News

When a teen is in a mental health crisis, what's working -- and what isn't

Local medical system at odds with sudden demand for psychiatric services

Sarah Gentile was shocked to find, in the midst of a crisis with her teenage son, that there are no hospital beds available in Santa Clara County for adolescents who need inpatient psychiatric care.

They were in the emergency room at El Camino Hospital in Mountain View just before the start of the school year. Earlier, her son's psychiatrist had called to tell her that her son, who has lived with depression since he was 8 years old, had a suicide plan and needed to be hospitalized for a medication change. He was placed under what is referred to as a "5150," a 72-hour involuntary psychiatric hold for individuals believed to be a danger either to themselves or to others.

At the ER, a psychiatrist told Gentile that they needed to start the hours-long process of transferring her son to an available inpatient bed at another hospital.

"I said, 'What do you mean? He can't stay here?'" Gentile recalled. "They said, 'No, we don't have an adolescent facility here.'"

Her next, immediate thought: Let's take him to Stanford Hospital. But the Stanford School of Medicine's Department of Psychiatry and Behavioral Sciences, which boasts comprehensive outpatient psychiatric clinics for patients of all ages, also offers no inpatient care for adolescents.

Other patients and families who live in Palo Alto or surrounding cities have reported being similarly surprised to learn that a teenager in psychiatric crisis who is taken to a local emergency room will be transported away from renowned medical centers like Stanford or El Camino for hospitalization.

The closest hospital with adolescent inpatient beds is Mills-Peninsula Health Services in San Mateo, where Gentile's son stayed for 10 days. Beyond that, in the Bay Area, there is St. Mary's Medical Center in San Francisco, Fremont Hospital in Fremont and Alta Bates Medical Center in Berkeley. There are 648 total beds in California available for child and adolescent inpatient psychiatric care, compared to 5,522 for adults. (Click here to see a map of beds available in the Bay Area.)

The lack of inpatient adolescent psychiatric services is likely shocking to a community like Palo Alto that is not only reeling from several teen deaths by suicide this year but is also home to acclaimed medical facilities like Stanford Hospital and Lucile Packard Children's Hospital Stanford. (Read: Why so few hospital beds for teens?)

As of last week, 19 students at Paly and 31 at Gunn had been hospitalized for psychiatric episodes this school year, with more students on both schools' at-risk "watch lists," according to the schools' principals. Inpatient psychiatric services for adolescents, a sub-section of the medical system that has been shaped by typically low demand compared to other populations, is suddenly at odds with these numbers in Palo Alto.

Teenagers who are sent away from Palo Alto for more serious inpatient treatment are impacted not only during their hospitalization but also in the most critical time afterward. Some mental health professionals say the physical distance creates a disjointed system of care that can put the onus for follow-up support on families, schools or community-based organizations that may not be prepared or equipped to treat the youth.

The 5150

When individuals are placed under a 5150 hold — which can only be done by police officers, designated professionals who provide psychiatric crisis-intervention services or other mental health workers authorized by their county — they are taken to the closest emergency room.

For Palo Alto teenagers, that is typically the Stanford Health Care Emergency Department, where they are evaluated by an emergency medical team and then by the child and adolescent psychiatry team when a consultation is requested. The attending physician and fellow, both specialists in emergency medicine, collaborate with psychiatry staff to determine whether hospitalization is required for that patient, explained Samantha Dorman, media relations manager for Stanford Children's Health and Lucile Packard.

If hospitalization isn't necessary, the team creates discharge and follow-up plans. If hospitalization is needed, a transfer team locates the nearest available bed in a psychiatric unit in the Bay Area. This often takes several hours; Sarah Gentile's son waited for six hours before his transfer and Manon Piernot, a current Gunn High School junior who was hospitalized twice this year after seeking emergency psychiatric care at Stanford, five hours.

Both Manon and Gentile's son were transferred to Mills-Peninsula in San Mateo, which has 17 beds available for adolescent psychiatric patients.

Gentile said she was not allowed to drive her son to San Mateo while he was under the 5150 hold — this is a typical policy to protect both the patient's safety and the hospital's liability — so her family footed the $3,000 ambulance bill.

Another current Palo Alto student who wishes to remain anonymous described her transfer from Stanford to St. Mary's in San Francisco as traumatic — "an experience that harmed more than it helped me."

"I have never experienced anything more dehumanizing than being strapped onto a stretcher and driven for 45 minutes in an ambulance up to the city, surrounded by two bored EMTs who obviously thought there were much better things to be doing with their time," the student said. "I didn't blame them. I felt terribly guilty taking up room in the hospital I was originally put in in Palo Alto, and the feeling only worsened when it became apparent that finding room for 'another 5150' made me into more of an annoyance to the medical community than anything else."

Gentile said she felt a similar stigma attached to the process.

"You feel like you're being sent away, and your child is being sent away," she said. "If you really want to reduce the stigma (around mental health), you need to have the county you're living in at least support that level of service."

Getting to San Mateo for twice-daily required visits was also stressful and time consuming for her family, Gentile said. Inpatient units typically offer limited windows of time for visiting. Mills' visiting hours are noon to 1 p.m. and 7 to 8 p.m. on weekdays and noon to 2 p.m. and 6:30 to 8 p.m. on weekends.

Like Gentile, Manon and her parents were surprised to find out she could not access inpatient services at Stanford when she first went to the emergency department in December. But she has a different take on the transfer: She actually found the distance from her familiar, stressful world in Palo Alto incredibly helpful.

"I just wanted to go somewhere that wasn't Gunn," she said.

She also developed close friendships with other teens who were at Mills during her second hospital stay; they're still in touch.

For Manon, hospitalization — anywhere — made a life-saving difference.

"If I hadn't gone to the hospital I don't think I'd be here today," Manon said.

Roni Gillenson, program director for the nonprofit Adolescent Counseling Services (ACS), which has counselors at Palo Alto schools, said it does make a difference where a teen is hospitalized, as the hospital is responsible for connecting a patient with resources and follow-up support in the local community.

Gillenson offered the example of a former Gunn student about whom counselors were concerned but who was reluctant to seek care. When the student finally went in to talk to ACS — "clearly in need of a 5150" hold, Gillenson said — it was just one week after she had turned 18. As a legal adult, she was hospitalized at Stanford.

"If it was a week earlier, it wouldn't have been that smooth," Gillenson said. "(It made) a huge difference because all the resources are here. The community is here. It's not like they had to have her wait and find a bed and ship her off somewhere.

"That's where it gets really disjointed because after they're in the hospital, ideally, what the hospital is supposed to do is connect them with local resources. Well, if they're in Fremont or in San Francisco, even in San Mateo, it makes it a little more difficult to make sure that that continuity of care gets done."

