Suicide & Overdose Deaths Have Doubled

Suicide and overdose deaths have doubled in San Diego County over the last dozen years.  While deaths assigned as suicide have decreased, overdose deaths are reaching unprecedented levels.  Further, as reported in the 2023 Annual Report to the Community, San Diego Suicide Prevention Council noted crisis calls have increased nearly 30% and Emergency Department Discharges for Self-Inflicted Injury/Poisoning are back to pre-pandemic levels.  

Shortage of Facilities & Staffing

Undoubtedly lack of facilities and staffing are part of the problem.  In 2021 Rand Corporation released the report “Adult Psychiatric Need Capacity, Need, And Shortage Estimates in California-2021.”  That report concluded that California is short approximately 4,800 psychiatric beds and that “hundreds of Californians in need of psychiatric beds are waiting in emergency rooms and jails for openings.”  In June 2023, Chris Van Gorder CEO of Scripps Health penned an op-ed indicating the need for about 1,660 psychiatric beds in San Diego County which is over double the current number.  
In August 2022 San Diego Workforce Partnership issued an eye-opening report indicating the region’s behavioral health system would need to hire 18,500 workers by 2027 to adequately meet demand.  According to the Steinberg Institute, California’s current behavioral health staff can only meet about a quarter of the demand.  
Staffing and facilities will need to be top of mind in addressing our mental health crisis in San Diego County.

County of San Diego Behavioral Health Continuum of Care

County of San Diego Behavioral Health Continuum of Care is committed to “achieve the vision of transforming the system from one driven by a crisis to one rooted in chronic and continuous care and prevention achieved through the regional distribution and coordination of services, and integration with primary healthcare, to keep people connected, stable, and healthy.” 
In recent years, the County of San Diego has significantly increased spending on this effort.  The County’s Behavioral Health Services department has seen funding more than double over the last 8 years to over $1 billion as the organization works to “flip the pyramid.”  Even more financial and intellectual support will be needed to make this a reality.  And there will need to be better collaboration and cooperation with commercial facilities to ensure a comprehensive system that does not allow any individuals to slip through the cracks.  

Over-representation of Mental & Substance Use Disorders

People with mental and substance use disorders are over-represented in the justice system.  According to the Substance Abuse and Mental Health Services Administration, 44% of those in jail and 37% of those in prison have a mental illness while an estimated 63% of people in jail and 58% in prison have a substance use disorder.  Nearly all these individuals will be returning to their communities making this one of the critical intercept stages for treatment. 

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