Plans for the county’s first youth crisis stabilization unit have been initiated following concerning spikes in mental health emergencies
VISALIA – Plans for Tulare County’s first crisis stabilization unit serving youth experiencing mental health emergencies have been set in motion, thanks to a grant awarded to the county’s Health and Human Services Agency.
The Tulare County Health and Human Services Agency (HHSA) was awarded a grant for $4,909,775.60 to partner with Kaweah Health for the creation of a child and adolescent crisis stabilization unit (CSU). The grant from California Health Facilities Financing Authority will allow Kaweah Health to build the county’s first 24-hour site for youth in crisis.
The CSU will provide around-the-clock crisis intervention services for children and youth under age 21. It will be a 12-bed unit with four private rooms for acutely agitated children and youth, severely mentally ill children and youth or very young children to separate them for safety. Services will include crisis evaluation, intervention and stabilization, as well as psychiatric services and discharge care. Care will be given regardless of insurance status or ability to pay.
Dr. Casie Ennis, the HHSA’s Division Manager for Behavioral Health Clinical Services, says the need for a CSU came from recent concerning trends in the mental health of Tulare County’s youth. These trends, she said, are in line with similar state and nation-wide patterns.
“Starting as early as 2018 and 2019, we’ve seen an increase in rates of crisis for our youth,” Ennis said. “We know that our young people are struggling. Also, we know that when somebody is experiencing a mental health crisis, meaning that they feel they’re not able to cope with or tolerate how they’re feeling, it’s due to some kind of mental health issue. And they could potentially be a danger to themselves in that way.”
Currently, there are no CSUs or even any psychiatric hospitals in Tulare County. People in need of mental health services during a crisis often need to either travel hours away to receive help or check themselves into an emergency room.
“Our emergency rooms are so important to respond to all critical issues about health. And we also know that they’re not really built to be that safe, quiet space that someone might need when they’re experiencing a mental health crisis,” Ennis said. “Kaweah Health has been interested in opening a unit like this for quite a while, and they have actual psychiatric residents that are available to rotate into a facility like this where they can ensure that youth who are in need of crisis stabilization have a safe place to do that, not necessarily in a busy emergency room.”
Ennis added that CSUs also work to prevent psychiatric hospitalization, which research shows can be traumatizing. Youth who seek services at the unit will be connected to resources that could ultimately keep them out of the hospital and on the road to healing.
Youth who are checked into the CSU will first be shown to a place where they can rest alongside somebody close to them. Then a clinician or psychiatric resident will conduct a clinical assessment before connecting them to whichever resources they deem appropriate. According to Ennis, crisis services are often people’s initial access point to receiving mental health services.
“We know that people are sometimes not coming to us as providers until they’re very ill. So if we have the right setup and we’re able to prevent hospitalization, we’re hoping that we can help our young people get on their feet, or quickly get them connected to the right resources and the appropriate outpatient care,” Ennis said.
Kaweah Health will staff this new venture thanks in part to its Graduate Medical Education Psychiatry Residency program, added in 2013, and a new Child and Adolescent fellowship added to the program in 2021. The Child and Adolescent Psychiatry Fellowship Training Program’s mission is to train child and adolescent psychiatrists who will positively impact the health of youth and their families in the Central Valley.
The CSU could pave the way for future improvements to all aspects of the county’s mental health crisis resources, Ennis said.
“I would say that this is needed for adults also in our county, and we are looking at doing that in a few different ways in the future. It’s just that this funding opportunity was for youth specifically,” Ennis said. “First we need to make sure that our crisis infrastructure is there. Per community, per county, we’re looking at how to build out what our specific needs are.”
The HHSA is doing this in part by hiring outside consultant Recovery International to review the county’s data on crisis encounters and provide recommendations on how to build out an infrastructure that supports individuals in need of emergency mental health services.
The HHSA and Kaweah Health are currently reviewing potential sites for the CSU. The grant funds will be accepted and executed with a grant agreement between Kaweah Health and the HHSA following approval from the Tulare County Board of Supervisors in the coming weeks.