Fairview Developmental Center was opened in 1959 to care for individuals with developmental disabilities. The initial bed capacity was for over 2,600 residents. At its peak in the 1960’s it housed over 2,700 people on a campus of over 750 acres. In 1979, most of that land was turned over to the City of Costa Mesa and a 36 hole golf course and housing were built.
Today, the Center covers 114 acres* with over 50 buildings including residential, medical treatment, an auditorium, training centers, offices and administration. There are now approximately 235 residents.
California’s developmental centers have been drawing down since the 1970’s. In May of 2015 Governor Brown proposed that Fairview be closed by 2021 and the residents placed in group homes.
But we have a much greater crisis at hand; the lack of mental health care and homeless care.
Orange County is in the midst of a mental health care crisis. Since 1995 we have lost over 65% of our acute mental health care beds. We have gone from over 1,200 beds to approximately 450 beds while the county population has grown by 35%. Orange County ranks last in California’s urban counties in beds per capita, and yet we live in one of the wealthiest places on earth. We are heading in the wrong direction. Our law enforcement has become the front line in mental health crisis while our emergency rooms are overwhelmed. These are the most expensive forms of treatment and do nothing to improve outcomes in the individual.
Half of the population will experience a mental health crisis in their lifetimes. This includes depression, anxiety and a range of other disorders. 6% of our population has an incapacitating mental illness that affects themselves or their loved ones. In Orange County that means 192,000 people. Most of those living with mental illness live at home and could benefit from recovery support services.
But mental illnesses in crisis are serious medical illnesses just like heart disease or cancer or diabetes. And when there is a crisis individuals need treatment and support immediately.
This often doesn’t happen for mental health emergencies. Because of the shortage of beds, patients often wait for 24-36 hours in the emergency room, sometimes under restraint, and then must be transported to a mental health care facility. Some hospitals have dedicated psychiatric units. Many do not.
Treatment itself is triage. Because there are not enough beds and because of cost pressures, diagnosis is swift. Medication is dispensed and the patient is released as quickly as possible, often to the streets or an unprepared family. The individual is at their weakest point and yet they are sent home with a prescription(s) and told to make an appointment with a psychiatrist. This often doesn’t happen. And so the revolving door is set in motion. And every time a crisis happens, the odds against recovery increase.
Many of our homeless have mental illness. Our jails and prisons are our largest and most expensive mental health warehouses. The sad fact is that treatment is scarce in jail and so the revolving door continues to spin.
We have to do better. In what other form of health care would we tolerate doing the same thing over and over again and expecting a different outcome? We have a tremendous opportunity sitting in front of us.
Fairview has a combination of facilities to house a game changing mental health center. It has residences. It has treatment centers. It has the administrative and therapeutic facilities to support psychiatrists, therapists, counselors, case workers, services, and training.
It doesn’t have to be big to make a difference. What it does have to do is to offer whole person, wraparound care from evaluation to treatment to recovery. By also incorporating a residence for low risk offenders with mental illnesses we can get people off the streets and on up on their feet.
There are many stakeholders. Our hospitals and mental health care facilities, our first responders, our doctors and nurses, our churches, our communities, our government and most important, our families all play important parts in caring for the most vulnerable members of our society. We need to do better.
When our psychiatric hospitals were closed in the 1960’s and 70’s we were promised community based mental health care. That promise has yet to be kept. It is the dirty secret of our current crisis.
We can reduce the cost of care, reduce the stress on our safety net, and improve outcomes for individuals in crisis. We can offer hope and a hand up. We can save lives. The people of Orange County can lead the way towards more compassionate, more effective solutions in mental health care and all of the issues related to this medical condition that has caused so much pain and heartbreak in our community.
Matt Holzmann, Chair – Government Relations, National Alliance on Mental Illness – Orange County Affiliate
Opinions expressed in editorials belong to the authors and not Voice of OC.
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