Troubling gaps in Napa County mental health care - Napa Valley (CA) Register

By Gayle Whitlock and Lawrence Swaim
August 29, 2008

It is no secret that the Napa County mental health system has trouble hiring and retaining staff psychiatrists. As the higher ups, we will be pleased to tell you that is mainly because of changes in funding — the money isn’t there. But it’s not enough to acknowledge that things are bad financially. In such situations, dedicated people should search relentlessly for innovative ways to compensates for economic limitations.

New ways must be tried, fine-tuning them afterwards as needed.
One possible way is to form a med consortium composed of nurses, case managers and psych techs that can meet regularly to do a med review for clients. They’d review the med stories of the clients, interview them, get feedback from residential treatment teams and then arrive at recommendations regarding meds. They’d communicate those recommendations to the staff psychiatrists who’d have the option of seeing the client or continuing to prescribe the meds in place, based on the recommendations of the med consortium.

Many variations of this scenario are reportedly already in use, particularly those in agencies with a public health orientation. The med consortium idea has been used in hospital-affiliated mental health programs and community-based clinics. They can function as screening panels for domestic violence, substance abuse, children at risk and high-risk behavior generally. Staff psychiatrists could see patients whenever necessary but if a med regime is working there may not be any need to do so. Clearly the Napa County Mental Health system has got to do something and this approach deserves consideration.
Sadly, lack of staff psychiatrists isn’t the only problem adversely affecting the mentally ill in Napa County. Because of demographic changes, more Latinos are beginning to come into residential treatment in Napa and many of them feel more comfortable talking to Latino counselors than Anglo ones. It isn’t enough for some staff to speak Spanish. A counselor needs to be both bilingual and bicultural for the necessary therapeutic bond to be established.

It is an astonishing reality that in the two main residential programs in Napa County, where the present writers work, there are no bilingual, bicultural counselors. When will Progress Foundation, who administers these programs, launch a hiring campaign for Latino staff? Are they trying hard enough to find qualified candidates?
The mental health system is strapped for money. Many say that is the proximate cause for the problems we’ve discussed. Lack of money is no excuse for not striving to create innovative approaches aimed at providing adequate services. And while more poor people coming into the system necessitate more thoughtful programs, race isn’t a reliable indicator of socioeconomic status, and it would be un-American and illegal to use it in that manner.

Just like anyone else, Latino families should have access to professional and timely mental health services.

(Whitlock is a counselor at Progress Place. Swaim is the SEIU shop steward at Bella House.)쇓