SLO County fails to provide adequate mental health services, Grand Jury finds

August 3, 2022

By KAREN VELIE

A resent Grand Jury investigation determined San Luis Obispo County has failed to create and maintain a safe, orderly, effective and efficient means for ensuring that people suffering from mental health issues receive the care they need, according to a July 26 report.

In SLO County, people on mental health holds are kept in local hospitals rather than mental health facilities, resulting in inadequate care for the mentally ill as the hospitals are not staffed with mental health professional. In addition, requiring hospital staff to oversee mentally ill patients reduces the quality of emergency care.

The Grand Jury also discovered that the county does not provide mental health services to juveniles or adults who do not fit the criteria for treatment at the County Psychiatric Health Facility. Most mentally ill patients are transported to out of county facilities.

About four years ago, the county contracted with a private company, Sierra Mental Wellness Group (SMWG), to operate a four-bed Crisis Support Unit, located near the Psychiatric Health Facility in San Luis Obispo. The facility is supposed to offer mental health care to those not under a mental health hold.

The contract initially required SMWG to provide a full-time registered nurse. SMWG, however, failed to meet the requirement.

The county amended the contract in 2021 to only require either a registered nurse, a psychiatric technician or other psychiatric service provider at the facility when clients are present.

Staff at the county Psychiatric Health Facility regularly ask staffers at the Crisis Support Unit to admit patients from their facility. On multiple occasion, SMWG staffers claimed they were at their four-patient capacity, even though they had no clients, according to surveillance cameras located in the facility.

“Unaware that any clients were in the Crisis Support Unit at that time, Psychiatric Health Facility staff checked the cameras and saw that the Crisis Support Unit was empty except for SMWG staff members,” according to the Grand Jury report. “When questioned about the situation, Crisis Support Unit staff responded by taping sheets of paper over the cameras, rendering them useless.”

The Grand Jury is asking the county to relieve the hospitals of the responsibility to warehouse mentally ill individuals by integrating and improving county services.

“SLO County should commit to creating a single, integrated and unified mental health services center that houses the Psychiatric Health Facility, the Crisis Support Unit, the Mental Health Evaluation Team, outpatient coordination, juvenile mental health services, and that includes a medical health triage and screening facility where all held persons, regardless of age, categorization or insurance status, can be medically cleared prior to placement in an appropriate section of the mental health facility.

Abiding by the recommendations will likely be difficult for the county, as it is currently working to further outsource and divide county mental health services. In June, SLO County administrators announced plans to outsource inpatient mental health services at the Psychiatric Health Facility to a private entity.

During the past decade, administrators at the Psychiatric Health Facility have been under fire for alleged mistreatment of the mentally ill. The allegation has led to a federal investigation and continuous turnover of staff.

The doctor in charge of the unit, the Behavioral Health Department’s Medical Director Daisey Ilano, is under investigation for her actions in the treatment and death of Andrew Holland.

Holland, a 36-year-old a mentally ill man, died in Jan. 2017 after jail guards left him strapped in a restraint chair, also known as the “Devil’s Chair,” for more than 46 hours.

The county mental health facility had refused to admit Holland. Ilano claimed at the time that the county facility was full and could not admit any inmates, while allegedly storing boxes in some patient rooms.

San Luis Obispo County officials are required by law to respond to the Grand Jury recommendations.


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After last month’s episode, The County of San Luis Obispo is busted for misappropriation of $millions in funds, this month our County has been deemed inconsiderate for it’s own mentally challenged. Certainly there will be other subjects exposed and it will be shame on us letting it happen. Yes, the paper trail leads back to the voters who get the government they deserve.


Since when is it the counties responsibility to care for these people?!? Ridiculous.


Why yes, I see your point. Because it was a far, far better system to just keep the mentally ill family members in the attic or the basement and pretend they no longer existed. Great thinking “unusualsuspect”! Let’s just go back to that!


Otherwise, they are doing just fine wandering the streets, yelling at the air and living in the bushes. Living like animals and accosting passers-by, starting fires. Don’t see what all the fuss is about. If a family can’t afford decent care with our current for very high profit health care system, so what? And if they have no family, then who cares? Well, obviously not you.


One of the most important markers of a civilization is how it cares for those most vulnerable. I am very glad you are not appointed to make those decisions.


Too many government handout IS the problem causing everything you just listed.


I have news for you Francesca. I worked for 19 years in the local “homeless services” field and I’m going to let you in ion a dirty little secret: The majority of those people you see “yelling at bushes” are not mentally ill, they’re on meth. Because addiction can’t be wrapped up in pretty paper with a bow on it like mental illness can, most local homeless service providers ignore the effects of substance abuse and excuse it away as mental illness so as to continue to attract donors. The real problem contributing to our nation’s homeless problem gets swept under the rug in favor of something that’s more attractive to the guilty rich who donate big bucks. You can take any meth addict or alcoholic in full blown delirium and sit them down in front of a Psychiatrist. Without a breathalyzer or blood test for drugs and alcohol, diagnosing the problem as mental illness looks just the same on paper. Yet the real problem never gets addressed.


ok so for the record the PHF that they are talking about is an acute care facility and only meant for someone who is actively suicidal for anywhere from 24 hours to 2 weeks. Definitely not any kind of solution to “get someone off the streets.”


not to mention that only a couple of counties in California have PHF facilities – which are regulated by the state.


I am sure the upper level management at the county is guilty of a lot of rotten things – but being held responsible for what happened to an INMATE in JAIL CUSTODY is certainly not one of those things. That being said, those people who did that should definitely be held responsible, inmate or not that was disgusting. Total George Floyd vibes. Just gross.


Doing a great job Sheriff Parkinson, and dont expect DA Dow to do anything about it.


No wonder Judy Vick suddenly “retired”. This story is going to get even more juicy as it unfolds…Thank you CalCoast News for covering this.