When Bernalillo County opened its first 24-hour crisis triage and treatment center in December 2019, the idea was a good one: Provide free behavioral health services for those who might otherwise end up in the more costly emergency room or jail.
Anyone who has experienced the hours-long waits in metro-area ERs as inebriates fill beds or has had a loved one thrown in jail when they simply needed to sober up knows a safe but stepped-down site was absolutely needed for around-the-clock detox, short-term sobering and help for those we too often see walking/sleeping on the streets with behavioral health issues. It’s one reason voters approved a behavioral health gross-receipts tax, which the county has been collecting to the tune of around $20 million a year since 2015.
In July 2020 a $5 million expansion of the Bernalillo County CARE Campus at 5901 Zuni SE was supposed to help fill some of the gap with services for detox, behavioral health observation and assessment, an outpatient health clinic, 24-hour intake and a peer-run living room program. The expansion was intended to increase its capacity from 11,000 clients a year to no less than 14,000. (The county and University of New Mexico broke ground on a $40 million Behavioral Health Crisis Center in September.)
But staffing shortages at CARE are resulting in just a fraction of that goal being met and far too many people amenable to getting clean being turned away. From July to December last year, CARE recorded 4,285 intakes and 743 people turned away, mostly due a lack of available staff. That means people had about a one in seven chance of being denied a bed and help.
Donovan Glascock, released from jail on auto theft charges late last year, is one of those who wasn’t turned away. The 38-year-old says his years of living “fast life on the streets” cost him his family and two sons. He now lives in residential housing on the CARE campus and is getting services while recovering from fentanyl addiction.
“I mustered up the strength to do it,” he says.
All he wants now is “a normal life,” with a family and a job to get up for in the morning. He says he isn’t sure he would have gotten sober had he been turned away like hundreds of others.
County officials are struggling to maintain a sufficient workforce at the CARE Campus, which last week had 71 vacant jobs. It has barely half of the staff it needs. A single employee calling in sick could force the 24/7 detox unit to temporarily halt intakes until a replacement is found for the shift.
So far the county has provided back-to-back pay raises for employees (substance-abuse technicians now earn $18.48 an hour, around $38,438 annually, and licensed clinical social workers/clinical counselors make $32 per hour), but staffing shortages mean it still can’t operate at full capacity. The detox program is limited to 30 people, though it has space for 48. The “Observation & Assessment” sobering unit is designed for 60 clients but is capped, for now, at 20. On a recent weekday morning the Journal found the O&A room had dozens of empty recliners and two men napping.
CARE has recorded 188 turnaways so far this year.
Bernalillo County officials need to get serious about long-term solutions — adequate CARE Campus staffing would also help alleviate shortages at the Metropolitan Detention Center, take a load off deputies and likely shorten ER waits for everyone. The county (and city and state) need to be creating pipelines of behavioral health workers for their programs with local organizations and higher education programs like New Mexico Highlands and the University of New Mexico. Where are the partnerships with paid internships or practicums that get students into the field? Are certificate and degree programs as streamlined as possible? What about incentives for employees who stay in New Mexico for a period of time?
We get some of the CARE applicants, most of whom are homeless, are more interested in a place to sleep than a detox program. But turning away hundreds of potential clients annually because of understaffing is a poor business model, shows poor stewardship of public dollars and in this case is also potentially deadly.
Behavioral health experts often say the first step on the road of recovery is acknowledging a problem; too many of those who are taking the first step by showing up at the CARE campus are told there isn’t room. And the scourge of fentanyl is exacerbating the situation. Program supervisor John Chavez estimates eight out of 10 intakes are detoxing from the synthetic opiate, which he says “beats up their bodies way more severely, in my opinion, than heroin or alcohol, like sooner.”
The overdose death rate in Bernalillo County rose 170% from 2017 to 2021 in part because of fentanyl. And it will only get worse if people are being turned away from treatment. Dr. Bill Wiese, who worked in addiction and behavioral health for 15 years, says if the detox programs aren’t occurring, more people will die “faster and sooner.” Unable to meet its full mission, the CARE Campus is referring some to Albuquerque’s West Side homeless shelter, which is that warm bed some are looking for but absolutely not a crisis triage and treatment center.
If people can’t get into the CARE campus or don’t want to take the long drive to the West Side shelter, we’re back to letting them wander the streets or sending them to jail, an ER or the morgue. And that’s not what voters and taxpayers were promised in 2014 when they agreed to direct part of every purchase they made in Bernalillo County to providing crisis behavioral health care.
This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.