Ventura County, most others delay launching mental health changes

Ventura County will delay expanding the conditions under which someone can be treated involuntarily for mental illness because more groundwork needs to be laid, the Board of Supervisors has decided.

The county is one of perhaps 45 in the state holding off on implementation of Senate Bill 43, which makes it easier to find that patients are "gravely disabled." Individuals with the designation can be treated against their will for up to two and a half months or placed under conservatorships of a year or more.

Passed without dissent in the Legislature and signed by Gov. Gavin Newsom in October, the law goes into effect Jan. 1. But the legislation allows counties to delay implementation until January 2026. Ventura County supervisors exercised that option at their Tuesday board meeting but plan to revisit the situation every six months to see if it can be done earlier.

Board Chairman Matt LaVere said he wanted to see the changes launched as soon as possible.

"I think for years people who truly are gravely disabled have not been able to receive care because the definition was so restrictive," he said. "I fully support the expansion of this definition, but I also understand the amount of unknowns. What I would like to see is that as soon as we get the level of definition and understanding from the state to move forward that we jump on it."

Under current law, an individual is gravely disabled if unable to provide for their personal needs for food, clothing or shelter due to a mental disorder. Critics argue that is such a high bar that many people who would benefit from hospitalization fail to get necessary care and spiral deeper into mental illness.

The new law adds the inability to provide for personal safety or necessary medical care. It also applies to many more people — not just those with psychiatric illness but severe substance-use disorders and a combination of the two conditions.

Ventura County's health care chief, Barry Zimmerman, told the board an array of policies and procedures needs to be put in place before the county starts implementing the new law. Training of medical staff and first responders should also be done, he said.

“There are big hurdles,” he said.

One question that's been raised is where the larger population of patients would go for treatment.

Ventura County has had a recognized shortage of inpatient psychiatric beds for years. Then two months ago, the options shrunk when county officials suspended the ability of private Vista del Mar Hospital in Ventura to admit involuntary patients because of serious deficiencies in patient care. That left the 43-bed Hillmont unit at Ventura County Medical Center that is almost always full as the only local option.

Nor did health care officials know how the new population of substance-use patients would receive treatment on an involuntary basis.

Zimmerman told the board he knew of no facility in the county that offers that type of care.

“I don’t really think there is an effective facility in the state of California,” he said.

In a letter to LaVere, a hospital trade association official said counties lack the capability to provide involuntary treatment for substance-use disorders.

"Such a model of care does not even exist in the state," said Audra Strickland, regional vice president of the Hospital Association of Southern California. "New programs, training, education, and processes must be created to serve this population newly eligible for involuntary detention."

Kathleen Wilson covers crime, courts and local government issues for the Ventura County Star. Reach her at kathleen.wilson@vcstar.com or 805-437-0271.

This article originally appeared on Ventura County Star: Ventura County delays launch of mental health changes