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New Crisis Stabilization Unit opens today at SNMH

In recent years, the emergency department at Dignity Health Sierra Nevada Memorial Hospital (SNMH) — like other ERs around the country — has seen a marked increase in the number of patients arriving in need of mental health services.

While physicians and behavioral health crisis workers work to meet their immediate needs, those patients requiring more advanced psychiatric treatment must often wait in the ER while the appropriate level treatment facility is identified.

“Unfortunately, there simply are not enough resources for these patients, and as a result many are unable to be discharged for extended periods until a psychiatric bed becomes available,” said Dr. Brian Evans, VP, Chief Medical Officer at the hospital.



In response to this growing community need, SNMH and Nevada County Behavioral Health have worked closely together for the past two years to help create a new crisis stabilization unit at SNMH, which opens today.

The goal of the Nevada County Crisis Stabilization Unit (CSU), located just outside the SNMH Emergency Department, is to provide emergency psychiatric care and a soothing environment for those in a behavioral health crisis.




The 4-bed CSU acts as an intermediary treatment facility, giving more in-depth care to patients while determining if they need to be transferred to a psychiatric hospital or if they will respond well to local outpatient intervention services.

Unlike the emergency department’s bright lights and hum of activity, the CSU is designed to be a restful place for those in crisis. Interior rooms are painted in blues and greens, with comfortable areas for family members to wait.

“The CSU will provide an environment conducive for healing. Patients will receive expert care in a safe environment while waiting for an inpatient psychiatric facility to become available,” said Evans.

A high level of support will be available for each client, according to Director of Nevada County Behavioral Health Rebecca Slade, MFT. The CSU staff includes a full-time psychiatrist, psychiatric nurse or technician and other crisis workers.

Funding for the CSU came through a grant from the California Health Facilities Financing Authority (CHFFA), and was made possible through Senate Bill 82, the Investment in Mental Health Wellness Act. The bill passed in 2013 with the help of former state Senate President Pro Tem Darrell Steinberg. CHFFA helps administer grants and distribute monies to counties based on grant requests.

“We applied and we were blessed to receive two different grants,” said Slade.

The first grant made it possible for the hospital to add crisis workers in the emergency department 24 hours a day, seven days a week. The second grant provided for the bricks and mortar portion of the CSU program, paying for the physical building and everything inside it necessary to run the facility, Slade continued. The CSU is owned and operated by Nevada County.

The idea behind SB 82 was to provide for behavioral health services at an earlier stage of psychiatric care need.

“The goal is to keep people in their own communities and out of the psychiatric hospitals,” said Slade.

The number of available psychiatric beds in California has declined significantly. From 1995 to 2011 (the most recent year numbers are available) California lost 3,000 psychiatric beds, 32 percent of the total in 1995. In the same time period, 44 psychiatric facilities in the state closed — a 24 percent decrease.

There are currently no psychiatric hospitals in Nevada County. The closest, according to Slade, is in Placer County and is often full. This means that some Nevada County patients have been sent as far away as Riverside, which can be difficult for families who don’t have the financial means to travel or to stay away from home for an extended length of time.

It is also difficult for patients who are away from their support systems during a vulnerable time in their lives.

The CSU can provide patients up to 23 hours of intensive treatment. In this time, patients are assessed for the best level of treatment. They may be found able to return home and provided with an appointment to visit a psychiatrist within 36 hours. Other options include licensed residential respite facilities that allow a short break away from the stresses of life.

The challenge of providing behavioral health care to our community is ongoing, according to Evans.

“Providing proper psychiatric care for our more vulnerable members of the community has enormous benefits for all of us. I believe we will all need to continue focusing on improving care for these patients, and additional resources and investment will be necessary,” he said.

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.


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