Dawan Utecht poses for a photo with supervisors Tuesday.

Fresno County’s Behavioral Health Department Director Dawan Utecht presented an update on on her department Tuesday and urged the Fresno County Board of Supervisors to support long term solutions as she departs. 

Her presentation included pleas to fix a system where state and local governments make segmented decisions surrounding behavioral health, creating a cycle of failed attempts to make lasting change. 

Under Utecht, the department implemented the Affordable Care Act. It also implemented the Drug Medi-Cal Organized Delivery System, which helped provide better services for substance use disorder. The department also opened a 16-bed adolescent psychiatric facility during her time at the county. 

“When I stood before this board eight and a half years ago that was one of my stated goals, and I’m happy to say we got that done pretty quickly – the only one in the Central California region for over a decade,” Utecht said. 

Pivoting to telehealth services during the pandemic was also a feat accomplished under Utecht’s leadership. 

“As you often hear, systems yield the outcomes they were designed to produce. And government-designed health care is no exception. There’s a long history of all levels of government tasked with resolving complex problems like homelessness, caring for children in the foster system or health care delivery to underserved populations,” she said. 

Solving problems, she said, requires consistency, collaboration and multi-year commitment. It also requires a thorough analysis of the root causes of issues.

“However the one-year legislative budget cycle does not lend itself to this approach. As a result, we often end up with siloed systems, disjointed solutions and what I call noble causes driven by magical thinking where legislators attempt to resolve the most difficult problems with simplistic or unrealistic solutions,” she said. 

Worst case scenario, the department is forced to compete for grants to provide vital services, Utecht said in her statement to the board of supervisors. 

Her concern surrounds how the department is funded – the Behavioral Health Department receives none of the county’s general fund. 

Staffing shortages also top the list of concerns. Pre-pandemic, we were already experiencing shortages with the Central Valley having the lowest qualified behavioral health staff per capita than any other region of the state including for psychiatrists, licensed clinical social workers and marriage family therapists, substance use disorder specialists and mental health nurses, she said. 

“Since the pandemic we’ve seen burnout, retirements and relocations, and even behavioral health professionals leaving the health care field altogether to pursue work in other fields,” Utecht said. 

The staffing shortages are threatening the ability to care for the community, but there also needs to be a pipeline for the up and coming workforce. 

Supervisor Nathan Magsig remarked on Utecht’s passion for her position, and acknowledged her efforts to treat the root cause rather than symptoms of the community’s health care needs.

“There’s many things that government can’t solve, yet someone in Sacramento thinks it’s a good idea to introduce a bill and maybe have funding for one or two years. And then if anything they’ve exacerbated the problem – they haven’t really gotten at the root cause,” Magsig said. 

“You’ve left the department in a great position to continue to move forward and provide all the great services that Fresno County desperately needs,” said Supervisor Sal Quintero.

Susan Holt has been appointed as the Interim Director of the Department of Behavioral Health, effective Dec. 6.