Maria Daehler, a child and adolescent psychiatrist with a private practice in Palo Alto, said far-away hospitalization is also challenging when medical treatments for mental illness take weeks to have an impact.

"We don't have immediate treatment that works within a day or two in order to stabilize these kids," she said.

Facilities don't always provide the length of stay that a patient needs, Daehler said, and the distance can make it harder for families to be as involved in their son's or daughter's treatment. A page in Mills' "Adolescent Inpatient Program Orientation Handbook" stresses that parental participation in "therapeutic structured visits, family meetings, and psycho-education" is critical.

Gillenson said there is often inconsistent communication between Palo Alto schools and the hospitals, and students can receive insufficient discharge plans. If a teen mentions that school offers mental health services on campus, the hospital staff might write that into the follow-up plan without talking to someone at the school to make sure that's the best route, Gillenson said.

"What ends up happening is because there isn't that transition program that the kids automatically then get filtered into, oftentimes the kids come back to school because the hospital knows that there is some sort of mental health counseling on campus," Gillenson said. "We're there from 8 (a.m.) to 3:30 (p.m). We're not there on weekends. It's not an ideal referral."

Daniel Becker, longtime director of adolescent mental health at Mills-Peninsula Health Services, said his hospital does connect with patients' schools when they and their parents agree to it but that there is a need to develop a better system for the two bodies to communicate. He also noted that with the long waiting lists to get in to see mental health providers in the community, school personnel might seem like a more accessible support.

"How do we put together an optimal mental health care system? That's something that's a work in progress," he said.

Gentile said a behavioral therapist from her son's high school was in contact with Mills and even talked with her son on the phone while he was in the hospital. Manon said Gunn staff members were aware of her hospitalization. Her psychiatrist had contacted the school beforehand and her father spoke with Gunn administrators while she was there, who informed her teachers. Manon said the communication helped.

However, schools can be in the dark about a student's hospitalization if the parents opt not to tell the school. Gillenson said there is still a significant stigma attached to mental illness, which means parents might treat their children's return to school differently than following other illnesses.

"We argue, as mental health professionals — if your child had pneumonia or a broken wrist, there would be a doctor's note ... and when they come back from a psychiatric hospitalization it's just not treated the same way."

If the school is aware of a student's hospitalization, a "re-entry" meeting is set up upon his or her return with the parents, the school psychologist, Adolescent Counseling Services, a guidance counselor, administrators and a school nurse. They help the student decide what to tell peers and teachers about where they've been, work with teachers on which assignments can be excused to avoid added stress, talk about positive coping skills and identify people on campus to whom the student can reach out. Someone on the team also checks in daily with the student and makes sure he or she is connected with an outside mental health provider to continue care.

Manon said her transition back to Gunn was smooth. Her teachers were extremely supportive and understanding when she returned to school, though she had to complete a significant amount of makeup work. (After her first hospitalization, she came back during finals week.) What was more challenging, she said, was figuring out what to tell some of her classmates about her absence. She said she told most of her close friends, but it was difficult when it came to others with whom she isn't as close.

Intensive programs aid recovery

What does seem to be working within the local system is what comes after hospitalization: intensive outpatient programs that allow teens to return to school and their lives while still receiving significant and frequent psychiatric support services.

Following her second two-week hospitalization at Mills in late January, Manon entered the hospital's intensive outpatient program. For three to four hours after school every day, she participated in individual, group and family therapy and stress-management education. She said she actually was hospitalized this second time with the express purpose of getting into the outpatient program, which she hadn't been told about during her first hospitalization and which gives priority to patients coming straight from the hospital.

Manon stayed in the outpatient program for eight weeks, with the number of treatment days per week gradually tapering off. She called the program "amazing" and credited it with helping her to lessen the stress-inducing value she had placed on things like grades and college admissions.

"Going there and seeing people that were feeling the same thing that I was — that was extremely helpful," she said. "For once I wasn't talking to my friends about grades at school or their stress or my stress about school. We were actually talking about things that mattered, like our lives."

The value of — and demand for — intensive outpatient programs is high in the Palo Alto area. St. Mary's in San Francisco runs an outpatient educational and therapeutic program but only for students from the San Francisco Unified School District. The primary local option is El Camino's After School Program Interventions and Resiliency Education (ASPIRE) program, which keeps its cohorts small at eight to 10 teens and has a long wait list.

ASPIRE was created in the wake of the suicide cluster in Palo Alto in 2009 and 2010, after a community task force was convened to analyze the issue. Michael Fitzgerald, director of behavioral health services at El Camino, told the Mountain View Voice newspaper in 2013 that the group didn't simply want to hospitalize suicidal teens for a few days and then release them. The task force came to the conclusion that they would have to address the root of the problem.

"It's based around the concept of kids developing skills to manage their symptoms of anxiety and depression and stress that enters their life," Fitzgerald said in an interview with the Weekly.

ASPIRE requires a time commitment of at least four afternoons per week for eight weeks, with individual counseling, dialectal behavior therapy (a specific type of cognitive-behavioral psychotherapy used to treat mental health disorders), "expressive arts" and lessons on mindfulness and stress-management. Parents are also required to come in regularly for therapy and attend a group that teaches how best to support their children.

The program is more educational than, for example, the Mills' outpatient program, and El Camino staff takes pride in that. The hospital even offers academic credit to ASPIRE participants from the Mountain View Los Altos and Fremont Union high school districts. (El Camino this week received accreditation from the Western Association of Schools and Colleges, or WASC, which will allow the hospital to also offer credit to Palo Alto students.)

"Our belief is that this is a really good way to tear down stigma," Fitzgerald said of providing academic credit for the program. "It's still a validation of the work that they do and a different way of framing mental health treatment in terms of just, actually, it's an educational process."

But only small numbers of teens in crisis benefit from this popular program. Gentile tried to get her son into ASPIRE but was told it was full with a wait of several months. The family ended up piecing together their own version of an outpatient program: therapy with both a psychiatrist and a psychologist, weekly meetings with a depression/bipolar young adult support group in San Francisco (the closest one for teens they could find), in-home therapy for sensory issues and participation in the therapeutic services offered by his school.

"My son needed support services immediately after leaving the hospital in order to continue recovering," she said. "Fortunately, we were able to find, put together and afford the combination of private services."

El Camino is well-aware of the demand in the community. The hospital is in the process of doubling the size of ASPIRE as well as planning a middle school version and a similar program for young adults (ages 18 to 25) coming out of state custody or foster care, Fitzgerald said. Two Los Altos couples also donated $1 million each this year to El Camino, one to support ASPIRE and the other the hospital's behavioral-health services program, including a new $52 million behavioral health facility set to open in 2018.

