And here comes Anaheim’s “Be Well” Van: our Marshall Moncrief Interview.

Speaking of the long arc of history bending toward justice and all that, today finally marks the beginning of Anaheim’s contracting with Orange County’s Be Well to care for its residents who are experiencing mental or substance abuse crises.

Yes, in Orange County’s largest city, someone having such a crisis who is not presenting a threat to anyone will now be met, not by a group of armed policemen, but by a team of two mental health workers driving the “Be Well” van pictured above.

This would have saved the lives of at least three or four young Anaheim people we know of, all of whom couldn’t get their medications for one reason or other and were acting out – mostly harmlessly – and ended up being killed by Anaheim police. We’re thinking of Peter Muntean, Brian Drummond, Monique Deckard, probably Justin Perkins… and that’s just off the top of our heads. And we only hear about the ones who die, not the ones beat up or wounded. It’s a truism, but cops aren’t trained to deal with mental illness, they’re trained to shoot.

And yes, Anaheim HAS been talking about making this move for the better part of a year, but there’s a good reason it’s taken this long – they are trying to do this perfectly, including putting the mental health workers through the same sort of training and background checks that police go through – for one thing this will make the police trust them more (they say.)

Since my wife Donna Acevedo-Nelson was the main driving force in getting Anaheim to make this move, we were invited by Marshall Moncrief (the CEO of MindOC, which is the nonprofit that operates Be Well) to tour their Orange campus, which has been in operation a year now. This was in the middle of last week’s heat wave…

Marshall is proud of the healing peace and quiet his facility exudes, and as he sits with Donna and me in the lounge he explains that this is partly achieved by the use of walls that can open and close, allowing all the patients to socialize and attend events together when it benefits them, but at most other times allowing each of them “their own calm space.  A lot of other mental health treatment environments don’t feel very healing – they’re more scary and cold, like a jail.  Not here though.  We have 93 beds in this place, and they’re basically full, but feel how calm and serene it is.”

He and his colleagues aim at a middle ground, or “sweet spot” between the two contrasting models of mental health and addiction care that currently exist: “On the one hand you’ve got the county-contracted services – they’re not only SLUGGISH but also kind of BLAND in the way they provide care. I mean, there isn’t a motivation to be on the cutting edge of clinical treatment, or to go the extra mile.  And the facilities themselves are drab, old… there are good PEOPLE working there, but they’re not AMBITIOUS like ‘What COULD we do to help this particular person,’ it’s more like BOX-CHECKING.”

Donna: Like College Hospital, or Fairview, where I used to work.

Marshall: “Exactly. And then on the other hand you have these for-profit hotshots, like all those ones in Newport Beach, and everything looks glossy, polished and beautiful, but the care isn’t that great, and they prey on people for profit [body brokering] – they have patients come back and come back and come back.  They’re taking advantage of people at their most vulnerable for profit…”

“…While WE are trying to hit a SWEET SPOT in the middle, that says, ‘Could we create something that looks and feels dignified and therapeutic, and warm and welcoming?’”

D: Did you guys get a new paint job out front?  I don’t remember it being blue before. It looks SOFTER; before it looked kind of beige.  It does look more comforting. 

M: Good.  I want our facility to look nice, not to be impressive, but because I want the community to see that mental health matters – it matters in the same way that anything else in healthcare matters – and we’re giving the same quality care, and the same dignity and respect, to whoever walks into this place for care, as you would get if you went into St Joe’s Hospital for a surgery. 

Wait – Who IS this “Marshall Moncrief?”

An OC native who’s lived all over the county, Marshall tells me his interests arose from “deeply personal reasons” – his family was “significantly affected by mental illness.” He has had an MFT – that’s a marriage & family therapist’s license, for decades, and has done lots of clinical work over the years – twenty years in OC hospitals, and he also got an executive MBA for doing administrative work.

And while working for these OC hospitals, for twenty years, he and other folks he worked with saw so many problems, the lack of an overall system, so many challenges in the ER’s, that he and a lot of his colleagues came together to come up with a better more unified system. Marshall figured if they all approached it together – hospital administrators & county officials (supervisors and management,) academia, the faith community, nonprofits….

Anyway it all led to the creation of a 501(c) named Mind OC, which was created to FACILITATE and run “Be Well,” which in turn Marshall characterizes as a “community movement.”

“…And you have to have the public sector involved, the county and cities, they’re just too important not to.. but yeah oftentimes they just work so slowly that it just feels you’re never gonna get to the goal-point. So the benefit here is, we’re trying to leverage the public sector for the financial, for the approvals and stuff like that, but then use the private side to move things faster.”

