Los Altos resident Sarah Gentile was shocked in 2014 when she discovered that there were no hospital beds in Santa Clara County, including at Stanford's two hospitals, for teens experiencing a mental health crisis.
Facing such a crisis with her own son, her family waited for six hours in the emergency room at El Camino Hospital in Mountain View while the staff searched for a bed in one of the few adolescent psychiatric units elsewhere in the Bay Area. Other local families have had the same experience at the Stanford Hospital emergency room and at other county hospitals.
In Gentile's case, a bed was finally located at Mills-Peninsula Hospital in San Mateo, but some families end up referred to hospitals more than an hour away, adding more trauma and logistical challenges to what is already a difficult and emotional family situation.
With great courage and determination, Gentile went public with her family's story, studied the problem and became the leading advocate for establishing at least one in-patient adolescent psychiatric unit in Santa Clara County, California's sixth largest county. (A May 22, 2015, Palo Alto Weekly cover story, "Beyond the 5150," explored the topic.)
Gentile enlisted the support of Santa Clara County Supervisor Joe Simitian, other parents and concerned mental health professionals physicians, and in December the county invited medical groups to propose concepts for how a new in-patient program could be established in the county.
This week, the county released the four submissions it received, including a joint response from El Camino Hospital, Stanford's Lucile Packard Children's Hospital and Kaiser Permanente that proposed opening an 18-bed facility at El Camino's Mountain View campus that would initially serve 12- to 17-year-olds, including those without insurance coverage and unable to pay.
The three other responses, all credible, came from Fremont Hospital, which operates one of the few existing area adolescent psychiatric units and that proposed operating a facility to be located at the Santa Clara Valley Medical Center in San Jose; EMQ Families First, a nonprofit that would expand a small facility it currently operates in Campbell for teens in crisis; and Bay Area Children's Association (BACA), a San Jose nonprofit that provides adolescent psychiatric services.
The interest demonstrated by these responses is conceptual and non-binding, but they are more than adequate to propel the idea to the next phase -- the issuance of a formal request for proposals by the county -- later this month.
The El Camino-Packard-Kaiser submission emphasizes the importance and stability of a partnership of three leading regional health care providers. While no formal agreement yet exists among the entities, the response suggests that El Camino is prepared to temporarily incorporate the new adolescent facility into an already-planned mental health building scheduled to open in January 2018. By 2020, a separate 18-bed facility is envisioned that would be jointly operated by the three groups, presumably to spread the financial risk and encourage collaboration among physicians serving this relatively small, targeted patient group.
The submission states that the facility would serve youth diagnosed with a broad range of disorders, including anxiety, post-traumatic stress disorder and substance abuse. It notes the expense and complexity of operating a secure psychiatric facility for teens and suggests the size and financial resources of the three health care organizations is an important advantage.
The collaboration would likely benefit from the fact that Stanford and El Camino already jointly operate a 15-bed adolescent inpatient eating-disorders clinic at El Camino Hospital.
Given the pace usually associated with such initiatives, it is nothing short of miraculous that in little more than a year since Gentile raised a public alarm about the inadequacies of services for teens needing in-patient care there is a real prospect of such a facility opening within two years.
Last year, noting that Stanford Hospital and Lucile Packard Children's Hospital produce medical miracles almost every day for patients from all over the world and are in the midst of major expansions, we urged the two institutions and the Division of Child and Adolescent Psychiatry to develop a plan for addressing this major gap in adolescent in-patient care.
Stanford, Kaiser and El Camino are to be commended for stepping up and collaborating on a possible solution, as should the other three groups who responded.
With Gentile's perseverance in bringing this problem out into the open and educating the public, Simitian's county initiative and the submission of four possible solutions, the momentum to solve this problem is hopefully irreversible. There is no defensible reason our county should not be serving this vulnerable teen population.