‘Give me another solution.’ Counties resist mental health centers, betraying patients and families

Rosa Rivas was furious, but not surprised, when Monterey County supervisors recently voted to halt planning for a multimillion-dollar mental health center project in Salinas. 

Rivas was angry for her family, which has struggled to support her 35-year-old daughter who was diagnosed with schizophrenia 15 years ago. Rivas also felt for many other families who will have to go without aid or support. 

“I feel so betrayed, so sick to my stomach,” said Rivas, who works as a family advocate in Salinas. “Give me another solution; just saying no is not enough.” 

The unopposed motion to cancel the proposed Monterey County Department of Health Mental Health Rehabilitation Center means patients and families across California — not just Monterey County or the nearby communities on the California Central Coast — will continue to struggle amid a lack of local mental health support for serious diagnoses. 

When Rivas’ daughter required hospitalization about four years ago, there were no available beds at the Natividad Medical Center in Salinas, where they live. Her daughter needed 24-hour support; coming home wasn’t an option. Hospital staff found a facility far north of Salinas. 

“I didn’t know where Santa Rosa was, but I said if that’s the only place, go for it,” Rivas recalled. 

Santa Rosa is more than 150 miles from Salinas. Rivas could only visit her daughter every other day, due to the distance. Rivas saw some patients in shackles; they were inmates whose mental health needs precluded them from staying in a county jail. 

No available mental health space

Monterey County’s lack of available mental health space affects patients needing 24-hour care and those under conservatorship — people considered “gravely disabled” by the state and who are unable to provide their own food, shelter, clothing or medical care. 

In total, nearly 100 Monterey County patients are housed outside of the county —some as far north as Santa Rosa, others more than 300 miles south in Long Beach — in state hospitals, locked intensive treatment programs or in board and care facilities, the county Health Department said in a presentation.

Researchers at RAND pinpointed the need for more residential programs in parts of California in a 2022 report: “The shortfall at the community residential level is particularly severe in such regions as the Inland Empire, Southern San Joaquin Valley and Central Coast.” 

The RAND experts and Melanie Rhodes, behavioral health director for the County Health Department, said Monterey County is experiencing a phenomenon that spans California and the nation, beginning with the dismantling of state mental institutions decades ago. 

“This transition to community-based services — although well-intentioned — has resulted in a paucity of infrastructure to serve the needs of individuals who would otherwise benefit from a stable and supervised residence, particularly those with serious mental illness,” the RAND report said.

Back in 1955 there were 337 psychiatric beds per 100,000 people; in 2016 there were 12 beds, RAND reported.

Gavin Newsom has tried to make mental health support one of the cornerstones of his legacy as governor, but progress has been slow. And, as the RAND report notes, even within the field of experts, “there are no consensus best practices for determining psychiatric bed needs.” 

Coping with land limitations

Monterey County’s Mental Health Rehabilitation Center would have eased the lack of conservator facilities in the region. Construction for the first phase of the project — three dorms and a support building — would have begun in 2027 and finished by Summer of 2029, according to a community presentation. The health department expected to serve patients from the county, nearby areas along the Central Coast and from elsewhere across the state. 

The department was limited to use land or space owned by the county, so it initially proposed using a vacant wing of the old county jail.  A previous sheriff agreed. But current Sheriff Tina M. Nieto stopped the proposal in 2024, saying the wing was needed for vocational programs and laundry. 

Next under consideration was some undeveloped land in Salinas’ Creekbridge neighborhood, conveniently close to Natividad Medical Center and near the city’s soccer complex. The proposed campus would have included six, 16-bed dormitories with rooms for doctors’ visits, meetings, exercise and shared living space. The project also would have built a support building with an industrial kitchen, a maintenance shop, administrative offices and meeting rooms. 

The shift from renovation to brand new construction saw the project price increase nearly four fold, from $45 million to $172 million. 

Monterey County Supervisor Luis Alejo said in an October board meeting he was concerned that the “numbers skyrocketed” and questioned initial community outreach. He suggested ways to better engage the county’s residents and added he does not question the need for the center.  

From the start, neighbors of the location objected to the proposal. During a community presentation in November, the majority of speakers said no to the rehabilitation center, raising concerns about safety and proximity to schools and the soccer complex. 

One speaker accused the county of a “bait and switch,”  saying real estate agents told prospective homebuyers that land would remain undeveloped. 

The public remarks also revealed a lack of understanding about mental health and behavioral rehabilitation. One resident asked how patients would be released, would patients just walk away from the facility? Then the speaker declared: “No one will be cured there.” 

Another resident said: “You’re asking me to put a mini-mental health institution here.” 

‘They’re not criminals’

One neighbor asked: “How are you going to keep track of them? Are you going to put a tracker on their ankles?”

Rivas attended that meeting. “I stood up and said, ‘They’re not criminals,’ That’s what made me outraged. To hear residents talk that way about mental health patients.”

The supervisors indicated that cost and the resident complaints guided their decision to halt the project. 

Rivas believes that more community engagement and public education was necessary. She recalled the successful efforts to bolster community support for the Alisal Integrated Health Center, a mental health clinic that caters specifically to teenagers and young adults. 

And if the county is constrained by property ownership, staff needs to look elsewhere, Rivas said. 

“Find some property somewhere,” Rivas insists. “I don’t care if it’s in Soledad or Gonzalez. As long as we have a facility like this, somewhere, instead of having to go to Santa Rosa.”

Besides, Santa Rosa is only an option for local patients and families who are savvy enough to navigate hospital staff, insurance and state bureaucracy and are able to afford the gas and time to visit. 

Rivas knows some who are unable to access that help. She has a nephew who, like her daughter, has been diagnosed with schizophrenia. He has been unhoused for 35 years. 

The last time she saw him, he was living out of a car in Watsonville, a farm town north of Salinas in Santa Cruz County.