An ambitious plan to open a North County youth mental health center is proving to be a challenge, beset by delays and escalating costs as Santa Clara County officials scour Palo Alto for a location.
The project, called Headspace, proposes creating two clinics in Santa Clara County that would serve as one-stop shops for youth ages 12 to 25 in need of mental health services. Psychiatrists, psychologists, clinicians and primary care doctors will all play a part. The hope is that local teens will feel a sense of ownership in order to quash the stigma of seeking help.
County officials have already found a suitable site for one Headspace center in San Jose and are working on the design. But the search has been difficult in the North County, with dozens of locations considered and ultimately rejected. County staff, partnering with the Stanford Center for Youth Mental Health and Wellbeing, looked at 30 properties -- all in Palo Alto -- and toured eight of them. Only one met the standards for the clinic, but the property owner rejected the county's inquiry last August.
The Peninsula's hot real estate market doesn't help. Headspace needs a whole lot of space -- 6,000 square feet -- and to be located near public transit. It's not clear why only Palo Alto is being considered, since the city's restrictive ordinances are compounding the challenge, according to a county staff report. For example, vacant first-floor retail space can only house retail services and can't be converted to a clinic use.
The first setback came quickly when county staffers concluded they had no chance of owning the Headspace centers, and would instead need to lease space for both locations. The original budget to fund the leasing costs and facilities improvement, projected to be $964,000, is now expected to be closer to $4 million.
A real estate broker working on behalf of the county sent a letter of interest for a property at 2741 Middlefield Road on March 29. If the latest effort leads to a lease agreement, county officials expect to make improvements and have it operating sometime in the 2019-20 fiscal year.
County Supervisor Joe Simitian said Midtown Palo Alto would be a great location for Headspace, centrally located and a popular hangout spot for teenagers going back decades. But he said progress has been sluggish for turning Headspace into a reality despite an urgent need for the services, and he is "beyond frustrated" that there has yet to be a site secured for the North County location.
"It's been three years since I sat down with people from Headspace in my office," Simitian said at a recent Health and Hospital Committee meeting. "That's a long time to still not have a site under contract."
The delays could be partly due to the challenge of coordinating with three county departments involved in the real estate search, but Simitian wondered if Headspace faces an additional hurdle because the county can't find a contractor in the North County to actually provide the mental health services. The county's behavioral health director, Toni Tullys, confirmed that finding an outside provider is still a work in progress.
Headspace has been in the works since 2016 as a partnership between Stanford University and Santa Clara County that aims to transform the way children and young adults receive mental health care. The goal is to provide integrated mental health and primary care services all under one roof, which can help identify the early warning signs of mental illness and suicide, according to a description of the program. Patients will receive services regardless of whether they are on Medi-Cal or private insurance, uninsured or underinsured.
Although Headspace is based on a network of mental health centers with the same name in Australia, the county is expecting to adopt a new name -- Allcove -- in the coming months. Santa Clara County is the first to try out the Headspace model in the United States, but not in North America -- there's a similar program in British Columbia called Foundry that's based on the Headspace model.
Launching the two mental health centers relies heavily on funding from California's Mental Health Services Act, a 1% income tax on those making in excess of $1 million each year. So far, much of the tax's revenues have yet to be spent. A portion of the funding is set aside specifically for "innovation" programs like Headspace. Santa Clara County officials are planning to spend just under $15 million in those innovation funds on Headspace over the course of four years, which had to receive formal approval from the Mental Health Services Oversight and Accountability Commission in August last year.
Commissioners at the time praised the concept for having the potential to reach people at a young age and address mental health problems before they become more severe, more difficult and more expensive to treat. There is significant interest in seeing how the model works in the U.S., with neighboring counties and jurisdictions as far away as New York, Michigan and Illinois all expressing interest in whether the Headspace model can survive and thrive in America's more challenging health care environment.