MENDO’S NEW MENTAL HEALTH SYSTEM
by Malcolm Macdonald
In August, the California State Auditor’s office issued a performance review on the Mental Health Services Act. Its summary stated: “Providing effective services and treatment for those who suffer from mental illness or who are at risk of mental illness is an issue of great statewide and national importance. Recent statistics by the US Department of Health indicate that approximately 11 million US adults, or 4.8% of the population, had serious mental illnesses in 2009. Critical incidents, such as the school shooting in Sandy Hook, point to the seriousness of these issues. Over time California has attempted to serve its mentally ill population through a variety of services and programs, and in 2004 the voters approved Proposition 63, the Mental Health Services Act (MHSA), to expand on these services and to use innovative methods more likely to identify, mitigate, and treat mental illness. The MHSA stresses that mental illnesses are extremely common, affecting almost every family in California, and that failure to provide timely treatment can destroy individuals and families.”
The first 32 years of my life were affected by mental illness; the mental illness of my late sister, Muriel. In another sense I got a bird’s-eye view of mental health care in California and this county in particular because my mother was a psychiatric social worker, employed first at Mendocino State Hospital in Talmage, then out of downtown Ukiah offices that serviced Mendocino County, and by the time of her retirement a small handful of psychiatrists and psychiatric social workers were responsible for all the mental health cases in both Mendocino and Lake Counties. In the 1960s dozens of psychiatric doctors and social workers were employed at Mendocino State Hospital. Proposition 63 would have been unnecessary if the state government had not gutted mental health services under Governor Reagan.
As of this summer, Mendocino County’s system of mental health care for adults has been placed in the hands of a private company, Ortner Management Group (OMG). The entire state of North Carolina privatized its mental health care system in 2001. A recent comprehensive study of that effort found: “The quality of care that North Carolinians with mental illness have received has declined while allegations of fraud and waste have increased.”
The proof will be in the pudding. Here is one local case study, in progress: William is in his early 30s. He suffers from schizoaffective disorder (a condition that causes a loss of contact with reality [psychosis] and mood problems). William’s mother, Carole, states that William has threatened suicide many times, including specific locales and methods. William has leapt onto roadways in front of oncoming traffic. He has been picked up by law enforcement at least half a dozen times. Carole is at her wit’s end with William. He can no longer return to her home.
During the first week of August, Carole went to the county mental health office in Fort Bragg to try to get crisis care for William. She was told that they didn’t perform that service anymore. She was given an 800 number to call.
Carole called the 800 number and spoke to a woman named Sarah who asked, “Is he currently a threat to self?”
Carole responded, “He always is.”
Sarah said that William needed to call her. Carole got him to do so. Sarah took William’s number and told him that she would have someone call him back. The day went on with no call back.
Carole went to the Fort Bragg Police Department, asking Chief Mayberry to take her son to the Emergency Room the next time he got picked up. She told the chief that William was suicidal and needed professional help.
The next day Carole called the 800 number again. Sarah told her that a referral would be sent to a crisis worker. Apparently the crisis worker was in a meeting most of the day because neither Carole nor her son received a call back.
Another day later, Carole called the crisis line number and spoke to a different woman, Stephanie, who asked if William was in crisis. Once again Carole replied, “He always is.”
Carole also wanted to know why the crisis worker had not returned her call. Stephanie responded that the crisis worker had a lot of referrals on her desk and that the crisis worker returned calls in the order they came in.
A week after making her initial call Carole was told by a Mendocino County employee that they had lost all record of her calls (those described above) to the Mental Health Crisis Line. Fortunately, Carole had documented the calls.
Carole does not take such obfuscations lying down. She sent out an August 12st email, decrying the lost records, to her supervisor and Tom Pinizzotto, director of Mendocino County Mental Health. Carole also sent copies of the email to Jim Shaw, the chair of the Mendocino County Mental Health Board, as well as most of the members of that board, Mendocino County Sheriff Tom Allman, Fort Bragg Police Chief Scott Mayberry, and the National Alliance on Mental Illness (NAMI).
By this time Ortner Management Group was fully in the saddle as the purveyors of mental health service in Mendocino County. At the August 21st County Mental Health Board meeting, chaired by Jim Shaw, an Ortner representative said there was no multiplicity of phone numbers to call, that the Mendocino Coast Crisis Line number was still 707-964-4747.