Vern: “Usually there’s someone trying to figure out a way to make a profit off of these things. That’s why Anaheim, under Mayor Tait, had the easiest time working with the Salvation Army. They don’t care about making a profit, it’s just in their nature to try to help poor people and troubled people.”

M: “Yes that’s just what they do, and they do it so well.  We’re meeting frequently with the Salvation Army, to look at the synergy between where we meet a patient who is sometimes in an acute state and the long-term sobriety programs they have and the work training programs they have where we can plug people into the system they have for long-term support.

D: Where are you now on building your other facilities, or campuses?

M: We’re coming along. We hope to start demo on the site in Irvine probably early this fall. Then it’ll take us the year of 2023 to build it out and then open it up early ’24.  [Ignore the dates on the announcement to the left, who knew what a problem Covid would be?] Compared to what the County usually does that’s actually super-fast!  We’ll get it done in a year.  Before the County breaks ground, it’s usually two years to find an architect or whatever…  

V: Are there any other campuses planned besides Irvine?

M: Well the GOAL is we think we need three of these at least, and so…

V: Probably around HB or Seal Beach?

M: Well you’re right on target, we were looking at Costa Mesa. And the third one could be a big one like this, or maybe the third one could instead be two satellites.  Like one even further in north county, and one further south.  We need these things in close proximity, so wherever you are in OC it’s a 10 or 15 minute drive.  Or else people won’t use them, law enforcement won’t come here.  They’ll go to a jail or an ER, and we know the outcome of that is not good.

Adventures on Anna Drive

Here’s just ONE incident from last year that led Donna to try to hook up our town of Anaheim with Be Well: One evening, a young lady nobody knew walked right into one of our neighbors’ apartments and started hitting one of the men there. She was hysterical and crying and seemed to think it was her place – we didn’t know if she was on drugs or mentally ill. The neighbors did two things – they called the Anaheim Police, and meanwhile one of them ran over to our place to get Donna.

Donna did her best calming the young lady down and getting her to come outside. Meanwhile the police showed up, I think six of them, and they weren’t sure what to do. They had never heard of Be Well, and all of us were aware that the “CAT Team” could take hours if it came at all. The police called for an ambulance to take the girl to an ER, but they weren’t sure how to get her on the gurney, and she noticed that some of them had their hands on their guns, which made her freak out again. Donna managed to calm her down again, and talked her into getting onto the gurney.

I overheard some of the cops saying “Donna can take care of this, Donna’s got it under control.” That was kind of funny. It wasn’t her job, and it shouldn’t be their job either. Now it won’t be.

Donna: “Yeah, you’re just trying to help someone but you don’t want to get shot, I don’t like to be right in the middle, you know…”

M: Exactly, I so appreciate what you’re saying.  So, an officer is dealing with a burglary or a break-in, and in those situations their lives are threatened and so they’re used to doing this.  But when you’re dealing with the people we’re dealing with, they do this instinctively but it has the opposite effect, it doesn’t help, it hurts.  And so we really just have to help EXCUSE them from these situations.  It’s better for them, it’s better for the community, and all of us.  And that’s what this mobile program’s about. Once this gets up and running in your town, I’d love for you guys to do a ride-along….

V&D: Okay!

Marshall’s HB Stories!

I haven’t mentioned, but Huntington Beach, with the enthusiastic support of then-Police Chief Julian Harvey (formerly Anaheim’s deputy Chief) along with their Democratic-majority Council, has had this program for nearly a year already. And Marshall, who currently lives in Surf City, has stories he likes to tell from those months:

“The very first family that we helped in HB, this mom was calling the police multiple times a week to come out to her house because her 12-year old son was punching holes in the drywall and acting out violently.  And the police went out every time, and they were actually great, they were compassionate.

Donna: So they probably already had a relationship with the family. 

MM: “Yes, but all law enforcement can do is take someone to jail, take em to an ER, or leave.  And so they’re not gonna take this 12-year old to jail, and he didn’t need to go to ER.  So they’d come, settle the situation down, and then leave.  And then a call would come in the next day. And the same thing over and over.  Well, on the very first call that WE ever went out on, our team, being trained, went into the house, sat down with the boy, the other clinician sat with the mom.  And they learned that the boy’s dad died a year ago.  And mom was dating all these guys who were kind of rough around the edges, and scaring the boy – of course he was acting out.

