Publisher’s note: This is one of several stories about mental health issues in the Lake Tahoe Basin that will be running through October. The other stories may be accessed from the Home page under Special Projects, then click on Mental Health.
By Linda Fine Conaboy
Living at beautiful Lake Tahoe and the lake’s surrounding areas, where some of the most dazzling scenery in the world is always accessible, should contribute to a stress-free existence not to mention a well-balanced, mentally fit and happy population, right?
Partially right. It appears that living in stunning surroundings does not necessarily guarantee a cure for what ails us. And to compound that, there is a great divide when it comes to serving people with mental illness as opposed to those who have a physical ailment such as a sore throat, although physical and mental health cannot truly be separated.
Medical care for folks with mental health needs within the Tahoe basin, it seems, has long been on the decline, at least in the area of study that included South Lake Tahoe, El Dorado, Douglas, Washoe and Placer counties. However, new and concerned people have recently relocated to the basin, recognized the situation and are doing their best to rectify it.
Caring people like Jeanne Nelson and her husband, Alan, who are Family to Family instructors for the El Dorado County branch of the National Alliance on Mental Illness or NAMI, the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness, are two of the bright spots, doing their best to bring the situation to light.
“Primary care physicians must incorporate mental health screening into their standard of care,” said Jeanne Nelson, adding that “families need to openly discuss mental health in the same manner as going to the dentist.
“Preventative care and sharing family histories of addiction and mental health issues are a must to help encourage early intervention. Stigma prevents people from seeking help; it also makes individuals feel they can get better on their own.”
Although providers exist, knowing how to navigate through the system can be daunting. Many people, Nelson said, drive long distances to Sacramento, Roseville or Reno for treatment, because in-patient services simply do not exist within the basin.
She added, this is what comes with living in a beautiful, rural area, a sentiment put forth by nearly everyone who talked to Lake Tahoe News about the state of mental health at Tahoe and environs.
Sgt. Michael Seligsohn, coordinating supervisor with the El Dorado County Sheriff’s Office Crisis Intervention Team lamented that we are definitely facing a mental health care crisis in California and nationwide. He also echoed Nelson’s statement that living in a rural area can have drawbacks.
The CIT is a group of deputies assigned to the patrol division who are specially trained to recognize and understand mental illness and brain disorders. They are familiar with the resources available to support individuals in need and they are also trained to understand the impact on families.
“Acute psych beds are few and far between,” Seligsohn told Lake Tahoe News. “Mental health clinics that are available have very restrictive policies about whom they may treat based on diagnosis and insurance. Those with multiple problems, such as a psychiatric diagnosis, drug or alcohol issues and/or traumatic brain injury, may fall through the cracks in the system as the issues that they have are not all treated by the same clinician or even in the same clinical setting.
“To a real degree, the geographic isolation of the Tahoe basin from major metropolitan areas exacerbates the problem. As an example,” he said, “the nearest in-patient psych facilities are in Placerville and Reno. One receiving treatment in either of these communities is a long way from home and support. Once separated from these facilities, follow-up with the treating psychiatrist may be difficult for some, and impossible for one of limited means.”
Seligsohn was upbeat as he described some of the services available at El Dorado County Mental Health including the Outpatient Clinic, and the Wellness Center and Intensive Case Management.
The same services exist on the West Slope of El Dorado County. In addition, in Placerville there’s the Telecare El Dorado Psychiatric Health Facility, a 24/7 community-based, locked intensive inpatient psychiatric treatment program for individuals 18 and older who experience an acute mental health crisis.
“A key factor,” Seligsohn said, “is to understand that while there are beds, they are few. As an example, if detained in South Lake Tahoe on a 5150 (involuntary psychiatric hold), you can be confined to a location in California. It is not unheard of for patients to sit for days or weeks in a non-psychiatric setting, not receiving acute psych care, while waiting for a bed. On many occasions, beds have been found in the San Francisco Bay Area or even further.”
Seligsohn said that surprisingly, he is not aware of a facility that can provide psychiatric as well as medical care (wound treatment for example), concurrently. He added that the El Dorado County Sheriff’s Office is committed to the idea that people ought not to be incarcerated for symptoms of mental illness.