Avoiding hospitalization through intervention, prevention

Lacking integrated, intensive outpatient programs like Mills' hospital-based program or El Camino Hospital's ASPIRE, other health care providers are taking different approaches.

In September, EMQ Families First, a statewide nonprofit that serves children and families, opened a small, short-term crisis stabilization unit in Campbell for children and adolescents who are at risk of suicide with the goal of preventing unnecessary hospitalizations. After a patient arrives, a team of nurses, psychiatrists and family specialists work with a timeline of 23 hours and 59 minutes to evaluate and release the patient with a plan for further care.

"At the end of that 23 hours, we have to make some decisions," EMQ Chief Clinical Officer Craig Wolfe said. "In most cases, the decision is the kid can go home with some family support or with our crisis transition team. In the majority of situations, we're able to avoid hospitalization."

The crisis stabilization unit — which only has seven beds — has served more than 700 youth since opening eight months ago, Wolfe said.

EMQ also operates a 24-7 mobile crisis unit in Santa Clara County for children and adolescents experiencing an acute psychological crisis. They perform 5150 assessments, take patients to emergency rooms and link families to agencies that offer longer-term mental health services in the community. The bulk of mobile crisis referrals come directly from schools' staff (who can't place students under the 5150 hold) and police officers, though individuals can also use the service, Wolfe said.

Stanford offers outpatient evaluation and treatment but no intensive after-school programs for teenagers like at El Camino or Mills. They have instead focused on "meeting kids where they are," with, for example, Stanford child and adolescent psychiatrist Shashank Joshi serving as the Palo Alto school district's mental health consultant, visiting campuses following a suicide and speaking at parent education nights and community panels. Through a partnership with the Tipping Point Community, a San Francisco nonprofit that fights poverty in the Bay Area, Stanford embedded a mental health clinician or "wellness educator" at East Palo Alto Charter School and JobTrain in Menlo Park to serve both students and parents.

Stanford mental health providers are also eying the continuum of care, hoping that better and more innovative prevention, education and outpatient services would decrease the need for emergency psychiatric care.

"The whole model of children coming to clinics is something that may even need to be revisited," Stanford child and adolescent psychiatrist Victor Carrion said.

This year, Carrion spearheaded the launch of a mindfulness curriculum for all 3,400 students in the Ravenswood City School District through a partnership with a southern California-based nonprofit that brings health and wellness education to K-12 schools throughout the country. Palo Alto Medical Foundation also started offering this year a free drop-in yoga class for teens on Tuesday afternoons.

"We have to come up with more things like that," Carrion said.

Carrion currently serves as chair of the state's Mental Health Services Oversight & Accountability Commission's evaluation committee, which is in the midst of collecting and analyzing data about outpatient programs throughout the state, he said.

"This is the type of data that we actually need as we ... concentrate on how can we work on the whole continuum of care rather than just the last point when someone needs to be hospitalized," Carrion said.

In the meantime, families are left to struggle with the emergency and support system. Just as Gentile was shocked to find out that there were no adolescent inpatient psychiatric services available in Santa Clara County, she was surprised at how hard it was to find a local, ongoing teen depression support group that was appropriate for her son. The Palo Alto chapter of the Depression and Bipolar Support Alliance offers a regular drop-in, peer-led support group at the Palo Alto VA Hospital, but Gentile said mostly adults attend.

Palo Alto Medical Foundation has since 1999 run a co-ed teen therapy group, which is now on Thursday afternoons and requires a minimum eight-week commitment and costs $59 per meeting. (Though Gentile's son's pediatrician is at PAMF, Gentile was unaware this group existed.) Palo Alto Therapy, a private therapy center in downtown Palo Alto, offers an eight-session "Stress to Wellness" support group for teens who are experiencing anxiety, depression or other mental health issues but have already been exposed to some cognitive behavioral therapy, as well as an eight-week "Tackling Anxiety" therapy class for both teens and adults. Both cost more than $500 and are capped at seven people.

So Gentile, a member of a special education community advisory committee that serves the Mountain View Los Altos High, Mountain View Whisman, Los Altos and Palo Alto Unified school districts, helped spark the development of a new adolescent support group that will launch at the Community Health Awareness Council (CHAC) in Mountain View this fall. The group will likely meet on a daily basis year-round (compared to other local programs where support groups only last for several weeks), with teens coming in on their own for support and their parents also meeting with CHAC staff at the same time, said Executive Director Monique Kane. The students and parents will also sometimes meet together, Kane said. The group will be free for any teens in the area.

CHAC also recently started a quarterly speaker series in which local teenagers talk to adults in the community about topics like anxiety, depression and academic stress.

Reflecting on her family's experience with local care, Gentile compared it to seeking help for her daughter, who suffers from a rare neuromuscular disease.

"It was easier for me to find services for my daughter than it was to find them for my son, and her (illness) is under the extremely rare category," she said. "Depression is common."

---------------

There is help

Any person who is feeling depressed, troubled or suicidal is urged to call 1-800-784-2433 to speak with a crisis counselor. People in Santa Clara County can also call 1-855-278-4204.

Other resources:

(Note: This is not an exhaustive list)

* California Youth Crisis Line: 1-800-843-5200; youthcrisisline.org

* Crisis Text Line (free, 24/7): text "start" to 741-741

* EMQ Families First Services: 877-41-CRISIS (877-412-7474)

* Trevor Project Lifeline, specializing in crisis help for GLBTQ youth: 1-866-488-7386

Local clinics that will triage and/or see individuals:

* Palo Alto Medical Foundation: 408-730-4370 in Palo Alto or 650-696-4666 in San Mateo

* Lucile Packard Children's Hospital Stanford: 650-723-7704 for children and teens

* El Camino Hospital ASPIRE Intensive Outpatient Programs: 650-940-7000 (Mountain View); 408-866-4021 (Los Gatos)

* Mills-Peninsula Intensive Outpatient Programs: 650-696-4666

For more resources, go to Resources: How to help those in crisis

Related content:

Why so few hospital beds for teens?

