Health Agency | Behavioral Health

What is this service?

The Behavioral Health Department operates a 16-bed, licensed Psychiatric Health Facility (PHF). The PHF provides observation and treatment for acute mental illness under licensed psychiatric direction.

1 (800) 838-1381 
Psychiatric crisis emergency number available 24 hours a day, 7 days a week
 
The Psychiatric Health Facility (PHF) is an inpatient facility that treats individuals in psychiatric crisis who cannot be safely served in outpatient services. 

• A psychiatric crisis is a non-life threatening situation in which an individual is exhibiting extreme mental health symptoms, considering harm to self or others, disoriented or out of touch with reality and has a compromised ability to function safely.

The PHF is operated by the County under a license issued and regulated by the State Department of Health Care Services (DHCS) as a facility for:

• 72 hours of psychiatric evaluation and treatment.

Patients have a right to refuse medication unless there is a court order for medication or the patient is displaying imminently dangerous behavior toward self or others, and the doctor orders involuntary medication (W&I code 5325.2).

 
There are subsequent fourteen (14) day legal holds that may be enacted if the individual continues to meet medical necessity criteria. All additional holds require judicial review. Patients have rights and are provided legal representation by the Public Defenders Office. Patients also have access to a Patients’ Rights Advocate.
 
The PHF is staffed by a Behavioral Health Program Supervisor, an RN Nursing Supervisor, Psychiatrists, Registered Nurses, a Licensed Clinical Social Worker, Psychiatric Technicians, Vocational Nurses, and Behavioral Health Workers. Contracted services include Primary Care Physicians, Nurse Practitioners, Rehabilitation Services, and Dietary Services.
 
The PHF is licensed to treat 16 patients at any point in time.  The PHF serves:

• Individuals who, per Welfare &Institutions Code 5150, may be involuntarily detained due to indications they are, as a result of a mental disorder, a danger to self, danger to others, or may be gravely mentally disabled
• Misdemeanants in custody of the County jail, determined by the Court to be incompetent to stand trial (per Penal Code 1370).  Inmates are treated at the PHF to restore them to competency, in order for them to participate in their legal proceedings.
• Conserved individuals (gravely mentally disabled and permanently housed elsewhere) in need of stabilization.

 
The PHF is the only such facility within San Luis Obispo County. The nearest alternative 5150 facilities are located in Salinas, Santa Barbara, and Fresno/Bakersfield, and are often also at or near their licensed capacity. Approximately 340 individuals are transferred directly from our area hospitals to out-of-County alternative inpatient psychiatric treatment facilities every year.
 
PHF admission criteria is set forth in the Welfare & Institutions Code 5150, and California Code of Regulations, Title 22. Individuals are assessed by qualified professionals for admission. 
Admission criteria includes:
 
As a result of a mental disorder*, the individual is deemed to be:

1. A danger to Self,
2. A danger to Others,
3. Gravely Disabled (no ability to nourish oneself, obtain clothing or shelter, no third party caregiver).(Welfare & Institutions Code 5150)

 *mental health conditions covered by CCR Title IX 1820.205

It is often important that individuals receive a medical clearance prior to receiving a mental health evaluation for inpatient psychiatric treatment for the following reasons:

• The PHF is free standing, with no medical support attached. 
• Medical support is provided by local hospitals.

The following regulatory criteria describe persons who may not be legally retained in the PHF:

1. Only persons diagnosed with major mental disorders are to be treated in PHFs.
2. PHF shall not admit and treat patients with the primary diagnosis of an eating disorder.
3. PHF shall not admit and treat patients when the primary diagnosis is chemical dependency, chemical intoxication or chemical withdrawal.
4. Individuals with major mental disorders shall not be admitted to PHF if their treatment requires medical interventions beyond the level appropriate to a psychiatric health facility including:
   • Detoxification from substance abuse
   • Treatment for substance induced delirium. (22 CCR 77113)

 
Persons with a communicable disease that is required to be reported (per 17 CCR 2500), shall not be admitted to the facility. Examples are active treatment resistant infections (MRSA), Tuberculosis, etc.
 
A facility shall accept and retain only those patients for whom it can provide adequate medical care.  

“…when a patient’s particular injury or disease would ordinarily be treated on an outpatient basis absent the mental disorder, the facility may admit the patient only if the facility has appropriate policies, procedures and resources to ensure the safety of other patients and staff.”

Examples of such medical conditions are some types of Diabetes, and patients requiring supplemental oxygen, dementia, and Alzheimer’s.
(22 CCR  77135)
 
The law precludes the PHF from housing patients who are non-ambulatory, meaning they are unable to transfer their own weight.
(Health & Safety Code Section 1275.1)

Patients who are voluntarily or involuntarily admitted to the PHF for psychiatric evaluation or treatment may have visitors during regularly schedule visiting hours (6:30pm - 8:00pm). All visitors must be 18 years of age or older. No outside food or drinks are allowed. For more information on visiting the PHF, please see our PHF Visitors Policy.

The Psychiatric Health Facility Program Supervisor can be reached at (805) 781-4752
 
The Patients’ Rights Advocate can be reached at (805) 781-4738