“So they helped connect the boy to counseling, and the mom to counseling and parenting classes, and now they actually have a path of getting better, and the calls to police stopped! It wasn’t a big heavy thing, it wasn’t a big mental illness, but this family needed help.  And the police, as compassionate as they were with this family, weren’t really able to help. 

“Then there was another couple who kept calling law enforcement over these domestic violence situations, both the husband and wife were drinking really heavily and they’d go after each other.  Police would go out, they’d calm the situation down, they’d leave and get called back the next day.  Well, our team went out, and – coincidentally – it also happened that they had a child that had just passed away.  And they were drinking through their grief.  And escalating their conflicts.  Well we went out the first day, kinda settled things down, and followed up the next day, hey how are you guys doing, we built a relationship with the husband, and on day three HE called US, to say, hey I think I’m ready to go in to detox.  So we went and picked him up and took him to detox. 

“All of these beautiful little interventions where families like that struggle all the time.  All day long.  But there isn’t really an immediate channel for them to plug in for help.  The vast majority of people that we’re meeting, we’re not bringing to facilities like this.  We’re stabilizing the situation right there in the community and helping them connect to what they need.  That’s the goal... And then when you NEED a facility, we’ve got the van to take you to a facility. Let’s go look at the van, one just pulled in.” So, out we ventured into the 105-degree swelter…

Behold the Be Well Van!

The first thing Donna and I noticed when we went into Be Well’s back lot was that only a row of bushes separated us from the scene of a big riverbed homeless eviction a few years ago; no, not the giant one in 2018, the one before that in ’16 or ’17.

Now Frank, the driver and manager of the van fleet, was pulling in, and this one he was driving is actually going to be the Anaheim van – it’ll get a magnet placed on the side with our city logo. Huntington Beach with just over half our population has two vans; Garden Grove has one – you’d think at our size we’d need four or five, but… baby steps! Says Marshall:

“For OC’s biggest city to be stepping in with mobile is a big deal is a really big deal.  For one thing, it makes other cities say ‘Hey maybe WE need to do that.’  So we’re really pleased with Anaheim for supporting this.  It’ll be new and we’ll have a lot to learn.  And what’ll be interesting to see, is, Anaheim is SO BIG.  Geographically huge, the number of people are just huge, the diversity is enormous, and so it’s possible that this might have to grow into a couple of vans.

“Right now, if somebody’s covered by MediCal, it’s the county that’s paying for them to be here at this facility.  So we have to be very careful to follow the rules of the county.  But the mobile program, the van I’m gonna show you, that’s launched by Anaheim, that’s funded by Anaheim.  Which is what we’re so excited about, because historically cities have not stepped into that, they’ve just said ‘Well, it’s the county’s responsibility.’  Well, we can say that all day long, but the county’s mobile program isn’t meeting the needs.  How long does it take the CAT Team to respond, Donna?”

D: WAY too long.

M: Right. So we need this, at a local city level, to be more responsive. And so Anaheim agreeing to fund this, and fund CityNet, is something we need to celebrate. So the City Council needs to hear from people like us, cheering them on and saying “That’s a great thing you’re doing. That really makes a difference.”

D: Well, at least CityNet is finally answering their phone now!

We see that there is room and seats for family to accompany the patient, if they feel more comfortable that way. Donna asks about folks being “5150’d” and compelled to get onto this van, but that can’t happen – the County has control of the 5150 process; people only come onto the Be Well van voluntarily.

Frank the van man chimes in: “Yeah, we can de-escalate a situation, and we can do a risk assessment to see if we think someone’s a danger to themselves or others, and if we see that we’ll call a Captain.  But if they’re not quite at that level, we can take them into the van voluntarily and take them somewhere to get stabilized.” 

M: The driver’s up there, and a counselor might be in the passenger seat, or the counselor could come back and sit with the patient.  If the person is really distressed, we might keep the divider closed, just to keep everybody safe.  So, just like the facility you’ve seen, we try to approach the van from the perspective of what’s comfortable, dignified and respectful for the person, AND thinking of safety. 

V: It’s still got the new car smell.

D: What do you keep up there, medical supplies?

M: Different types of supplies.  We don’t replace an ambulance so we’re not trying to be medical, but we have first aid type things, blankets… COVID masks..

D: This has been in the news a lot, do you have NARCAN, and NARCAN training?

M: Yes. So, we try to strike a balance – when something’s overtly medical, we’ll call the EMS, or, like Frank said, if somebody is overdosed in front of us, we’re gonna take action.  Yeah, so we’re really proud of how this is turning out so far, and…

V: How many of these vans do you have so far?