Simitian: Need for inpatient psych beds for teens is 'significant'

Breaking the silence: How youth, adults overcame cultural stigmas against depression and got help

Storify: Palo Alto community urges support for teen wellbeing

Comments

45 people like this
Posted by anonymous
a resident of Crescent Park
on May 22, 2015 at 7:35 am

Thank you for the well written article. This is clearly a huge 'dirty secret' of our community that occurs once we are able to get our kids into the system. One additional point I would like to make... Evidently, if a kid is 18 or over (or all other beds are full for the under 18), the age of the most 'at risk' students in their senior year of high school, the options of these other facilities disappear and the kids are transported (by police in handcuffs) to West Valley Medical. Here they are housed in a stark, clinical, general mental health holding facility, reeking of urine, surrounded by screaming patients, reminiscent of something out of 'One Flew Over the Cuckoo's Nest.' As this is clearly not a 'crime' for which we want to scare the kids straight, these kids emerge so traumatized, questioning whether they did the right thing in the first place by accessing the 'system.' This is a horrific thought after all the work that has been done to de-stigmatize the decision to call any of the mental health hotlines. A moment of questioning, in the event of a future crisis, could make the difference of life and death! Not only are more beds needed but we also need to accommodate those kids that are over 18 but still transitioning into adulthood as the handling of their crisis is so delicate. A further comment is that the city of San Diego has implemented a program called PERT <Web Link; where a specially trained group not only performs the intervention (freeing the Police from this duty) but also performs the transport to the facility in a safe, caring and dignified manner. As a community, we need to ensure that by providing for and encouraging our kids to utilize the crisis resources available to them, we are not leading them over a cliff. Our efforts and resources need to also go in to ensuring that the kids get the care and treatment they need in terms of intervention, housing, care and treatment. Thank you again for writing this article about an all too often hidden and difficult to accept/discuss topic yet is SO important to our community!


5 people like this
Posted by Anonymous
a resident of Crescent Park
on May 22, 2015 at 7:43 am

The web address to the above referenced PERT program is:
Web Link


28 people like this
Posted by another anonymous
a resident of Palo Alto High School
on May 22, 2015 at 8:21 am

A stunning, well-written, timely, and important article. Thank you to the author. I urge people to share this meaningful article with others.


25 people like this
Posted by Diana Weistart
a resident of Palo Verde
on May 22, 2015 at 9:57 am

From. Denver

Best to all of you! Thanks to Sarah Gentile for quickly and intelligently forming a new committee. We in Denver are watching.


22 people like this
Posted by Ferdinand
a resident of Barron Park
on May 22, 2015 at 10:43 am

Elena,
thank you for a thorough, informative, and provocative article. There is so much to think about, especially how we community members can fill in some of the gaps to support our young people. While continuing to parent our own children with kindness and clarity is a high priority, extending this caring to all the other young people we contact is next in line.

Much thanks.


31 people like this
Posted by HS Parent
a resident of Palo Alto High School
on May 22, 2015 at 11:16 am

What an excellent article. I am so impressed by the individuals contributing their stories. Thank you Sarah Gentile and Manon Piernot for bravely sharing your experience to help others.


34 people like this
Posted by Care close to home for kids in crisis
a resident of Another Palo Alto neighborhood
on May 22, 2015 at 11:19 am

Now that Stanford's enormous new hospital has been approved and construction is well underway (the largest development project in Palo Alto's history), perhaps they might consider including some services for LOCAL adolescents, enabling local parents (many of them are Stanford-affiliated families) to conveniently visit and support their kids in crisis, enabling these young people easier transition back to school and community.

Here is a tangible way Stanford could provide meaningful HELP and give back to the community. Let's hear less talk about how to support kids from Stanford and see some meaningful ACTION.

What was all that noise Stanford made about providing LOCAL services when they were advocating for their gargantuan hospital project? Where are those local services for adolescents in crisis? What is "comprehensive" about adolescent psychiatric care that doesn't provide a hospital bed close to home?


19 people like this
Posted by letters
a resident of Another Palo Alto neighborhood
on May 22, 2015 at 11:23 am

This is an important article to read and act upon.

"mental health professionals say the physical distance [between Palo Alto and teen mental health beds] can put the onus for follow-up support on families, schools or community-based organizations that may not be prepared or equipped to treat the youth...hospitalization — anywhere — made a life-saving difference."

All the doctors who wrote 100+ letters, appeared at school board meetings, and were quoted in newspaper articles placing the onus on Gunn High School and pushing for it to eliminate zero period classes should send 100s of letters to their own boards and employers pressing them for more adolescent mental health beds too.

More beds at their places of work - our local medical centers, foundations and hospitals - WILL save lives, unlike the elimination of zero period which MAY or may not.


4 people like this
Posted by Howard Hoffman
a resident of South of Midtown
on May 22, 2015 at 11:26 am

I want to recommend a book to everyone interested in the topic of depression: The Depression Cure by Dr. Stephen Ilardi. The title may seem a bit bold, but the book is outstanding. It explains why we are having a depression epidemic (not just addressing adolescents). It explains what depression is and why it is so insidious. And, it tells you what most people need to do to get out of depression and to stay out. There is also a great TEDx talk by Dr. Ilardi that can be seen by going to YouTube and searching on Stephen Ilardi. I can tell you this, for the most part, drugs are NOT the answer. However, the book works with depressed people whether they are taking drugs or not. Check out the reviews on Amazon. The TEDx talk explains why this epidemic is getting worse over time, especially for young people. This is a life or death issue for many people.


18 people like this
Posted by Parent of former Paly student
a resident of another community
on May 22, 2015 at 11:45 am

Thank you for putting the time and effort into writing this important article. And I would like to second the comment about the treatment of young adults (18-21) placed on a psychiatric hold. It was traumatic not only for my daughter--but for me to watch--the way she was strapped down and transported. And equally horrible to hear from my daughter about the conditions at the psych ward in San Mateo. As for the availability of therapy in the area, on another occasion, I attempted to get my daughter in to see a psychiatrist at a moment in time when she was willing and open to it, but that moment passed as we waited 6 weeks for an appointment at PAMF (why don't they hire more psychiatric staff???) and futile calls to private psychiatrists whose practices were full.


26 people like this
Posted by 5150'd
a resident of Crescent Park
on May 22, 2015 at 12:32 pm

My teen daughter was 5150'd in the Stanford emergency room, where we were informed that the closest facility was Mills-Peninsula, which had no beds. After 20 hours, they found a spot for her in Vallejo. Not a fun experience, but I guess there is not much profit in adolescent psychiatric emergencies! If your kid has an eating disorder, though, you'll be fine at Stanford.


28 people like this
Posted by Been There
a resident of Los Altos Hills
on May 22, 2015 at 1:10 pm

My son tried to harm himself at the age of 12 and I took him to Stanford Emergency Room. The closest bed was at John Muir Hospital in Pleasant Hill where he had to be transported by ambulance (health insurance paid for the ambulance). By the time he got there it was 10 pm and he had to deal with the intake all alone--they don't allow parents to meet the ambulance. The buildings are locked and secured--no entering/leaving without keys. The floor is secure and clothing is confiscated--especially shoe laces and hoodie strings (can be used to hang oneself or strangle someone else). I could not see him for 2 days until he was assessed. It is a very harsh process but there are a wide range of issues they have to deal with.

Parents can initiate a 5150 if your child is under 18. Once your child turns 18 and does not cooperate on getting help, your only recourse is to call the police who will take them out in handcuffs. Turning 18 takes any control away from the parent (whether good or bad).

