Officials hope new psychiatric facility in Oceanside will open by year’s end

Dignitaries walked the halls of the county’s newest psychiatric hospital Thursday, taking in the design of the free-standing, 16-bed mental health care facility on the campus of Tri-City Medical Center in Oceanside. While the construction has been complete since 2024, officals provided no firm date on when it will actually begin serving patients.

With Tri-City closing its in-house, 16-bed behavioral health unit in 2018, and Palomar Health gradually reducing its 22-bed unit, eliminating the last dozen beds in 2024, North County is in severe need of inpatient treatment capacity. Today, many residents must travel south to San Diego if they need intensive care. However, significant strain has been taken off hospitals with two crisis stabilizations centers in Oceanside and Vista, which the county says have reduced overall hospital admissions by 40%.

Faced with outcry from constituents across much of his district, newly elected county Supervisor Jim Desmond made building a new stand-alone mental health facility at Tri-City one of his first initiatives. He was on hand during Thursday’s ribbon-cutting, a day that many thought would arrive faster and cheaper when local politicians agreed to move forward as quickly as possible in 2019.

“It was six years ago, so it was lightning speed for government to get this done this quickly,” Desmond said, noting that the initial $17 million project budget increased to $27 million by completion.

Cost escalation, though, did not lead to faint praise. The supervisor said the increase in treatment capacity was worth the investment.

“We knew how badly we needed these beds,” Desmond said. “For too long, people in crisis have been stuck in emergency rooms or in jails, and that’s not because most of them are criminals but because they had nowhere else to go.

“Unfortunately, our jails are still the number one place where people get mental health treatment.”

Designed with a full complement of “anti-ligature” features designed to prevent self-harm, the facility feels like a modern hospital wing with a light color palette and significant natural light in common areas. There is an outdoor patio off the facility’s dining room that will be supplied by Tri-City Medical Center’s nearby kitchen and large-screen televisions in several gathering areas.

A mix of single- and double-occupancy rooms are spaced along two hallways connected to a glass-paneled central nursing station, providing visibility in both directions.

A locked facility operating 24 hours per day, seven days per week, the building, which is being called a “Psychiatric Health Facility,” will be operated by Exodus Recovery Inc. Exodus already runs two county mental health care crisis centers in Vista and Oceanside.

An agreement between the county and Tri-City has the hospital repaying half of the building’s cost, less $1.8 million in land value, through services such as providing three balanced meals per day to patients and other services such as custodial staffing, landscaping and linen services.

Crisis centers in Vista and Oceanside, which can hold patients up to 24 hours for evaluation, are expected to refer patients to the new psychiatric facility at Tri-City.

The focus, said Nadia Privara-Brahms, acting director of behavioral health services for the county, will be those covered by Medi-Cal, the state’s health plan for needy residents, though there will likely be some room for patients with private insurance as space allows.

“I would say it will probably be 90% to 95% Medi-Cal, but they also do serve private pay,” Privara-Brahms said.

Many patients who end up in locked units are initially picked up on “5150” holds when someone calls 911 because they think a person’s behavior makes them a danger to themselves or others or that they are gravely disabled, a term that means they are likely unable to provide for basic necessities such as food, shelter, safety and health care access.

State law requires an initial evaluation by a licensed mental health care professional and, if inpatient treatment is deemed necessary, patients are checked into locked units for 72 hours. At that point, they may be released or, with a hearing, held for 10 days or even longer in some cases.

Privara-Brahms said that the expected treatment span for most who are admitted to the new unit at Tri-City is expected to last from five to seven days, though there is no hard-and-fast rule for every patient.

“It will depend on the person, but they can stay until they’re determined to not meet medical necessity anymore, so it could be 14 days, if that’s what they need,” Privara-Brahms said.

The Tri-City unit will serve adults only. It was not clear on Thursday exactly when the first patients will be admitted. Officials said that they hope it will open by the end of the year.