M: Geez, I don’t know, Frank, how many vans do we have?

F: We’ve got eight right now, and we’ve got five more waiting in the shop for conversion… just waiting on the seats actually.

M: We need to move on because in a few minutes Senator Min is coming for a tour … I’m a little bit nervous when I think about our mobile program, just because of the amount of need in Anaheim. I have no illusions.  I think that just one van out of the gate won’t meet all the needs. But I don’t want to call it a failure, I want to call it a BEGINNING point – what can we learn from this, do we need to improve it, do we need to expand it, what is it doing well, what is it not doing well.  There’s just so much to learn to get it right, and so I will be keeping in touch with you two to see how things are going.

D: And we don’t MEAN to be the boots on the ground, we just happen to be there a lot.

M: Yes, and it’s overwhelming.  It’s overwhelming for all of us… I was talking to… I guess it was the Anaheim Kiwanis about this center the other day, and I was all excited talking about this campus saying we have a this now, a that now, a sobering center, a crisis unit, and all this. And then I kind of paused because I was thinking, you know, in some ways it’s so exciting that all this is here, but then it’s also like, THIS SHOULDA BEEN HERE TWENTY YEARS AGO.  And it’s like in some ways it’s terrific and it’s new, but in other ways, this is what we’ve needed.  And to NOT have it was kind of unacceptable.

Dr. Lauren Brand, and the Intake/Garage.

Well, where does the van drop you off when it takes you to Be Well? First, to an intake-slash-garage in the front off to the side, which was designed by Dr. Lauren Brand (Doctorate in Clinical Psychology and Director of Operations, and pictured to the right.)

M: “This is my favorite part of the campus, which may sound weird. It’s really important, because we don’t take them to a jail, we don’t take them to an ER, instead they come here.  And so, if someone’s ever been taken to an ER before, when they get out of that car, when they get out of that ambulance, the ER is totally chaotic, right?  And so, what Lauren has designed here is this very quiet, discreet, dignified place where they can get out of the vehicle, there’s not a lot of lights and sounds, it’s nice and calm. 

“And then we have two doors here.  Sobering center and the crisis unit.  And so if someone is bipolar and manic, and also alcoholic and under the influence, then Lauren and her team are making clinical assessments about what’s the forward-leaning problem of the moment?  And based on whatever that is, that’ll determine the door the patient goes into.”

V: Triage.

Lauren: Yeah. This was designed specifically for the entry point for any first responders.  We designed this so people could get a different experience from going to an ER or a jail.

M: Our vans will come in here too, go in the same exact way and drop them off.

L:  The advantage of having the sobering center and the mental health crisis unit doors right next to each other is because sometimes people will come in and we think they’re going to go into one of the doors and then when the staff come in and talk to them or do an assessment, they realize that, oh, this person was brought in to the sobering station, but they seem confused and maybe there’s some psych stuff? 

D: And maybe they’re off their meds, haven’t been taking them…

L:  Exactly.  So, even if they’re intoxicated, they won’t necessarily be going into sobering, they could be going into the CSU instead, and sobering up, and get their meds if that’s what they need. 

D: We know of two people who weren’t able to get their medications, and ended up being killed by the Anaheim police.

V: Actually three or four, probably more.  Peter Muntean, Monique Deckard, Brian Drummond, probably Justin Perkins. And that’s just the ones we know of, who died.

L: “So, think of it as an urgent care, where… I was just on the phone with someone yesterday, a clergyman who, one of his congregants has a 24-year-old son who has bipolar disorder, and not quite in crisis, but almost, and he wanted the phone number to this place, because he said, when he gets into crisis, we’ll bring him.  And I said, “He doesn’t need to be in crisis to come here, almost there is fine.” And so last night we were able to pave the way for this 24-year-old to come in here before he got to that crisis point. 

“As long as someone can be stabilized within the 24-hour period that we can keep people here, it’s very effective.  They come in, their interaction with law enforcement at the drop-off, it happens very quickly. It takes 15 minutes, and then they’re in care, they’re not in police custody.  And then within half an hour the intake is complete, they’re in a nice comfy recliner with clean bedding, the staff are starting to work on their plan. 