The facilities for a 5150 situation are very specialized and expensive. They have to keep the child safe and secure (locked and monitored)--it is like a prison with linens--and the number of nurses/aides/doctors is very high relative to each patient. The first night of a 5150--an aide has to sit by the bed all night and make sure the child does not do anything except sleep. This "watch" may last for more than one night, depending on the severity of the situation. It was a very scary situation for me, let alone for a 12 year old boy.

Clearly more needs to be done and we as a community should understand the scope of the facility--it is not just dedicating some beds to kids--it is about a very specialized and secure facility with a lot of human resources.


13 people like this
Posted by Bette Houtchens
a resident of Los Altos
on May 22, 2015 at 1:47 pm

This is an excellent, much needed, article. I too am very impressed by Sarah Gentile's and Manon Piernot's courage to share their stories. Brings to mind Margaret Meads's quote: "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has."


27 people like this
Posted by Sarah1000
a resident of Los Altos
on May 22, 2015 at 3:47 pm

I am Sarah Gentile. Thank you, Elena, for taking such care in researching and writing this article and thanks to Bill Johnson as well. I wanted to respond to Been There by saying that I am sorry that you and your son had such an awful experience. I was able to ride in the ambulance with my son and remain with him through the intake process and as he settled in at Mills. The staff at Mills were compassionate and accommodating and I will be forever grateful to everyone there. My own son is now 18 but I feel we must all come together to make Santa Clara County a model for adolescent mental health care. We are so fortunate to have some individuals and organizations who have the experience and knowledge to guide us. MVLA (especially Dr. Susan Flatmo) has an excellent and effective suicide prevention program. (There will be seven full-time therapists at MVLA next year, two of whom are funded by El Camino Hospital.) EMQ has a comprehensive mental health program run by bright and dedicated individuals that could serve as a framework. Charlotte Ross (Fisher) lives in Saratoga and has been an invaluable resource for our group. (Google Charlotte Ross Suicide Prevention). There are many more. . . And I believe that the tide is turning in Palo Alto (with Ken Dauber and Max McGee making some real change). I am glad that Stanford has decided to join in the conversation and, hopefully, they can adjust their plans and provide some adolescent mental health programs in their $2 billion expansion. I encourage anyone who cares about teens to get involved. Go to the teen forums and show your support. Attend the "Let's Talk" discussions at the Los Altos Library. Follow our group on Instagram @mentalhealthSELPA1 If you are a business owner or are on social media, post suicide prevention info (e.g., you can text to 741741 to start a texting conversation with a trained counselor). Thanks to Trudy Palmer who started the SELPA1CAC mental health subcommittee and has worked tirelessly to motivate change. Lastly, thanks to all who come forward to share their own stories of depression. Your bravery is my true inspiration. ❤️


16 people like this
Posted by 5150 victim
a resident of Crescent Park
on May 22, 2015 at 4:13 pm

I recently had my first and hopefully last experience with a 5150 a few weeks ago. It was the most horrifying experience of my life. It was incredibly traumatizing and I learned that if I ever consider suicide as an option, I will NEVER tell anyone of my intentions. I still can't believe that what happened to me was legal. Maybe someone reading this can help me make sense of the awful ordeal.

A few weeks ago I had an appointment with my Gastroenterologist (GI) at the Sutter Health clinic in Mountain View. I had been having uncomfortable GI issues for years and was feeling depressed that nothing seemed to cure me. I was also unemployed and running out of money, feeling a lot of stress. At the beginning of the appointment I was asked to fill out a questionnaire of symptoms, circling the symptoms that applied. Among the many symptoms listed, I circled "depressed" and "suicidal" because I had thoughts of suicide for years because of the discomfort I felt. I'd been circling "suicidal" at every doctors appointment for the last year but was never questioned, until that appointment with the GI doc. She asked me if I had thoughts of suicide and a plan, and I told her that I thought of it often but didn't have the items needed to follow through. I was crying when telling her this because I had been feeling ill/stressed out for years. She then walked me down the hallway and said I needed to talk to someone. I told her I was fine and didn't need to talk to anyone. She then took me to urgent care where I heard a man at the front desk tell her that they didn't have a psychiatrist on call but that I would have to be taken by ambulance to the ER. I realized that everything was being blown WAY out of proportion so I decided to go home. The GI doctor followed me to the parking lot where I assured her that I would not commit suicide. I told her I was fine. I'm well over 30 years old and not a minor.

About 15 minutes after arriving at my apartment in Menlo Park there was a knock on my door. Three Menlo Park police officers entered my apartment and started searching. They told me my GI doctor (not a psychiatrist - I don't see a psychiatrist or take any meds of any kind) called them to check on me. I told them I was fine but they insisted on driving me in their police car to the MP police station. Since the clinic where my GI appointment took place was in Santa Clara County, the San Jose police were called. I waited for them to show up and explained again that I was OK. Although I was calm and cooperative, they insisted on handcuffing me and driving me to the Santa Clara County ER psychiatric facility on a 24 -72 hour hold (5150). I felt I had no choice but to obey. I had never before broken the law - never even stolen a stick of gum, I'd always been good and had never had any dealings with the police. No one in my family had ever been arrested so I had no clue what to expect.

The ER was a nightmare. It was basically a large room with lots of chairs, a table, and a TV. There were police standing guard, one doctor and several nurses on call. It was like a prison with no means of escape. I had no idea what to expect or how long I would be there. No one told me anything. I sat in a chair and looked at the clock on the wall, waiting for someone to let me go home. Most of the "inmates" seemed to be bi-polar people off their meds, and most were very young - a lot of teens. There was also a homeless man and some older people who were unruly. Occasionally one of the patients would try to make a run for it and the police would come running and tackle them to the ground. There were beds fore the patients who were medicated. The rest of us had to sit or stand for the duration. I wanted out but no one would tell me when I would be released. Apparently a doctor had to evaluate me, but there were 32 patients ahead of me so it would take a while. I stared at the wall till the next day. There was nothing to do - no books to read or internet to alleviate the boredom. just crappy TV (CNN, sports) ant utter boredom. Every once in a while a highly medicated patient would try to talk to me. It was like One Flew Over the Cuckoo's nest. The next morning I thought surely I would be let out, but no. I had to wait another twelve hours before the doctor FINALLY talked to me. I had been there for 26 hours and thought I'd never get out. I thought I would go mad.

Finally I was called to see the doctor. I told him my story and he agreed that I should not be there. He asked that a taxi be called to take me home (I didn't want any of my friends/family to know that I was there) at their (the taxpayers?) expense.

It took me several days to recover from that experience. The very sad thing was that there was no nurturing or caring at the ER - no one to talk to. Just sitting and waiting to be released. It was just a place of observation so that the doctor who reported me would not be liable had I actually committed suicide.

