>>Ventura County extends number of days involuntary mental health holds can last

In a move key psychiatrists call long overdue, a Ventura County board has expanded the options for involuntary hospitalization of severely mentally ill patients in keeping with other large counties in the state.

The Board of Supervisors authorized the change unanimously last week, permitting certain psychiatric units to petition the courts for up to 60 additional days of treatment beyond the initial limit of 17 days set in state law.

The decision follows what psychiatrists said was a lack of action on requests dating back almost 20 years. They had earlier focused on a longtime option allowing up to 30 days of additional hospitalization but the period has now been extended to up to 60 days if warranted under legislation that took effect in January.

Doctors say 17 days is often too short to assess, treat and plan for patient discharge, resulting in the cycling of severely people from hospitals to the streets to jail and back.

“Sometimes the symptoms take far longer to treat,” said Dr. Joseph Vlaskovits, a strong advocate of the extended treatment who has worked with severely ill patients for more than a decade.

The supervisors’ vote allows Ventura County Medical Center and the private Vista del Mar Hospital to petition the courts for the additional treatment in locked facilities for patients deemed “gravely disabled” due to mental illness.

Virtually all have profound symptoms of psychosis, severe clinical depression or catatonia that impair them from meeting basic personal needs for food, clothing or shelter and lack outside assistance to provide it, county officials said. Patients may remain hospitalized only for as long as they remain “gravely disabled,” in the extensions requiring court approval, officials said.

It’s not clear exactly what prompted the delay in Ventura County, but the most common explanations are fears over patients’ loss of personal liberties and concerns over whether hospitals had the capacity to handle the increased demand for care.

To activate the option for longer treatment, county boards of supervisors must pass resolutions stating that any additional costs will be covered by new funding and/or by redirecting existing funds, but that no mental health services will be reduced as a result of the expansion. The board took that step Feb. 28 after managers said they expected that the policy would reduce costs for institutional placements and curb the need to place patients under conservators.

No members of the public stepped forward to oppose or support the measure last week when Behavioral Health Director Scott Gilman briefly presented the idea to the board, nor did supervisors discuss it in depth. It took a little over a minute for supervisors to hear Gilman and approve a resolution allowing the expansion, an unusual show of unanimity for issues involving compulsory mental health care. Gilman tied the quick vote to the fact that he had provided an in-depth explanation in documents that went to the board.

Ventura County has been an outlier, according to a letter that Gilman and county Health Care Agency Director Barry Zimmerman sent to the board.

The 30-day option has been implemented for years throughout the state, most notably in Santa Barbara and Los Angeles counties, the administrators said.

Gilman acted quickly after taking over last summer as the new director of the county Behavioral Health Department, bringing the measure to supervisors in six months.

Vlaskovits and Dr. Jason Cooper, medical director of the county’s Hillmont psychiatric inpatient unit, said they asked Gilman to move on the idea shortly after he arrived. The county Behavioral Health Advisory Board, which recommends how mental health needs should be met, and the county chapter of the National Alliance on Mental Illness also are in support.

“Honestly, I don’t know why it wasn’t used before,” Gilman said.

Two years ago, the advisory board had placed the 30-day option for extended treatment at the top of a list of recommendations. But it never reached the Board of Supervisors for a vote amid multiple changes in county management and the COVID-19 pandemic.

Gilman predicted the expansion will allow for more efficient use of the 43-bed Hillmont unit at Ventura County Medical Center because patients won’t be released too soon.

“They are not stable, and we have to readmit them,” he said.

Gilman said he expected around one patient a week to be held for the extended care and that the change would take effect immediately.

Kathleen Wilson covers Ventura County courts, crime and government issues. Reach her at [email protected] or 805-437-0271.

This article originally appeared on Ventura County Star: Involuntary mental health treatment extended under board action