To expand access and services for mental health care in the Tri-Valley, the Pleasanton City Council unanimously approved using city funds for a regional mental health pilot program on Tuesday.
"A mental health crisis, a first break happens like such a lightning bolt -- you don't expect it, you don't understand it, and you certainly haven't prepared for it," Vice Mayor Julie Testa said before voting. "This is so vital. So, so important. And I'm very grateful that our city has played a role in taking the lead on this."
Pleasanton, along with the cities of Dublin and Livermore, will pay $321,495 for project budget year one costs to launch a pilot program providing urgent care services to Tri-Valley residents experiencing a mental health crisis.
According to city staff, all community members, "regardless of income or insurance status," could access the program, which would be managed by Axis Community Health, the local nonprofit that approached local city leaders and other stakeholders about the idea in October.
Each city would pay a third of the program's total, though staff said a $250,000 grant expected from Alameda County Behavioral Health would "dramatically decrease the fair share contribution for each of the cities."
During Tuesday's discussion, Testa commended the program's low barrier to access, noting "having private insurance can actually be a barrier to getting the help that your loved one needs" and that some programs are not available to people with insurance.
"They think we're saying if they don't have insurance, we're still going to be able to help them -- it's really the opposite," Testa said. "Even if they do have private insurance, we're going to be able to get that process started, and that's enormous in the Tri-Valley."
Testa added, "People really don't understand that, because it's counterintuitive, definitely."
Local need for mental health services has grown substantially in the past decade and been pushed further during the COVID-19 pandemic, but "there is not enough capacity to meet the demand" and "the systems are complex and difficult to maneuver, especially in a crisis," city officials said in their staff report to the council.
Patients -- especially those not already receiving care -- often wait weeks to see a mental health professional. Insured patients are often faced with "a confusing array of options for services," while uninsured patients have limited choices and experience delays in receiving care.
The pilot program would have same-day appointments available for individuals with urgent mental health needs. Services will be provided via telehealth during the pandemic, but staff said a walk-in access point is part of long-term plans.
Eventually, the center would "serve as a central entry point for assessment, triage, treatment, and care coordination for anyone seeking mental health treatment."
"Like a medical urgent care setting, Axis Mental Health Urgent Care Center will provide assessment and timely connection to services in a setting that is less costly than an emergency department," staff added.
Patients will be assessed to determine whether their condition is mild to moderate, moderate, or severe when they arrive. Staff anticipate most patients that use the center "will be treatable at the site and/or via telehealth services," but a small percentage (about 5%) will require medication and be referred to higher levels of care.
Assessments for patients presenting with suicidal thinking will also be available, and staff will "de escalate and avert 5150s when possible." Staff also said Axis' behavioral health providers "are experienced at intervening when suicidal thoughts are presented, and most often, following careful assessment and development of a safety plan, a 5150 can be avoided."
Councilmember Valerie Arkin said the need for such a program "is very great in our community," and asked if there will be "any limit to any one person accessing a certain amount of services."
Sue Compton, CEO of Axis Community Health, said people could make use of program services "within reason."
"We're looking at this as an intermediate service, so possibly maybe five sessions until we can get them situated. This is not a long-term solution," Compton said.
Arkin then asked, "If somebody in the community was worried about somebody, could they call and could there be some outreach to somebody that is in crisis, that may not realize they are or not want to seek help -- is there any mechanism?"
Compton replied the idea is "definitely something that we will be exploring," then adding, "HIPPA and those can of things always get in the way, but I think it's something we can be exploring as part of this. I'm sure we'll get those types of calls as well."
"This is something I've always advocated strongly for, so thank you so much for bringing this to our community to help our residents," Arkin said.
In addition to potentially funding the mental health urgent care pilot program, the city is currently funding $70,000 for a two-year agreement with Axis to provide behavioral health services for local youths, ages 12 to 18.