I can't believe that what happened to me was actually legal. Never again will I share my feelings with a doctor!


8 people like this
Posted by PAUS is not prepared fo support our Mentally Ill Students
a resident of Barron Park
on May 22, 2015 at 4:28 pm

Forget about hospitals being far away, but think about our school district who have had so many students died to suicide, and are not yet ready to appropriately support our emotionally ill students. They are good at supording students who have accidents and break their bones if the students have fractures that can be seen, but when it comes to emotionally illnesses, our district is really bad. We had our IEP meeting this morning our mentally ill child who tried to hurt herself and has been in the psy hospital unit and been also been hospitalized in a mental facility. The student came out, and we thought that with so many incidents they would be able to care for a child experiencing mental illnesses, but the school district has just told us at the IEP that to give the student support under special education she needs to have the qualifying symptoms for longer time. Therefore we have asked the school principal what can they do to support her so she can come back to school, and to our surprise they do not have $$ to hire someone to make sure the child stays safe at school. She did went back to school after the hospitalization but a assistant principal who do not know how to deal with mental illnesses questioned the child to the point that he drove her to feel suicidal again during the questioning. We also found out that the principal has no idea of what to say or not to say to the students to prepare them to act properly as the child returns. It is so frustrating. At least the hospitals have been available to her but not her PAUSD school because the staff is not trained to act properly in cases like our child's. She needs social and emotionally support to comeback to school, and cannot get it for her. Luckily our child trust in her family and we are there to support her, but the school has failed her.
Any advices would be appreciated.
Thanks for this report


10 people like this
Posted by Sarah1000
a resident of Los Altos
on May 22, 2015 at 5:14 pm

PAUSD is not prepared- I am so sorry that you haven't gotten the support your child needs to return to school. Let's work together to change that.
I do not know your ethnicity. If you are Asian, I met a woman at a talk this week that may be able to help. Her name is Dr. Chiao-Wen Chen. She is the Chinese Outreach coordinator for NAMI Santa Clara County and the leader of mental health ministry for River of Life Christain Church (as well as a provider of mental health peer support for the County). Would you feel comfortable contacting her through River of Life?
If you go on Instagram, you can leave me your contact information through direct messaging under @mentalhealthSELPA1 or you can contact me through the SELPA1CAC website.
Thanks.
Sarah


11 people like this
Posted by Sarah1000
a resident of Los Altos
on May 22, 2015 at 7:11 pm

I wanted to add, with regard to 5150 victim and anonymous, I do hear you on adult psych services and, yes, those services are woefully inadequate. I'm sure that just reading about your experiences will give me some sleepless nights. If you go on the El Camino Hospital website and read about the new mental health services building they have planned, you may have a little hope. I can highly recommend the DBSASF group that meets on Monday nights at St. Francis Memorial Hospital in SF. Free, anonymous, year-round support. Worth the drive. (They also have a Saturday group and NAMI has groups on other days at St. Francis as well.) Thanks.


3 people like this
Posted by Marc Vincenti
a resident of Gunn High School
on May 22, 2015 at 7:26 pm

For a less troubled, more forgiving life for our high-schoolers, sign the "Open Letter to the School Board and Superintendent" that you'll find at:

www.savethe2008.com

Join more than 300 other moms, dads, grandparents, neighbors, LMFTs, doctors, teachers, faith-leaders, businesspeople, professors, engineers, artists, a yoga master, and a filmmaker--whose names will be printed in the Weekly on June 5th.


12 people like this
Posted by parent
a resident of College Terrace
on May 22, 2015 at 7:54 pm

to anonymous crescent park, first poster:

Thank you for saying the problem with the over 18.

Our problem began last year with a young adult age 19. Our family had not prior experience with these issues. Student's experience in Palo Alto high school was very normal- so there is no blame of stress, academics.
We shifted from Valley Medical to Fremont to El Camino. I will not go through the details, its too sad.

Side effects of medications are so horrid and can be life threatening. I appreciate these posts because the problem is more serious than depression. Depression makes the problem sound too simple/manageable. There are many brain diseases causing psychosis and treatments are questionable and unpredictable.

Pharmacy research seems so limited for mental illness. If we really want to help this population we need to make funding and research improvements, and yes more space- for special groups including young adults.



16 people like this
Posted by Marietta Webster
a resident of another community
on May 22, 2015 at 8:59 pm

Thank you for your informative article, and for those sharing their own experiences. By open discussions, perhaps we can lift the stigma attached to not treating emotional and mental problems in the same way we have immediate care for heart attack patients. Not many years back, those diagnosed with Alzheimer's and their families, did not discuss openly their situation, and now, thanks to more publicity and the willingness to talk about this disease, we are closer to discovering a cure and/or a prevention. Keep up the good work!


14 people like this
Posted by wouldn't it be nice
a resident of Monroe Park
on May 23, 2015 at 6:06 am

Wouldn't it be nice if some of the local business successes in the area took this on as a serious challenge - donating money for facilities and research, the way some do with other diseases. Or if a group of moderately successful multi-millionaires got together for such an endeavor.


16 people like this
Posted by Parent
a resident of Another Palo Alto neighborhood
on May 23, 2015 at 6:43 am

Thank you for this article, and to the participants in sharing their stories. I hope the Weekly will keep the community up to date on any improvements.


14 people like this
Posted by Been There
a resident of another community
on May 23, 2015 at 7:38 am

@Marietta
It is almost impossible for parents to openly talk about their child's problem--it is not our story to tell, it is our child's story and they are the ones who have to live with the stigma. The only people I can openly talk with are relatives and friends who do not live here because I know what I tell them will never come back to harm my son. If my son chooses to talk about it, it is his choice. He has already been trivialized by doctors who know what is in his health record--illnesses have been dismissed and he is not taken seriously. He has had to switch medical practices to get away from his past issues and start over in order to get healthy.


13 people like this
Posted by Hugs
a resident of Another Palo Alto neighborhood
on May 23, 2015 at 7:47 am

@5150 victim,
First, I'm sorry to hear about your GI problems. I just wanted to offer support.

Until people have been through it, it's hard to appreciate how demoralizing and degrading an experience of chronic, undiagnosed, or poorly treated illness can be. It's hard to describe, but it's like being treated like a despised object, like something less than human. (It only gets worse if one tries to speak up about that in the care setting.) Then the experience in the rest of the world of having chronic illness can be just as bad -- I find the only way to live with a chronic "invisible" illness is to do everything possible to "pass" by just hiding it whenever possible. I find it's better for people to even think it's laziness or unreliability than chronic illness, especially if some of the problems are chronic pain or something poorly treated or diagnosed. Never having anyone to really talk about it with is hard, and support groups never helped me because, for one, you have to go somewhere (which is impossible if you don't feel well, and burdensome if you do because you need to get things done when you are feeling up to it!), and two, it was really depressing to know other people were suffering like that, too. I know what it's like to be in so much pain, not caring whether the roof literally would fall in on a regular basis.

