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Comments to El Dorado County Board off Supervisor’s – shared on 14-May-2019 in person

Recognizing May 2019 as


Comments from NAMI (National Alliance on Mental Illness) El Dorado County

El Dorado County Board of Supervisors Meeting

May 14, 2019


My name is Fred Hjerpe.  I am Co-President of NAMI El Dorado County (EDC).  My wife, Mariel, and I reside in southern El Dorado County near the middle fork of the Cosumnes River within the Cosumnes River Community Services District where I also serve as Vice-President of the District’s Board of Directors.  We are thankful to be living in a beautiful rural community.


Please excuse the scheduling confusion that resulted in my absence two weeks ago when you passed the proclamation recognizing May 2019 as Mental Health Month.  Nonetheless, on behalf of our NAMI EDC President, Jeanne Nelson, our Board of Directors, our members, and all the lives NAMI has touched in El Dorado County, I want to thank the Board of Supervisors for recognizing May 2019 as Mental Health Monthand for proclaiming the necessity to ‘increase public awareness of the importance of mental health, promote greater understanding and hope for those who live with mental illness to reduce stigma and discrimination, and pay tribute to all who devote their skill and expertise to the cause of better mental health for our citizens’.  I did watch the video of the reading and adoption of the proclamation.


In much the same way that Bill and Dave founded in a Palo Alto garage the iconic organization and brand, Hewlett-Packard, a small group of courageous families gathered around a kitchen table in San Mateo County California in 1979.  NAMI blossomed into the nation’s leading voice on mental illness with more than 500 local affiliates working to raise awareness and provide support and education that was not previously available to those in need.  NAMI has completely changed the way mental illness is viewed and understood.  In 1979 I doubt anyone envisioned how these changes would profoundly affect public policy, the medical community, law enforcement, and the people and families dealing with mental illness and disease.


NAMI EDC is among the original few NAMI affiliates in the state of California.  Our mission states ‘We offer support, education, advocacy and awareness to families and individuals living with mental illness including co-occurring addiction.  Through community collaboration we advocate for integrated health care promotion of evidence-based community programs that advocate the latest scientific research that improve our community’s knowledge’.


To realize our mission we educate, we advocate, we listen, and we lead.  Let me offer only several examples:



One year ago, concurrent with Mental Health Monthwe successfully completed our largest ever fundraising effort. Using a Johnson and Johnson sponsored public health crowdfunding platform, CaringCrowd, we raised in excess of $32,000 through the generosity of over 120 donors and matches from Johnson and Johnson.  The funds will be restricted to the expansion of NAMI’s Family-to-Family Education Program, a free 12 session education program specifically for family members and friends of adults who live with mental illness.  As a result of our fund-raising success three additional individuals became certified Family-to-Family teachers, classes were conducted in South Lake Tahoe and, for the first time ever, in El Dorado Hills.  In July NAMI El Dorado County will also be sponsoring its own teacher training class in South Lake Tahoe where we require more certified teachers.  My teaching colleague, Victoria Debenham, and I want you to know that both HHSA Supervising Deputy Public Guardian, Nathaniel Houston, and EDSO PERT Deputy Mark Hangebrauck made important contributions to our El Dorado Hills class. Our commitment to the Family-to-Family program is being recognized at the upcoming NAMI California Conference where NAMI EDC will be the recipient of the 2019 Family Engagement Award.  The award is given for exceptional growth in family programs including Family-to-Family classes and will be awarded at the President’s Reception.



At the federal, state, and local levels NAMI is the most important non-governmental voice for policy and programs affecting our mentally ill population and their families.  From the very beginning, at the kitchen table, a large part of NAMI’s DNA is to be that squeaky wheel and, at times, disrupter to status quo thinking about mental illness, mental health policy and the stigma associated with mental illness.  Let me squeak regarding three programs.


