I understand that Behavioral Health now has limited room for subjects who need to be taken in the facility. According to that agency, the facility in San Diego has shut its doors, so there is no longer anywhere for the local Behavioral Health to transport individuals. Police and local hospitals can only medically clear the subjects, then they are to be transported to Behavioral Health. The staff there states that if and when they are full, they will refuse any subject, even if they are a threat to themselves. Some subjects can be a threat to others as well. Are these subjects going to be released into the communities? What are people who have loved ones in that situation to do? — Worried, Imperial County

There are aspects of this question that are true, and there are aspects that are not. We spoke at length with Imperial County Behavioral Health Director Michael Horn about the issue.

The hospital in San Diego where most of Imperial County’s transported patients go, Promise Hospital, did close, and there was a period of time between the middle of December and the middle of January where placement was frantic.

But, Horn said, the county always found a bed for the people who needed it. Now, he said, things are slowing down and partnerships and agreements are going in place with different facilities so this will not happen again.

Horn explained that when Promise Hospital closed, that immediately took away 100 beds meant for psychiatric placements, with only 12 remaining.

He said the change was sudden, and took San Diego County officials by surprise, too.

What’s more, it happened during the holidays, and the calls for evaluation by law enforcement skyrocketed.

With Promise Hospital being the destination for 75 percent of all of the county’s psychiatric hospitalizations, Horn said Behavioral Health is now forced to have contracts with many smaller facilities spread among San Diego County, Orange County and Riverside County.

During that monthlong period, mental health saw a 25 percent surge in referrals from that same period the previous year, Horn estimates, adding on top of that the changes at Promise.

Basically, he said, it was a frantic month in which his people at the crisis desk were working the phones, trying to find beds all over Southern California.

At one point, Horn said, mental health warned law enforcement agencies that the county might not be able to accept any more mental health referrals. “But it never got to that point,” he said.

In California, law enforcement officials can place anyone on a 72-hour mental health hold for their own safety to be taken to a designated facility for mental health patients.

Imperial County used to have an agreement with Pioneers Memorial Hospital, where a portion of those beds were for that purpose. That agreement ended 25 years ago, and since then, Imperial County Behavioral Health has acted as the intervening agency that evaluates and refers those 72-hour holds to the hospital to determine release with follow-through plans or transport for hospitalization.

Promise’s changes threw a wrench into those works.

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