GOVERNMENT

Collier commissioners raise concerns about mental health plan

As Collier County moves ahead with a high-level blueprint to better treat mental illness and substance abuse, commissioners on Tuesday dug into the proposal, some sharing concerns about a housing component and others asking for more details on potential costs.

The strategic plan, commissioned to grapple with an emerging mental health and addiction crisis, focuses on half a dozen priorities, from building and operating a new treatment center to improving prevention, advocacy and education related to mental health and substance use disorders.

“The actions that are taken in response to this plan are going to affect Collier County for the next generation,” Chet Bell, a consultant who worked with a county advisory committee that drafted the plan, told commissioners during a workshop Tuesday. 

More on this:Collier's mental health, addiction plan details need for new facility, better housing

Commissioners are expected to consider adopting the plan in December.

The plan's top priority is a new treatment center to serve people experiencing an acute mental health or substance use crisis. It is needed, the plan’s authors say, to keep up with demand that is outpacing the county’s current capacity and to provide appropriate services and treatment.

As is the case in many places across the country, in Collier most people who struggle with mental health issues are being “treated” at the local jail, committee chairman Scott Burgess, president and chief executive officer of the David Lawrence Center, told commissioners.

“We have about 100-plus inmates every day in Collier County jail that are receiving psychiatric medicine,” he said. 

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Law enforcement officials agree that the jail is not an appropriate place for treatment.

Collier County Sheriff Kevin Rambosk

“I think we’ve seen the need here,” Sheriff Kevin Rambosk told commissioners. “And as I’ve mentioned, if you have a mental health crisis, you don’t want me to treat you. You want a professional group, a professional team.”

Although the new treatment center is slated to be built using $25 million from a sales tax increase voters passed last year, some questions remain, including where it should go and how its operation will be funded. 

The committee estimates it will cost between $2 million and $3 million annually to run it. The plan suggests that a request for money from the state Legislature, supported with matching dollars from the county, "appears to be a logical approach” to get the funds needed to operate it.

Commissioner Burt Saunders asked county staff on Tuesday to research other, similar treatment centers in Florida to get a handle on what the cost will be and what kind of grants will be available.

“We’re talking about a 55,000-square-foot facility. We do not know where that facility will go yet,” Saunders said. “But we need to start developing how that facility is going to look, what is it really going to cost.”

Early draft plans had called for the facility to be built on the campus of the David Lawrence Center on Golden Gate Parkway. But according to the strategic plan, the county will study "multiple options" for where to put the new facility, including the David Lawrence Center option. 

Another possibility could be to co-locate it with other existing government services, such as the county government center. County officials say they’re studying additional options to make sure the county maximizes its return on investment.

Commissioner Donna Fiala said she was surprised other locations are being studied.

“The idea of not having the building we were talking about over on the DLC property, because they already own a property, and now changing it to another location is new to me,” Fiala said. “I hadn’t heard about that before.”

Burgess said he personally believes the David Lawrence Center site is still “the most ideal location,” in part because a “warm hand-off” from inpatient to outpatient increases the likelihood people will continue treatment. However, he added that “we’re all open to the idea of looking at different options.”

More:Collier's plan to tackle mental health, substance abuse challenges taking shape

Parts of the plan’s second biggest priority — increasing housing and support services for residents with serious mental illness and/or substance dependence — caused unease among some commissioners. 

The strategic plan suggests a “Housing First” model in which eligibility is not dependent on psychiatric treatment compliance and sobriety and housing units are integrated within the community. 

Commissioner Penny Taylor said to her, the housing component was the “most controversial part of this.” 

She said after the meeting that although she understands the plan’s goals for housing, she is “very uneasy” about the prospect of having homes without requirements of treatment compliance or sobriety scattered across the community.

“I can’t see neighbors going along with that,” Taylor said. 

Taylor said she is not “closing the door” on the issue, but added that it would take some more dialogue. 

“There’s going to have to be some convincing for this commissioner,” she said.

Read:Collier revives affordable housing trust fund; questions persist about funding

Experts, however, said the “Housing First” model works and that scattered-site housing, not group homes, is the “gold standard" for that approach.

“The retention rates, the success rate, is at an 85% level in Housing First,” Mark Engelhardt, a faculty research associate in the Department of Mental Health Law and Policy at the University of South Florida, told commissioners. “That’s more than any mental health research that I’m aware of.”

Collier County Judge Janeice Martin, who also is a member of the committee, said homes where sobriety is not a prerequisite wouldn’t be a “free-for-all” or “party house.” 

Instead people living in the house would get support to stay sober. The key point, Martin said, is that people living there who suffer a relapse would not lose the housing.

“We take one step forward and three back when we yank the housing the moment there’s a slip,” Martin told commissioners. “And so Housing First challenges us to push through that.”

Connect with the reporter at patrick.riley@naplesnews.com or on Twitter @PatJRiley.

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