Nearly two years after Santa Fe County commissioners approved a gross receipts tax increase that would, in part, fund behavioral health care, the county has released an expansive five-year plan for addressing a wide range of mental health-related needs in the community.

The document, which officials say is largely a “framework,” doesn’t specify how much money will be needed to reach various goals, when services would be implemented or how many county residents would benefit.

Instead, the report says the county aims to lead an effort in partnership with the city of Santa Fe, the state and tribal governments, and private providers and funders to fill gaps in mental and behavioral health services — which government officials and advocates increasingly cite as key solutions to an array of problems in a community wrangling with high levels of poverty and drug use.

“One key informant asserted that we do not really have a delivery system,” the report says, “but rather we have uncoordinated, scattered and disjointed services.”

A county official, however, said progress has been made, in part because the county has been willing to invest resources in solving the issue.

Rachel O’Connor, director of the county’s Community Services Department, said, “The county has really invested in the area of behavioral health.”

With a roughly $2.5 million annual budget, she said, the county has launched 10 behavioral health initiatives in recent years, including treatment for pregnant women using opioids and securing funds for an opioid crisis center.

Now, O’Connor said, “We are really looking more to coordinating the effort and putting together a group” of leaders.

The new Behavioral Health Strategic Plan, released late last month, cites several top priorities for the county moving forward: suicide prevention, mental health services for children and teens, adult treatment and recovery services, and even affordable housing.

In the last decade, according to the report, rent in Santa Fe has increased 65 percent while income has remained stagnant, making it more difficult for people struggling with behavioral health issues to find safe and stable housing.

The county also has a severe shortage of psychiatric services — just eight inpatient beds for adults and none for children — the report says, adding the county also lacks intensive home-based treatment for children and youth. While Christus St. Vincent Regional Medical Center is considering an expansion of beds for psychiatric patients, the report says, it has no plans for adolescent beds. The Presbyterian Santa Fe Medical Center is not planning any inpatient psychiatric services, according to the report.

The plan proposes a new Youth Services Division within the Community Services Department and more rigorous prevention education in local public schools; an effort to increase child screenings for adverse childhood experiences — traumatic incidents known among advocates as ACEs; and more home visiting programs for parents with new babies.

When it comes to addressing the needs of adults, a new behavioral health crisis triage center, set to open in 2020 in Santa Fe on Galisteo Street, is a milestone in the effort, the report says — but is no way a “cure all.”

Much of the county’s current funding for the center is revenue from a gross receipts tax imposed in 2017 by the County Commission. The tax — roughly an eighth of a cent for each dollar spent — was expected to generate about $4.6 million a year for county public health and safety services, including $1.5 million annually for the center.

The expansion of an existing mobile crisis response team also is an essential part of the effort to address mental health needs countywide, the report says. The team joins law enforcement officers in responding to emergencies involving people experiencing mental health crises, with goals of deescalating a situation, providing counseling to the patient and connecting the patient with treatment and aid. The result: fewer patients ending up in hospital emergency rooms.

So far, the county has just one team, which was dispatched 266 times in its first year, 2016, the report says.

Before any new initiatives are launched, the behavioral health plans says, the county must first establish formal agreements with other local governments and providers.

One such provider is New Mexico Solutions, a nonprofit that has a contract with the county to establish the behavioral health crisis center.

David Ley, executive director of New Mexico Solutions, touted the county’s new behavioral health plan.

“I am certainly excited about it and supportive of it,” Ley said. “The county has been really, really open to soliciting ideas, input, feedback on ways we can assist the community in meeting some of the unmet behavioral health needs.”

Sylvia Barela, CEO of the nonprofit Santa Fe Recovery Center, said the plan was light on specific drug abuse recovery goals but created a framework for partners, like the recovery center, to help develop a cohesive system of services.

“They are strong supporter of our services,” Barela said of the county, “and we feel definitely like a partner in working toward collaboration. … One of the great things about the plan is it strives to build that and build those services.”

Reporter

Rebecca Moss has covered the environment and Los Alamos National Laboratory for the Santa Fe New Mexican since j2015. In 2018, she was selected to participate in the ProPublica Local Reporting Network.