“And then if we can’t stabilize them in 24 hours we have options for them.  Then another track starts, which is do they qualify for one of the programs we have here?  Because it’s an easy transition from downstairs to upstairs essentially, whether it’s mental health or a substance use issue.  OR, do they qualify maybe for some other kind of treatment, maybe they need inpatient or something else, then that track begins, paving that easy transition for the person to go to whatever the next service is.  But the hope is that they come in, they get the right care very quickly, and then they stabilize enough to be able to go back to their lives. 

D: This is great.

L: And if anyone has been here for any length of time, then they’re part of our Be Well family.

Recovery

On our way out to the outside courtyard, still eagerly expecting Senator Min, Marshall remembered a whiteboard where patients were encouraged to scrawl words that came to their minds as they thought of the program. “Vern, you’ve gotta get a picture of this!” I squinted at the board and grumbled, “This is a collection of nouns, adjectives and verbs all mixed together…” Everyone laughed because I guess I’m a dick. “Just take a picture of it, Vern.” So here it is.

Out in the blistering heat of the courtyard, with a view of all different sections of this three-story building, Marshall still had things he wanted to point out to us: “On the front end here, that’s kind of the urgent care, the crisis unit… and then the residential programs are over there.  So the goal is to help as many people in the crisis units as possible, and get ‘em back home, into outpatient care.  It’s NOT to bring everybody into the residential area. If they NEED it then we have it.  So the second floor…

D: The goal is NOT to keep them here.

M:  Right. Unlike those for-profit guys that Vern was referencing, those places have a different goal: Keep that head in the bed as long as possible.  That’s not our motive.  And so, the second floor is the mental health floor.  And so, crisis residential is there, people are there for about two weeks, something like that… And then there’s a detox center on the third floor, and addiction residential on the third floor.  So the whole thing works as an addiction treatment center, a sobering center, a detox facility.  From the crisis unit, to the crisis residential, to the long-term residential. 

D: So everything’s here.

M: “EVERYTHING’s here.  And this is what I’m saying, on the one hand it’s so exciting that we have this, and on the other hand it’s like, WHY HAVEN’T WE HAD THIS THE WHOLE DAMN TIME?  And so, it’s the only place around where all of this is under one roof… and it’s also the only place in town where, say, John with MediCal can come here.  Joe has Blue Shield, he can come here.  Sally is homeless and has nothing, and she can come here.  And so, it’s the only place like that, where addiction treatment and mental health care is under one roof, and it doesn’t matter what kind of coverage you have.  And so that’s what we’re trying to do with all of this Be Well stuff.  Make it accessible to everybody and link all these types of services in the way that they should be…

“We’ve got two big classrooms back there, and sometimes we’ll bring all of the residents down to do some kind of educational event.  We have a little gym right here… it’s modest but it’s a nice little gym with exercise bikes and treadmills and stuff… And right now it’s really calm, because everyone’s in their own unit. 

“A lot of the time we’ll bring people down to this courtyard, and you see all those rocks?  When someone graduates from one of the long-term residential programs, they come out here to the garden and they do a ceremony, and they paint a rock. And look, some of them are really beautiful.  Look at the one that says ‘JOY’ right there.  Some of these are amazing right? And that cute little happy face…”

One last thing…

One last thing that we’ll have to look into later so as not to harsh this article, but… WASN’T THIS ALL SUPPOSED TO BE PART OF “DEFUNDING THE POLICE?” I mean, number one, this is NOT FREE, and Anaheim’s pockets are not as deep as they should be, for a lot of bad reasons. And number two, this should take a lot of workload off the Anaheim Police, especially as we get MORE of these vans and mental health workers, as we need to.

I clearly remember Chief Cisneros, in that contentious summer of 2020 after the killing of George Floyd and during all the protests, pulling out a PIE CHART and showing how much defunding of his department HE WOULD ACCEPT, if it went to a program like this. (I’ll find video if I can.) But I don’t think we’ve heard any talk like that since. I don’t imagine it went over well at all with the union, the APA. In fact, if I’m not mistaken the police department is asking for EVEN MORE money, as they do EVERY year.

But let’s save all that for a future article. Today we’ll thank the Anaheim Council for investing in its people’s mental health and safety. And particularly Councilman Steven Faessel, whose votes I usually deplore, but who has been VERY HELPFUL on this issue. Now take it easy, Anaheim, and BE WELL!

About Vern Nelson

Greatest pianist/composer in Orange County, and official troubador of both Anaheim and Huntington Beach (the two ends of the Santa Ana Aquifer.) Performs regularly both solo, and with his savage-jazz quintet The Vern Nelson Problem. Reach at vernpnelson@gmail.com, or 714-235-VERN.