Unfortunately, mental illness does not confine itself to only adults—it plays no favorites when it comes to age.
Cheyanne Lane is the supportive services Coordinator for Tahoe Youth & Family Services, which includes a drop-in center and a street outreach program providing services to runaway, homeless, street, couch surfing and high-risk youth up to age 24. This facility is in South Lake Tahoe at 1021 Fremont Ave.
In addition, clientele can be aged-out foster kids, those from dysfunctional homes (where the streets are actually safer), youth with mental health issues and/or substance abuse problems, LBGT youth, parenting youth and simply those who have fallen through the cracks, a term used as a catchall within the mental health community.
“We provide a full continuum of services that include emergency shelter, 24-hour crisis line, case management, individual and family counseling, food, clothing, showers, laundry and other survival items,” she told Lake Tahoe News.
Additionally, Lane said her organization aims to improve youngsters’ safety, well-being, self-sufficiency and permanent connections to caring adults while maximizing their potential to become productive citizens of the community.
“We conduct weekly outreach to our schools, street outreach to local youth hangouts, post flyers and we are on social media,” Lane said.
In Truckee, Tahoe Forest Hospital serves a wide population and annually updates a list of local behavioral and mental health providers. This directory can be found by accessing the hospital’s website, scrolling down to Quick Links then clicking on Mental Health Crisis Information.
In Placer and Nevada counties, Phebe Bell, the program manager for county Health and Human Services said part of her department’s activities revolve around providing mental health services to people on Medi-Cal.
“I think we are effectively serving the people who meet these criteria. We provide therapy, psychiatry and case management as needed to people who need our services. The challenge comes for people who don’t meet those criteria,” Bell said.
Bell agreed with Sgt. Seligsohn, saying in general, people in rural communities struggle with mental health issues in some specific ways. “There is more stigma in rural areas about mental illness and about asking for help,” she said. “Because our population base is small, we don’t have as wide an array of services as are available in urban areas.”
She added that like many resort communities, “We tend to have high levels of substance abuse, which can be closely connected to mental illness. I am not sure I would say we have a mental health crisis, but I do believe that we can do more as a community to support the mental health of all of our residents.”
Bell said that when Placer and Nevada counties survey the community about health issues that concern them, mental health always ranks at the top of the list. “I think we continue to have room to improve. From reducing stigma around mental illness to improving comprehensive services for everyone, we have plenty of work to do.”
Nelson said nationally there is a 50 percent deficit in psychiatrists, but at South Lake Tahoe, this problem is no longer a problem.
“The government recommends that a population of 32,000 have one psychiatrist,” she said. “The Lake Tahoe Basin has three, although there are none in Douglas County, but you can use Telepsychiatry if you’re chronic or severely disabled.” Telepsychiatry can be accessed at Barton Community Health Center. Barton’s main phone number is 530.541.3420.
Nelson commented that there is a striking difference in mental health services between Douglas County and the Lake Tahoe Basin. “Nevada has a long way to go in education, access and stigma,” she said.
As an example, Nelson pointed to the new and innovative kiosks to be found around South Lake Tahoe, crammed full of information about mental health. Each kiosk highlights local mental health services and educational materials printed in both English and Spanish.
They are at:
· Barton Community Health Center Lobby – 2201 South Ave.
· Barton Family Medicine lobby – 1090 Third St.
· Barton Memorial Hospital’s Emergency Department – 2170 South Ave.
· El Dorado County Probation and Sheriff’s offices — 360 Johnson Blvd.
· Lake Tahoe Community College in the Commons Area – 1 College Way
· South Lake Tahoe Library – 1000 Rufus Allen Road.
The burgeoning mental health situation at Lake Tahoe is in actuality one which many communities face. The area has dedicated people who are aware of the problem, who are trained in the field and who are determined to reign it in.
As Christopher Croft, the executive director of Tahoe Youth & Family Services puts it, “We’re seeing more and more of the area service providers and community members collaborate to address the issues … now, we’re all attempting to work together to figure out care programs for community members.”