Stepping Up, the nationwide evidence-based initiative to reduce the number of inmates with mental illness in jails was passed on January 5thin 2016 by the Board of Supervisors.  The resolution authorized the Director of Health and Human Services, the Chief Probation Officer, and Sheriff to formally support the program. In a mental health crisis people are more likely to encounter law enforcement than get medical help  You recognized that in many areas our jails have become modern day ‘asylums’ and that without appropriate treatment and services, people with mental illnesses continue to cycle through the criminal justice system thereby creating significant stress to primarily local government.  As required, a leadership team was established. In 2018 the leadership team met four times. I do not believe there have been any meetings in 2019.  To be sure Stepping Up can present reasonably complex and difficult issues.  Mental illness is complex and difficult.  I have discussed the initiative’s status with Leadership Team chair, Chief Probation Officer Richart, and we subsequently met with our Sheriff and Undersheriff.  Those discussions, now several months ago, did not suggest any lack of commitment to the initiative.  However, with almost half of 2109 behind us the initiative has stalled and seems to have an uncertain future.  NAMI EDC will continue to believe the promise of Stepping Up.  We hope the Board of Supervisors does also.


Psychiatric Emergency Response Team(PERT) is in the second year of a three-year pilot program paid for with MHSA funds. PERT can assess and diffuse people in mental health crisis, reduce unnecessary emergency room visits and prevent incarcerations.  The team, made up of a trained EDSO deputy and mental health clinician, has had a very positive impact.  NAMI EDC is thankful to all those associated with the program.  The problem is that we have only one PERT for the entire county. South Lake Tahoe does not have PERT access at all.  NAMI EDC urges recognition of the success of PERT by making the ‘pilot’ program permanent and authorization an additional PERT for the county.


Assisted Outpatient Treatment(AOT) has been operational for about a year and half.  The program gives families, agencies, and individuals additional tools to help people who need mental health treatment, particularly the seriously mentally ill.  It is estimated that El Dorado County has over 7,000 residents (approx. 4%) with serious mental illness including schizophrenia, schizoaffective disorder, bipolar disorder, and depression with psychotic features.  The AOT program uses a community-based, case management model to assist the seriously mentally ill with placement into treatment.  One AOT eligibility criterion is having a history of failing to comply with treatment.  I can tell you from direct experience that anosognosia or lack of insight regarding one’s mental illness is the most disturbing and insidious characteristic of serious mental illness derailing treatment and medication compliance rendering additional psychotic events inevitable.  Clearly AOT can be valuable proactive tool. It seems however that AOT is poorly understood, not widely communicated, and underutilized.  NAMI would look forward to the opportunity to work with HHSA to expand AOT understanding, acceptance, and utilization.



Our Warm-Lineprovides support to community members that need education, support or advocacy.  In 2018 our EDC volunteers responded to over 700 warm-line calls received throughout the county.  These calls range from wanting to be included in an upcoming education class to the despair of not knowing where to turn when a loved one is in crisis.  Last month alone the Warm-Line received 72 requests for support.


Family Support Groupmeetings take place monthly in both South Lake Tahoe and Placerville.  The meetings are designed for family members, caregivers, and friends supporting a loved one living with a mental health condition.  The groups provide a supportive environment that focuses on the challenges and emotional overload that are so much a part of caring for a loved one with a mental illness.  2018 monthly attendance was 23% higher than the previous year.




Community Outreach and Collaborationare central elements to our leadership.  Our 2019 Strategic Plan calls for presentations to community groups at least three times in both South Lake Tahoe and the western slope.  There are now fifteen Mental Health Resource Kiosks throughout the county providing nearly 5,000 NAMI educational brochures to the community in 2018 while subscriptions to our quarterly e-newsletter increased by 30% to over 900.  We have developed a strong relationship with Barton Health and Barton Foundation in South Lake Tahoe and have begun to collaborate with Shingle Springs Health and Wellness Center and Marshall Hospital.  Wherever possible we seek to quantify and/or measure our outreach initiatives.


Prior to late 2017 I knew very little about NAMI. In June 2017, our profoundly mentally ill son, in the throes of psychosis, drowned in the middle fork of the Cosumnes River. It was only after a family friend launched a memorial fund-raising campaign benefiting NAMI New Jersey that I began to understand NAMI’s mission and its value, particularly at our local level.


NAMI El Dorado County will continue to educate, advocate, listen, and lead.  We look forward to sitting at the table with all stakeholders who share a vision of results driven, evidence-based policies and programs that benefit our county’s mentally ill residents and their families.  Again, NAMI El Dorado County thanks you, our Board of Supervisors, for proclaiming May as Mental Health Monthand for the opportunity to speak with you today.

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