In Humboldt County, gaps in mental health care make treatment difficult
The rural Northern California community has its sights set on a new emergency mental health care facility to fill chronic gaps in resources.
Over the past 25 years, Arcata resident Lea Nagy has grown familiar with mental illness. Her youngest son is bipolar, and she has four grandchildren with serious mental illnesses.
“I’ve had lots of personal experiences,” she said. “Which, you know, you never want to be drafted into the mental health arena.”
As the president of the Humboldt County chapter of the National Alliance on Mental Illness (NAMI) and a county family liaison, she spent a busy recent day coordinating resources for families and attending meetings. By 4 p.m., she was just sitting down to eat lunch.
Nagy laughs easily and is quick to share the number for her cell phone, which is always on and goes off frequently, with families looking for help.
“People need what they need, you know, whether they need a place to listen or, you know, ideas about self care. I just think it’s important that they get a chance to not feel alone and so isolated,” she said.
This support is important in Humboldt County, where mental health services are severely lacking. Like many places, the county is dealing with the effects of the COVID pandemic and the opioid epidemic. But Humboldt is a rural county in far Northern California, removed from resources and funding. Its remote location exacerbates the challenges the region faces.
Now, the county’s Department of Health and Human Services and other partners are working on a possible solution: a proposed emergency mental health care facility in Arcata that would provide beds for patients to sober up, a crisis stabilization center and a substance use disorder residential treatment program, among other resources.
‘There’s still hope’
Nagy has degrees in child development and special education, and she spent 20 years teaching special education. But she stressed that “I’m not a therapist. I’m just a family member.”
“I got drafted into this stuff, and all I have here is life experience. That’s all I have,” she said, as she prepared to lead a weekly NAMI support group meeting in Eureka.
Twelve people gathered around a large wooden table in a conference room, with two others on Zoom. Most were the parents of children with mental illness. They took turns updating each other on how their kids were doing; some were doing well while others struggled.
Many parents discussed whether their children were taking their medications.
“I have a difficult time not asking him to go on his meds. He’s in a trench, and he won’t get out. He does not want to be on meds,” said Carol Green, talking about her son.
Others struggled with knowing how best to help a child who needed support.
“I don’t know how to get him help. I don’t know,” Liz Houghton, one of the co-facilitators of the group, said of her son. “Or we wait for crisis.”
“You got us! You got our group! We’ll help you through the hard parts,” Nagy said to one couple, who was navigating a transition with their son.
Michelle Norton’s son had been talking about suicide and taking a lot of the anaesthetic ketamine.
“Right now, my thing is accepting that he’s probably gonna die. I really really am having a hard time with that,” she said emotionally.
Another attendee, Gretchen Curtice, jumped in: “But I mean… There’s still hope.”
Maintaining hope is especially important in this group. One of their principles of support, passed around and recited aloud at the end of every meeting, is “we will never give up hope!”
But finding resources to help those who are struggling can be a real challenge.
Lack of infrastructure
In Humboldt County, “there’s not the infrastructure here to meet the needs,” according to Luke Brownfield, the county’s chief public defender.
Brownfield was born and raised in the county, so he’s familiar with its beautiful natural surroundings, its uniquely “awesome” people and its “different way of thinking.”
Mental illness is common among his department's clients.
“I would say our percentage would be at least 75 percent of our repeat offenders suffer from mental health histories,” he said.
Brownfield has often put clients through mental health diversion, wherein if someone can relate the crime they committed to a diagnosed mental illness, they can get treatment rather than jail time and eventually get the case dismissed. But he said there aren’t enough providers to fill that need.
This is also a problem for hospitals. In this rural county, there’s only one inpatient psychiatric hospital and a critical shortage of hospital beds.
Dr. James Goldberg, the medical director of two emergency departments in the county, said patients in need of psychiatric care take up crucial space in hospital beds.
“Just earlier this week, out of our 22 beds that we have here, we were actually holding 12 behavioral health patients,” he said.
Patients in crisis are frequently brought to a medical hospital, but they often don’t need medical care. The staff there don’t have the comprehensive training to help these patients, and they have sometimes been assaulted, Goldberg said.
“Unfortunately, like other communities, Humboldt County's been impacted by drug use and particularly with methamphetamine, which is really wreaking havoc,” said Paul Bugnacki, deputy director at the Humboldt County Department of Health and Human Services Behavioral Health Branch. “And there's an increase in need for psychiatric services and not a lot of beds available throughout the state.”
‘Trying to do the right thing’
To help address this problem, work continues on the proposed emergency mental health care facility. In February, project leaders applied for over $12 million in grant money from the state’s Behavioral Health Continuum Infrastructure Program, which is dedicated to behavioral health, and they’ll hear back on whether they received funding this spring. But even if they’re successful, the facility won’t be complete for at least two more years.
Brownfield is not a fan of the proposed facility because he sees it as another version of incarceration. Instead, he has been trying to start a mental health court in the county, which would provide individualized mental health treatment plans, and he'll test a version of that program this summer.
In a community this close-knit, the work is a personal mission for him.
“Being public defender, I often have pretty much all my old classmates coming through the courthouse, some of them being defendants, some of them being jurors, some of them being victims. You know everybody,” he said.
Despite the difficulties of the situation, Brownfield said client success stories happen frequently, and they make him appreciate his work even more. He’s glad to have recently seen more focus on mental health treatment in the community.
“Everybody’s trying to do the right thing. We’re all trying to figure it out,” he said. “I’m hopeful about the progress mostly because at least now it’s an issue that people are talking about and discussing.”
According to Darian Harris, chief executive of the two Providence hospitals in Humboldt County, attitudes are starting to change.
“There is a greater appreciation for the need to invest in mental and behavioral health,” he said, especially regarding health equity in “rural and remote communities like ours.”
In Eureka, Nagy’s support group ended, and people hung out and chatted for a while. The remnants of their conversation littered the table: water bottles, notebooks, a box of the opioid overdose reversal medicine Narcan.
Mental illness is tough to talk about and deal with, and Nagy has done both for decades. So she’s had to find ways to take care of herself.
“The best thing I ever did, I put in a hot tub in my backyard under a redwood tree. And every night I do a nice hot tub with spa music, you know, and I light candles. I have a little altar set up with Christ and Buddha and anything else I can find that seems, you know, uplifting,” she said.
What keeps her going, she said, is her desire to reduce stigma around mental illness and the hope that even if you can’t help your own kid, maybe you can help somebody else’s.