As of September 4, if someone in crisis can navigate the County of Mendocino web pages through the Health and Human Services home page to the Behavioral Health & Recovery Services page, bold print tells you that the Crisis Line is 800-555-5906. Scrolling down the page brings you to more specific crisis lines for Ukiah, Willits and Fort Bragg (which is 964-4747). Nowhere on the page does the name Ortner Management Group or OMG appear.
It seems that there is something of a rift within the Mendocino County Health Board. Near the end of the August 21st meeting, Chair Jim Shaw made a statement to the effect that the Mental Health Board serves the Board of Supervisors. Board member Dina Ortiz, a licensed clinical social worker (LCSW), demurred, “I thought we work for the people.”
Board member John Wetzler then read the Board’s “mission statement” aloud, “To be committed to consumers, their families and the delivery of quality care with the goals of recovery, human dignity, and the opportunity for individuals to meet their full potential.”
Wetzler added, “Doesn’t say anything about the Board of Supes.”
Chairman Shaw squirmed a bit as did Tom Pinizzotto, who is essentially in charge of mental health services for the county. Pinizzotto squirmed some more a few minutes later when the public comment section of the meeting brought to the surface the letter written by NAMI member Sonya Nesch; a letter directed to the Board of Supervisors, but with tough questions concerning the Supes awarding the adult mental health services privatization contract to Mr. Pinizzotto’s former employer, Ortner Management Group, instead of Optum Health, which Nesch describes as more qualified and more experienced in mental health care services. Nesch’s letter also asked why the Board of Supervisors has not required a medical provider license for the last five county mental health directors. Nesch raised more than a dozen questions, one of them directly pertinent to the earliest stages of William and his mother Carole’s dilemma. The question: “Why does Fort Bragg Mental Health turn people away and say we don’t do crisis here — call this 800 number?”
William was arrested again in August. The Fort Bragg Police did honor Carole’s request, taking William to the Emergency Room at Mendocino Coast District Hospital. Within a couple of hours, William was assessed in the the Emergency Room by Lisa Burtis, a licensed marriage and family therapist (MFT). By that night William was being driven to Ortner owned North Valley Behavioral Health in Yuba City, the same place Supervisor Dan Hamburg’s adult son was transferred to, presumably with far less advocacy required on the part of the family.
After a few days, North Valley wanted to ship William to the Ford Street Project in Ukiah. Carole objected, primarily on the grounds that Ford Street provides help for the homeless and would not be able to give William the professional psychiatric care he needs. The best case scenario for William right now would be for him to be legally “conserved” within a locked facility with truly professional psychiatric care on a daily basis that might help him get on the road to recovery.
Instead of the Ford Street Project, William was sent to the Redwood Creek care facility in Willits. Redwood Creek was recently purchased by Ortner Management Group. At present it still maintains several elderly residents under its previous incarnation as a board and care unit.
So what you have now is mental health patients like William being warehoused at Redwood Creek along with the elderly residents who cannot be removed because they are literally grandfathered in by law.
There really is very little professional psychiatric care for William at Redwood Creek in Willits either. And what’s to keep him from walking away? Nothing. He did just that late last week, arriving at Carole’s house Thursday night. Friday morning she drove him back to Willits, but the situation isn’t much better than it was when Carole first started documenting those “lost” phone calls to Mendocino County’s mental health system.
(Author’s note: William and Carole’s real names have been changed to protect their privacy and anonymity.) ¥¥
EARLY WINTER? According to the Farmer's Almanac, “Winter will be much rainier and cooler than normal, with mountain snowfall much greater than normal. Most of the rain, snow, and storminess will come in January and February, when storm damage will be a concern.” And Tom Stienstra remembers, “The craziest prediction I ever heard was years ago on KGO, where John Hamilton asked a rep from Dodge Ridge if he thought there was going to be a big winter for skiing. “Absolutely, a lot of snow coming,” he said. “I’ve seen the squirrels playing with their nuts.”
WHY DO THEY CALL YOU…?
By ‘Chili Bill’ Eichinger
There’s not a month that goes by that someone doesn’t ask me, “Why do they call you Chili Bill?” I feel the time has come to answer this question in a simple, straightforward manner to calm the turbulence in these perplexed minds. Said explanation will be put to paper and handed out upon inquiry, a la the method of the one-time owner of the renowned Horse-Cow Tavern in Vallejo, California, who grew weary of explaining what happened to the miniature submarine on the roof of his establishment.
