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Keeping mentally ill in treatment an elusive goal

Record - 9/9/2017

Sept. 09--STOCKTON -- Judge Richard Vlavianos sees it far too often: disturbed individuals who go through a revolving door of mental health services only to be arrested and placed back in jail.

It's a complicated issue that must be resolved to end a vicious cycle, Vlavianos says. A recent case involving a woman with severe mental and substance abuse problems epitomizes the problem, says the judge.

The woman is not alone. Other clients with mental problems have endured similar situations, said Vlavianos, who voiced his concerns in court Friday to two San Joaquin County Behavioral Health Services representatives who testified.

"How we can work about making sure clients stay engaged (in services)?" Vlavianos asked. "I want to learn how we can work to improve it."

Appearing before Vlavanios was a 51-year-old woman who was represented by attorney Archie Barkerink. A separate case involving a 31-year-old man also was discussed.

Barkerink requested The Record withhold the name of the woman, who was admitted to the San Joaquin Recovery House in French Camp twice in the past 120 days.

According to James Sooy, substance abuse services program manager with BHS, the woman was transferred to a crisis center in July after she was found outside the women's dorm covered in mud and with blood on her face.

"She told staff she was trying to dig a bone out of her nose," Sooy said. "Staff felt at that time we needed to get her to (the) crisis center."

But the woman refused to go into the crisis center and walked away. Law enforcement found her three days later in a parking lot in Stockton and a mobile crisis team designated her a "5150" -- a danger to herself and others. She was placed in an involuntary mental-health hold of up to 72 hours, said mental health services deputy manager Kathy Hannah.

Since Aug. 16, the woman has been booked into the San Joaquin County Jail. Why would BHS staff have allowed her to simply walk away in the first place?

"That was her choice," Sooy said. "When we determine someone is in need of crisis services, we don't take people over there to dump them off. We take them over there to get services. We're not going to bring them back into the program if they refuse the treatment that we feel they need."

In the case of the 31-year-old man, aggressive behavior had made it impossible to allow him to continue to stay at the recovery house, Sooy said.

He would threaten and steal from clients and staff, believed he was the late musician James Brown, and thought his food was poisoned. Released because he said he was going to stay at his aunt's or sister's house, he has not been seen or heard from since early August.

"This particular client is extremely delusional," Sooy said.

Earlier this year, San Joaquin County was awarded a $6 million grant from the CaliforniaBoard of State and Community Corrections to increase mental health and substance abuse services. The funding includes money to open a treatment center in the county.

The county's project, Homeward Bound, was one of 23 chosen statewide.

Funding for the grants came from Proposition 47, a voter initiative that reduced certain crimes from felonies to misdemeanors and redirected money saved by incarcerating fewer people for use in rehabilitation programs.

Sooy and Hannah said they are aware of the need to ensure that those who require mental health services get treatment. But there are several obstacles, including a limited number of beds. What would really help, Sooy said, is another large influx of cash.

"There needs to be a step up from crisis residential that's a little bit stronger that is for people that have the personality disorders, aggressive behaviors, not wanting treatment but being forced to treatment and be able to hold them there," Hannah said. "We have to follow the law; we can only hold them for so long."

Vlavianos said he understands BHS is under-resourced and wants to further discuss possible solutions.

"Our problem is everything is in a silo as opposed to working as an integrated system," he said as he looked at the woman seated before him, shackled and wearing an orange jumpsuit. "I see you as the face of a broken system."

Then, the woman spoke:

"I trust you, your Honor, I like you and I want to be successful," the woman told Vlavianos. "I feel like you want me to be successful and I'm not sure if other people do -- but I'm sure you do."

Contact reporter Nicholas Filipas at (209) 546-8257 or nfilipas@recordnet.com. Follow him on recordnet.com/filipasblog or on Twitter @nicholasfilipas.

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