Universal Health Services is partnering with Valley Children’s Hospital in Madera County to build a 128-bed facility. Image via Valley Children's Hospital

As the Covid-19 curve is on the downturn, health officials can fix their eyes on what counties in the Central Valley are calling an epidemic: the mental health crisis.

In a California Health Care Foundation market study presentation on the San Joaquin Valley region, it reported that physician-to-population ratios are below the state average, and are some of the lowest in the state.

It reported 6.5 psychiatrists per 100,000 people in the San Joaquin Valley, while the State of California has significantly more — 11.8 per 100,000 people.

The presentation noted that Valley residents report higher rates of mental distress than the state average. The San Joaquin Valley’s suicide rate is 20% higher than the state average. The Valley also has a shortage of psychiatric inpatient beds.

And while Madera County is working to fix this issue, Dawan Utecht, director of behavioral health for the Fresno County Department of Public Health and panelist on the market study presentation, says there is still work to be done.

“Universal Health Services is partnering with Valley Children’s Hospital in Madera County to build a 128-bed facility,” Utecht said.

The facility is slated for a 2023 completion.  

Fresno County is not part of that agreement, but does see it as additional resources to help where the Valley is under-resourced. 

In Fresno County there are 16 adolescent inpatient beds and 16 adult inpatient beds.

“It’s full all the time,” she said. “But some of the people are in that setting because the downstream beds are not available as well. So I really want to highlight that we have to really increase capacity throughout the system of care, otherwise we get those bottlenecks in emergency departments in crisis stabilization units, as well as inpatient units.”

Utecht says the county is under-resourced — specifically with youth.

“It’s easy to focus on the increasing number of beds, but there’s also this downstream continuum of care in services that are also needed,” said Len Finocchio, lead author of the San Joaquin Valley regional market study for the California Health Care Foundation.

Psychiatric patients’ recovery depends on what’s “downstream,” Finocchio said.  

“Particularly for mild to moderate, as well as substance use disorders, we’ve really been rushing to keep up in terms of growing our delivery system,” Utecht said. “The way that behavioral health fits into the health care delivery system is very siloed and fragmented. And the system design is how we get our results.”

Fresno County is looking at ways the structure can improve so that outcomes for mental health can follow. 

At the Tulare County Health and Human Services Agency, Director Tim Lutz said 23 youth were hospitalized in February due to mental health crises.

That’s a 53% increase from February 2020. Of that 53%, 26% had never received behavioral health services. Lutz saw a 15% increase in adults, and of those 15%, 25% had never received behavioral health services.

Utecht said Fresno County is also looking to diversify the mental health care that is currently offered, as well as expand services in schools.

It looks to give mental health services to younger populations and encourage children to pursue mental health practices as a career.

“Workforce and our partnerships are super important as we move forward,” she said.

Lutz believes actives stressors include family, relationships, substance use disorders and housing issues.

“It runs the gamut. I think that reflects this behavioral health epidemic that we’re definitely going to be seeing more of as things continue,” Lutz said.