In my early days as a cook in a small restaurant in The Cannery shopping mall at Fisherman’s Wharf, I was asked to make chili as part of the daily menu. Well, I knew what I liked from my youth in the Midwest: a bowl of spicy ground beef with about 1/8th inch of grease floating on the top. Add a couple of tablespoons of white vinegar and a handful of oyster crackers, stir it together and voila, 35¢ worth of heaven. I knew this cow wouldn’t fly with the boss, a native Californian and professional tight ass with the money. Beans would be prominently featured and the consistency would have to be a little soupier to maximize profit.
I dug around for recipes and stumbled upon an article in Esquire Magazine by the “World’s Greatest Chili Cook” — some mysterious person whom I suspect was either Calvin Trillin or Roy Andries deGroot, who both occasionally wrote articles about food. The recipe called for a number of odd spices, including woodruff, which is used to flavor German May wine. It also required freezing before serving; this caused me to wonder if perhaps this person had his head stuck someplace where it’s hard to breathe. I went ahead and fixed a batch according to directions and felt like the butt of a bad joke. I finally told the boss that for the sake of time — and money — we should just buy commercial chili in big #10 cans and maybe jazz it up a little with some spices. That way I could spend more time and energy on important things, like macaroni salad.
Now this doesn’t mean I gave up entirely on the idea of creating an edible “bowl of red,” as Texans like to call it. No sir. I went to work for the next ten or fifteen years trying to get it right, and I’d like to think that’s been accomplished.
During the Great Trial and Error Years, the chili cook-off phenomenon occurred. This began with the legendary Terlingua Texas World Championship Chili Cook-Off. Some marketing geniuses, including Carroll Shelby, of Shelby Cobra fame, decided that since so many people were coming from California to this obscure little town, why not just have a championship in California? The International Chili Society was formed with Budweiser as its official sponsor. Suddenly cook-offs were being held in every nook and cranny of California, Nevada and the hinterlands. These functions were all structured to be non-profit affairs with proceeds going to charity. The public purchased any number of small paper tasting cups, like the ones restaurants use for jelly. Since there were upward of 30 teams per competition and those cups went for 25¢ or more apiece, the charities usually did okay. How much of Budweiser’s money found its way into the pockets of the Chili Society is anybody’s guess, but I figure it was a tidy little sum.
In the mid-70s, myself and some beer-swilling buddies from Yellow Cab decided to form our own chili team which went under various appellations like Chili Bill and the San Francisco Pepperheads, Missouri Mule Kick-Ass Chili and Hell Bent For Chili, the last and favorite of all. We had our own little matching team T-shirts and a beautiful hand-painted banner that was hung above our table. About twice a month we’d pack up and head off for some exotic place like Newcastle, California or Fish Camp, near Yosemite. Most cook-offs were held on Sunday, so that the participants could get there on Saturday and get all tore up and be hung over badly the next day. At least that’s the way it seemed to me — just one big party. Our favorite town was Auburn, California, and we always stayed at the historic and slightly seedy Auburn Hotel, right on the main drag of Old Auburn. One advantage was that they had a room that would sleep four guys comfortably. And they had a balcony where we could suffer through the hot night with a couple of cases of beer while we planned our strategy for the following day.
“Steve, why don’t you chop the onions tomorrow?”
“Oh, man, I chopped the onions last time. The girls don’t go for the guy that chops the onions.”
“Okay, you wanna open the cans?”
“Yeah, that’s cool.”
Once these little details were sorted out we could sit back and watch the young people cruising endlessly up and down the boulevard in their pickup trucks and street rods. No matter how hard we tried, we could never get a carload of sweet things to come up to the balcony and help us drink all that beer, which meant that we had to drink it all. Which meant that we were always in great shape to handle sharp knives, hot pots and open flames in the AM. None of these cook-off organizers knew the meaning of the word “shade” either, so we were given the opportunity to sweat off all those suds in the noonday sun. Not a pretty sight.
