Nevada County Behavioral Health. Crisis, Access, and Linkage Services. Welfare & Institutions Code Section 5150 et al.

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1 Nevada County Behavioral Health Crisis, Access, and Linkage Services Welfare & Institutions Code Section 5150 et al.

2 Darryl Quinn, PhD Program Manager Adult Services Nevada County Behavioral Health Joy Nocerino Director Insight Respite Center

3 Nevada County Behavioral Health Adult System of Care Contract/In House Therapy for BH Clients Conservatorship s with Public Guardian Access Team Receives referrals and intake calls Crisis Services 5150 Assessment Inpatient Insight Respite Center Crisis Stabilization Unit Peer Support Psychiatrist/ Nursing Services Vocational Training/SSI Linkage Peer Counseling Training Navigator Link NonBH Individuals to Other Services Adult System of Care Case Management Drug and Alcohol Services Referral/ Assessment/ Linkage Turning Point Assertive Community Treatment AOT Catherine Lane Housing Programs Odyssey/ Supportive Independent Living Mental Health Court/Forensic Liaison/AB 109 Therapist Healthy Outcome Integration Team (HOIT) 3

4 Involuntary Hospitalization Welfare and Institution Code 5150! Who qualifies?! Danger to self suicidal! Danger to others homicidal! Gravely disabled due to mental illness unable to provide for food, clothing, shelter! Where do 5150 assessments happen?! Mostly at the Emergency Department of local hospitals where Crisis Workers are available 24 hours to see anyone in the community! NCBH Clinics! Wayne Brown Correctional Facility or Juvenile Hall 4

5 Involuntary Hospitalization 5150! NCBH Crisis Line! (530) ! 24 hours, daily for anyone in the community! Clients, family, and others can call if worried about someone who may be in an mental health crisis.! Supportive Phone Counseling! Referrals for NonCrisis Services at BH and other agencies 5

6 Other Crisis Services: Respite Insight Respite Center» An adult may have a home but needs respite to handle an escalating mental health problem (e.g., psychosis, depression, anxiety, suicidal thoughts)» Home environment, staffed 24 x 7 with peer supporters» May stay up to 2 weeks» Medically stable and able to do chores» Negative on drug/alcohol screen» For info contact BH access line ( ) or Respite staff directly at » Does not have to be client of BH or Turning Point» Services are free. 6

7 Insight Respite Center

8 Insight Respite Center

9 Insight Respite Center

10 Insight Respite Center

11 Other Crisis Services: Insight Respite Center " Guests are free to come and go as they see fit " Wellness Recovery Action Plan (WRAP), and a Strength Assessment " Seasonal outdoor group activities Yoga, Guided meditation, Gardening " Follow-up phone calls at 2 weeks and 2 months from Peers and 24/7 warm line for former guests " Regular alumni lunch dates " Clients can be self referred or by others, including Crisis Stabilization Unit (CSU), Emergency Department, psychiatric hospital, and family/friends. " 50% reduction in psych hospitalizations post stay for those who had a previous hospitalization in past 6 mos 11

12 Other Crisis Services: CSU Crisis Stabilization Unit (CSU)» Located next to ED at Sierra Nevada Memorial Hospital» Paid for by MediCal or slighting based» Adults, 18 years and older only» Entry occurs via the Emergency Dept.» For information call Crisis Line» Stays are up to 23 hours, 59 minutes» Clients sometimes transfer while on involuntary hold (aka 5150)» Medication Services, Nursing, Therapy, and Linkage to other services 12

13 Other Services! Access/Intake Services! ! 24 hours via Phone! Business Hours for Walk-ins! Screening for BH Services! Referrals for Services in the Community! Arrange Intake Assessments! Meet State criteria or Medical Necessity.» Has a Mental Health Diagnosis» Severely disabled in Work, Social, Self-Care or Other functioning, or Danger to Self/Other! Mild/Moderate Individuals Referred to Managed Care Plans 13

14 Other Services! Linkage Services! New Navigator Position! Brendan Phillips, ! Helps Individuals Navigate/Link Services» Jail Visits/Law Enforcement Ride Along» Hospital/ED Contacts» Hospitality House» Manage Care Plans for Primary care, Psychiatry, and Therapy» Drug Treatment in Residential Facilities, CORR, Common Goals, and Other Services 14

15 Other Services! Behavioral Health Services! Psychiatry/Nursing! Psychotherapy-In House or Limited Network! Drug and Alcohol Services» Referral, and Linkage to Residential! Limited Housing (SIL: Supportive Independent Living)! Odyssey House-24 Hr Residential Facility! Turning Point Assertive Community Treatment» Laura Law/AOT! BH Case Management/Service Coordination 15

16 Other Services! Behavioral Health Services (Continued)! Peer Counseling Training! Vocational Training (Snack Shack)! Case Manage/Service Coordination! Mental Health Court! Conservatorship! Healthy Outcome Integration Team (HOIT)! SSI Linkage for BH Clients! Patient Rights Advocate 16

17 Misdo Competency Process Defendant is likely incompetent on Misdo Is the defendant in court and the doubt is declared? yes 1368 and 1370 Hearings, eval by BH for 1368 and treatment plan at 1370 hearing, 90 days one follow hearing on progress. No No Is the case being dropped based on time served? yes BH does Preliminary Assessment for 5150, Involuntary Hospitalization by PD contacting Darryl Quinn, via , which can happen in jail PD can refer client based on treatment recommendations and/or refer to BH Forensic Liaison, Brendan Phillips Resolve the legal Case if competent or drop the charges BH evaluates the defendant. Does the client meet 5150 criteria? Grave Disability? No If defendant agrees, BH completes report and recommendations for treatment and sends to PD and DA yes Is the client competent? BH places in a inpatient facility, and use of involuntary meds if necessary to staibilize 17

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