and what was needed so it’s really building from many entities. But I think now we’re a little more certain and clear of some of the partnerships that need to happen to make things more certain and seamless.