The schedule went something like this: at 11am the signal was given for cooking to begin. From then on the teams had three hours to complete their pot of chili, which had to be at least three gallons when finished. At 2pm someone would come around and collect a quart of chili in a Styrofoam cup with your team’s number on the bottom. These were taken to a secret meeting room to be judged, which usually took about an hour. In the meantime, the public could sample chilis at will, using a clean paper cup for each sample. (Remember all those quarters). They were also allowed to vote for their own personal favorite. This proved interesting at times when the People’s Favorite wasn’t one of the three winners of the competition. It would be a bone of contention in the Rift That Was To Come.
The awards were divided into numerous categories. Besides 1st, 2nd and 3rd place in the taste division, there were trophies and prizes for Best Looking Booth, Furthest Traveled to Compete, Best Costumes, etc. In order to go to the World Championship, one had to win 1st place in any category at a Regional Cook-Off, not just any little Podunk City affair. As time went on, it became apparent that not everyone with a great pot of chili could win the Big Shebang. The winners always seemed to be teams with lots of husbands and wives in their 40s and 50s, who worked for some corporation. I personally tasted every chili at every cook-off and I can tell you there were some winning concoctions that I wouldn’t feed to a mad dog. I’m proud to say that we won a couple of 2nd Place trophies and even a popcorn pumper!
After a while the thrill started to wear off. The Chili Society had its own version of The Man With No Eyes (watch Cool Hand Luke to refresh your memory) in the person of one Joe Stewart. I don’t know if Joe had anything better to do, because he was at every single cook-off we ever attended, strolling around in his cowboy hat and aviator glasses, scrutinizing everyone, like he was going to spot a would-be Travis Bickle at any moment. (And if you don’t know who Travis Bickle is, get professional help.) If he enjoyed his work, he never let it show; smile was not in his vocabulary. I’ve always felt that he had some hand in deciding the winners (as in “don’t let those fags from Frisco win.”)
We were at our second visit to Newcastle when another wedge was driven home. The team next to us, Shotgun Willie Chili, had been sharing lively banter and Tequila for most of the day. On our way to the car, I saw one of the members and yelled, “See ya next time!” He turned angrily and said, “Ain’t gonna be a next time!” When I asked why, he explained that he’d managed somehow to get into the judges’ room unnoticed, and that he’d seen them set aside almost two thirds of the samples unopened. And then “that Stewart feller” saw him and ran him out. When Mr. Happy was confronted about what was going on, his answer was “none of your business.”
During the year following our exit from the cook-off circuit, a number of other regular participants apparently decided they had had enough of the International Chili Society’s way of doing things, so they formed their own group, the Chili Appreciation Society Incorporated. The Championship would once again be held in Terlingua, Texas, and the participants would be chosen on a “points” basis. This meant that you could qualify with a minimum of points, acquired in any number of categories, at all the cook-offs you attended. A 1st Place here, a 2nd place there; Best Booth in Reno, Furthest Traveled in Keokuk — it would all be lumped together. A much fairer system, I thought, and if I’d had the wherewithal to muster up another team, I might have had a go at it. But the old Coleman stove had been laid to rest, and rust, in the garage, and I had other ways of spending my leisure time.
I still look back at this segment in time with fond memories and thankfulness for lessons learned, as in Rule Number One of Chili Preparation: Chopping Hot Peppers And Handling Your Genitals Do Not Mix! Rule Number Two: The Beer Must Be Very, Very Cold, And There Must Be LOTS OF IT! And those special moments, such as the legendary Twenty-One Second Fart, which may or may not be recounted elsewhere; the sudden discovery that, hey, we’re out of propane here; or the Marine World Cook-Off where I turned to find myself facing a very large tiger on a very flimsy leash; and of course the time that we set a few empty dog food cans on our table next to the rest of the ingredients. Talk about excitement! Hoo boy, it just doesn’t get any better! ¥¥
YOU’RE INVITED to join a walking tour of water saving secrets, sponsored by the UCCE Mendocino County Inland Master Gardeners. Ukiah neighbors will share their tips and techniques for having a beautiful yard with a lower water bill. View and learn about legal grey water systems, drip irrigation, mulching, and water thrifty plants. You can grow herbs, fruit trees, flowers, and vegetables using less water. Meet Saturday, September 21, 9 am at the Ukiah United Methodist Church parking lot, on Bush and Standley. The tour will last until 11:30, covers about 1.5 miles, and will also end at the Methodist Church. This event is co-sponsored by the City of Ukiah Water Utility. Contact Louisa 707-485-1290 for more information.