The sad thing is that for many doctors still, depression for them is a diagnosis of exclusion -- if they don't know what's wrong with you, then you must be depressed, and that is very common with GI problems. Worse, if you are depressed because of being chronically ill, it's a double whammy because neither health problem then gets taken care of. Instead of at least providing effective help for depression, it's used as an excuse to get you to go away. Many physical health problems can also have depression as a symptom, especially GI, so it's a triple whammy. (I do not know what your problem is, but having had longterm GI problems myself, I can say that the GI system is one area where some alternative modalities really have a better handle on things. Unless you really need surgery, a very good naturopath, ayurvedic doctor, chinese herbal doctor, or even osteopath might be more helpful. Naturopaths in particular learn about diet, herbs, and health in ways even GI doctors have no idea. Usually people with chronic problems have tried everything, so I don't know if that's helpful.)

Please find a way to get compassionate help with the depression. Even if it is secondary to other problems, especially if it is secondary to other problems. (If you are up to it, there is a very good book by a neurologist/psychiatrist called A Dose of Sanity that deals with the mind/body and how our system often misses the boat. As a psychiatrist, the author feels much of his job should be as medical detective because depression is so often a symptom of other addressable things going wrong. It might be encouragement to persist to find answers so you can be healthy again.) Sarah, do you have any suggestions for compassionate depression care that won't gloss over the poster's physical situation? I don't have any answers for the depression, but my experience is that sometimes alternative modalities have very effective treatments for really bad GI problems that seem intractable with allopathic. In fact, if you contact me through Sarah (we just met over coffee after the last SELPA mtg), I could at least give you the names of the good ones in the area I know if you are looking. Alternative modalities may not be good at some things, but most have been concerned with treating human GI problems at least for thousands of years longer. If you have already been through that, you at least deserve having compassionate and professional support, in which you are treated with respect. Sometimes, too, GI problems come from other health problems that GI docs know little to nothing about, like endometriosis. Please don't give up, there are compassionate doctors out there who will partner with you, both allopathic and alternative.

I'm so sorry to hear about what you went through with the 5150, though. Thank you for your honesty in sharing your experience.








14 people like this
Posted by Snapping Turtle
a resident of Palo Alto High School
on May 23, 2015 at 8:31 am

This happened to a close friend of mine. Her fifteen-year-old daughter was sent all the way to MARTINEZ! As a result, my friend and her family could only visit on weekends. Not a decent situation!


12 people like this
Posted by keepit
a resident of Monroe Park
on May 23, 2015 at 4:21 pm

keep the conversations going. this is a serious topic.life and death.


18 people like this
Posted by Thankyou
a resident of Old Palo Alto
on May 23, 2015 at 5:33 pm

Thank you for this article. My child was also placed on a 5150 after self harm. He was young, 12, and so he was sent to SF. He was terrified, and treated as a criminal in the ED. At the hospital he was terrified by the older teens that had experiences he couldn't even imagine and drug addictions he had never observed. After that experience, we ended up not only dealing with depression but serious PTSD. Afterwards, I have heard that that PTSD following hospitalization is not unusual. It was an intensive program that saved his life. He is no longer depressed, recovering from PTSD, and learning to deal with his mental illness. I can't say the hospitalization did not jump start his recovery; I will never know whether it did more harm then good. But my heart aches to know how many kids can't get the intensive services he has received that saved him after regular psychiatric care and therapy were not effective.


17 people like this
Posted by Snapping Turtle
a resident of Palo Alto High School
on May 24, 2015 at 12:27 pm

Another friend of mine has a teenage son who was suicidal after the cancer death of his younger sister. STANFORD, of course, refused him a bed, so he was transported to Oakland--much too far away.

The despicable part is that he was attending Menlo School, which expelled him when they found out he was in a psychiatric ward. The poor boy was buried in grief, and the treatment he got all around was reprehensible.

Anyway, he was put on Zoloft which did not work for him. He begged his psychiatrist to let him try other new meds that had come onto the market, but the doctor insisted he stay on Zoloft. After six months of this, the boy finally downed a whole bottle of Zoloft to " prove his point", and was taken to STANFORD ER to have his stomach pumped. Why in Hades do STANFORD and Packard share the same ER? It is inappropriate! Anyhow, again he was shipped off Oakland after his stomach was pumped, and separated from his family. Then his mother lost her job because she had taken " too much time off" between the death of her daughter and the two hospitalizations of her son, plus the previous multiple hoitalizarions of her daughter.

Unbelievable how callous everyone was. This friend is a strong woman, but even this last blow of job loss was the final straw. She came completely unglued one evening and went to a locl hotel to be alone and pull herself together--that took ten days. The lack of compassion the hospitals,,psychiatrists, and school had was just unbelievable, to say nothing of the employer, who happens to be the County of Santa Clara!


10 people like this
Posted by A mom
a resident of Los Altos
on May 24, 2015 at 4:26 pm

My son committed suicide at the age of twenty in 2001. His first attempt occurred when he was twelve in 1992. At that time I thought the mental health system for children was archaic. Obviously nothing much has changed in the last twenty three years. These stories sound so similar to what we went thru as a family. Maybe your article will help to change that. Thank you for writing it.


11 people like this
Posted by Hugs
a resident of Another Palo Alto neighborhood
on May 24, 2015 at 5:13 pm

Dear Los Altos mom,
I am so sorry for what you, your whole family, and your son, suffered. It's terrifying that so little has changed. Thank you for sharing.

(Hugs)


7 people like this
Posted by Theresa
a resident of Adobe-Meadow
on May 24, 2015 at 6:13 pm

It is a national crisis. Its worse for the schizophrenics. They are simply given a prescription which many refuse to take. That means psychotic episodes, violence to the poor family or themselves. No asylum. The left did such a job pretending that insane asylums were all bad that now we have no option.

1.5 in a hundred are schizophrenics. There is no cure. And no asylum. This disease destroys lives, families. The mass murders have been committed by those in psychosis. The jails are full of schizophrenics suffering under inhuman treatment.
Its a humanitarian outrage. But families to stigmatized to come forward.

Asylum. Look up the meaning of the word. That is what the patients, their families and society needs. We need more and better psychiatric hospitals. We know what is needed. Care, compassion, treatment, shelter, safety. Why cant we have it?


19 people like this
Posted by Actually
a resident of Another Palo Alto neighborhood
on May 24, 2015 at 7:09 pm

@Theresa,
Actually, it was Ronald Reagan who shut down all the mental health facilities and said we should serve people in the community. Little problem, though, he ordered the former without providing for the latter. I am old enough to remember that that's when this nation's homeless problem began.


7 people like this
Posted by ConcernForTheCommunity
a resident of Los Altos
on May 25, 2015 at 4:20 pm

This article highlights a community-based matter that could be seen as concerning:

As an icon of Palo Alto and Santa Clara County (and one of the world's richest and highest profile educational institutions), Stanford University's primary involvement with adolescent psychiatric care seems to be through and with non-profit partnerships (as cited in this article). Is this the best Stanford can offer the troubled-adolescents in the community of which it is part?

What prevents Stanford from directly creating a more complete spectrum of psychiatric care, including and especially for adolescents, to vastly improve the lives of those in its community?

Palo Alto, along with neighboring communities throughout Santa Clara County, should come together to support rapid and advanced development of this complete spectrum of care - supporting Stanford and its partners at every step. This level of attention to mental health care could set a new standard that others would revere, nationwide.


9 people like this
Posted by Hugs
a resident of Another Palo Alto neighborhood
on May 25, 2015 at 4:35 pm

@Concern,
I'm not completely letting Stanford off the hook here, but PAUSD has some seriously troubled and troubling culture issues in the district office, which the last leadership only amplified, and the current hasn't yet dealt with. Problems get blamed on or foisted on families because they make such easy targets by people who have power and very little accountability. Troubled students can be trouble, and that's not such a great mix when we're talking administrators with no compunction about taking out petty slights on others. At best, I think our new leader (someone I still cling to high hopes for) is hoping to quietly fix things and as a result, is not fixing things. It's not just disaffected parents who should be heard, I've spoken with many people at Stanford and in professional arenas related to Stanford who were equally disillusioned by attempts to relate with or help the district. In this current environment with so many students affected, moving forward with restored trust is just so important. It can't be fake, it has to be earned through self-honesty and reconciliation, or already hurting kids will be hurt more.

This isn't a general criticism, I (and so many other parents and professionals in the community) know exactly who, what and why, but haven't seen any attempt yet to really fix the organization. The trouble is that kids who have had any mental health-related issue may now be exceedingly vulnerable to problems in our system that have hurt so many other families already. The poster above "@PAUSD is not prepared to support mentally ill students" has it exactly right, and shouldn't have had to suffer any of that if others who came before had been taken seriously.

We should adopt the Google motto (don't be evil) and go for it.


11 people like this
Posted by Snapping Turtle
a resident of Palo Alto High School
on May 25, 2015 at 5:51 pm

Does either STANFORD or Packard have any explanation as to why, as ridiculously overpriced ( my last two insurance companies forbid us to use them) as they are, are not able to EVEN after EXPANSION, to maintain an adequate number of psyche beds for adolescents? In fact, as a children's hospital, Pakard should have its own E/R and psychiatric unit. Young people up to age 21 are in their cancer unit, this I know for a fact.

When my own daughter was small, her white cell count dropped to zero and she had to be quarantined. Yet Packard insisted we go to Stanford's E/R, where we waited THIRTY hours for admission, and saw only one surgery resident, not one pediatric specialist. This first-year resident, without any supervision by his attending physician, took our little girl from my arms and tried to whisk her off to a surgery she did not need! She was feverish and dehydrated from vomiting and lack of hydration during our extended wait, and had developed some constipation which needed hydration, or surgery. With a WBC count of zero, they should never have left us sitting with patients wth communicable diseases!

Small wonder STANFORD loses so many lawsuits ( a recent one cost $23 million)! They are lax, lazy, arrogant, negligent and provide Kaiser quality for mega- bucks. They need to be audited to say the least, and grow a conscience! Can't help but wonder how they stay in business, and even expand. Their gross overcharges and double-billing must make up for their malpractice suits.


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Posted by Snapping Turtle
a resident of Palo Alto High School
on May 25, 2015 at 5:58 pm

Correction: end of second paragraph should read....hydration, not surgery....


2 people like this
Posted by Donna James
a resident of Portola Valley
on Jun 3, 2015 at 10:14 am

Thank you, Elena, for this great article. It is important to be informed about the lack of accessibility to mental healthcare for young people here in our own community. We will only be able to make improvements if we know the full extent of the problem. Thank you, again.

A recent report by the Robert Wood Johnson Foundation states that "helicopter parenting" is paying off when it comes to kids mental health. More families are getting their children with serious mental health issues into care earlier. The kind of mental healthcare available when they seek help is the problem to solve. We have an amazingly resourced community and with effort we can improve mental healthcare for our young people.

A side note. The families referenced in this article had the financial resources to piece together treatment for their children. Imagine if you were a low income parent. What happens to kids and families with serious mental healthcare needs with MediCal is often even more horrendous.


1 person likes this
Posted by Gloria
a resident of South of Midtown
on Aug 20, 2017 at 8:28 am

The disgraceful the mentally ill and their families are treated has gone on far too long. When will this become a national issue where more funding is put into brain research? When will coverage for psychiatry stopped being limited when the so called physical health care is not limited. The fact that someone becomes an adult at 18 and many breaks occur in college or after someone is an adult and the families are blocked out because of HIPAA without a signed consent by the person with the brain disease, is rididulous. Also most medical docs have almost no training in recognizing warning signs of suicide or an impending mental health crisis is not OK. I'm sure that 99% of physicians have never experienced a mental health crisis and most have never had any with what actually happens to someone who is put onn a hold (5150), Don't forget that a once considered mental health treatment program, La Selva in Palo Alto, had a fatal shooting in their front yard Christmas day a couple years ago by an untrained Palo Alto police officer. Palo Alto has a lot of well educated families and hopefully someone will get this conversation started in a public forum with the Stanford psychiatric community. It is so sad to hear about all of these bad experiences that shouldn't have happened.


3 people like this
Posted by Sarah1000
a resident of Los Altos
on Aug 20, 2017 at 12:53 pm

Gloria- I just saw your comment. I don't see doctors (including psychiatrists) as the problem. At Stanford's free Mood Disorders Education Day yesterday, Dr Nolan Williams explained that a new "burst" protocol for TMS depression treatments is having a 100% effectiveness rate. People with long histories of medication-resistant depression describe themselves as feeling "well". (He is now figuring out how to sustain this alleviation of symptoms beyond weeks/months.) Also, mental illness does not discriminate in favor of doctors. Suicide is now the leading cause of death in the U.S. for male residents (physicians). Web Link What we do need is for hospitals to provide treatment for mental illness in the same way they treat physical illness even though it is not as profitable. I am hopeful that Stanford's administration will finally allow hospitalization for our children (who continue to die by suicide) when the newly-expanded Children's Hospital opens. To send away children from a Children's Hospital who are literally dying from mental illness is unconscionable.


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