Luis Cruz: Welcome to “San Diego News Fix: The Backstory,” where we tackle important questions about journalism ethics and give you a behind-the-scenes look at our industry and our newsroom.
San Diego County, like many places nationwide, faces a mental health crisis. For three days last year, nearly two dozen journalists with The San Diego Union-Tribune followed patients, police, clinicians, dispatchers, and those struggling for help to create a minute-by-minute of our overwhelmed system. ing us now to discuss this in-depth, multimedia special report are Union-Tribune public safety editor Dana Littlefield, communities editor Tarcy Connors, managing editor Lora Cicalo, and we begin with publisher and editor Jeff Light.
Jeff Light: Thank you, Luis. First off, I wanted to congratulate Dana and Tarcy and the large reporting team on this remarkable project, which I’m really looking forward to publishing so that our audience can benefit by your journalism. So, thank you for that.
Let’s start with Tarcy. Maybe you could just get us all up to speed on what your team found out. What was the reporting and what did we discover?
Tarcy Connors: We discovered things in two ways. We discovered things with the reporting we did over the three-day period and then a very, very deep dive of data that we analyzed to have a better sense of where we are today compared to 10 or 20 years ago.
Some of the findings were: Over the last three decades, the rate at which adults were placed on 72-hour mental health holds almost doubled. For children, that number has increased nearly tenfold. Also, during the 72-hour period there were more than 40 psychiatric patients waiting in ERs for a mental health facility to take them. Rady Children’s Hospital – during the 72-hour period – always had at least 10 children who were waiting to be itted for treatment.
We found that over the past decade, the county has lost more than 500 beds in the community. Those are the kinds of beds that people coming out of psychiatric treatment need; it’s to step down for lesser treatment. Those have disappeared, making it really, really difficult. As an example of that, we found that one patient at Sharp Mesa Vista had been there for 242 days, because there was nowhere for them to go in the community. Scripps had a patient for 530 days, because there was nowhere to go. And the Psychiatric Hospital of San Diego County had a patient who was there for 711 days because there was nowhere in the community for them to go for further treatment.
Jeff Light: So, these are psychiatric patients – there’s no place for them to be released to. I think in reading the project we also see people backed up in the ERs, with no hospital bed to go into, so that there are people who are judged to be a danger to themselves or others just being chained to the gurney, occasionally, in an emergency room. We see the flood of calls to police around the clock. It’s really an amazing portrait of the crisis in our system.
Now, Tarcy, that 72 hours that your team examined closely is sort of the stage that this story plays out on, but the preparation to report on that goes way back and work that you did to help gain access and gain familiarity with the mental health system, which I thought was a novel approach and a really smart one. Maybe you could tell us a little bit about how you approached the story.
Tarcy Connors: Yes, it was almost two years ago that we embarked on this whole project, really not with the sense of just how big it was going to be at the time. The goal was to try to get a better understanding of the breadth of the mental health crisis. We saw it in the jails that we covered. We saw it on the streets with the homeless, and we saw it in other ways, but not with an understanding of just how big it was in the community.
So we sat down as a group and talked about what were the things that we needed to do to try to capture what was really going on in the community. We decided we couldn’t do that unless we had buy-in from the gatekeepers, and those gatekeepers were invited to sit down at a meeting where we presented the project to them. That was Mayor Gloria, Supervisor Fletcher, District Attorney Summer Stephan, then-Sheriff Gore and San Diego Police Chief Nisleit. After a two-hour meeting with them, they all committed to giving us access – with some caveats regarding confidentiality and privacy – so that we could tell the story in a much more impactful way.
Following that meeting, we went on a daylong bus ride, courtesy of the county, that took us around to the various agencies and places that touched mental health – crisis stabilization centers, nonprofits – and that was great. Then, after we had met some of the people who are actually on the ground doing all of the work, we spent the next six to eight months writing a series of stories to gain a better understanding of all the various facets of mental health, building trust with the people who we hoped would give us access later on down the road, and then eventually settled on a three-day period in which we would go out into the community.
I don’t think I explained this earlier, and I apologize: We chose a 72-hour period because that is the amount of time that a person can be held against their will if they are deemed a danger to themselves or others. We wanted to capture what happens in San Diego County over that 72-hour period. And we eventually set on three days of last April and laid out where we were going to go.
Jeff Light: Yes, it’s a fascinating project, and I think that process of gaining access, getting understanding – as a staff – and building a sense, on the one hand, of trust but also of ability, which is the basis of any journalistic pursuit, you can really see the results in this project, where you have a staff that’s deeply knowledgeable and has access behind the scenes to what’s going on in the community in ways that haven’t really been seen before. It’s really quite powerful.
Dana Littlefield, I wanted to turn to you because you were part of orchestrating and engineering this project and, also, you were one of those behind-the-scenes people, right? You spent many hours at the San Diego police dispatch center, listening in. I thought maybe you could share with us a little bit about that experience.
Dana Littlefield: I’ve seen a lot of things when it comes to reporting on law enforcement and reporting on courts in particular, but I hadn’t really seen up close how things work with dispatch. So being able to sit and watch those calls come in was really enlightening. It was really informative. We got to see the pace of the calls, of course, how the calls are handled, how dispatch interacts not only with police who are dispatched to the scene, but also the PERT teams. It was really an interesting thing to see.
One of the things – again, having seen parts of this process in other venues throughout much of my career – I had not been privy to was watching the pace at which these calls came in. That was really, frankly, surprising to me. Also surprising was the volume of mental-health-related calls.
We went in knowing there would be some – there was no question of that – but the frequency with which they came in, and how they were handled by the dispatchers, how they were triaged, the wait times. For example, you’ve got a call that’s holding because there are no PERT teams available or there are no officers available because the officers are already on scene at perhaps three or four other calls that are mental health related. So we saw that, because of the resources that are and are not available, how things run on that level. It was really interesting. And that information served as somewhat of a backbone to the telling of our story throughout those three days – when and what the calls were and how they were handled. It was a really interesting process and a nice tool for us to use in telling this story over that three-day period.
Jeff Light: I have to say, as a reader, it’s a torrent. I mean, what’s going on in the community – I think as Tarcy said – you sort of get a glimpse just walking around, right? Wow, mental illness on display in the streets. We see it in the stories we write about incarceration and about jail deaths and about police violence. Mental health plays a role through so much of what we cover, but, boy, it was super eye-opening to see it happening on an every-minute basis, which for sure is what’s going on.
You know, the 72-hour period, we just said, “OK, we’ll pick three days and we’ll see; we’ll try to be in position to document what goes on,” and those 72 hours basically began with a suicide at the Coronado bridge – an everyday occurrence, not at the bridge but in San Diego – and then ended with the shooting of a CHP officer by a suspect who was having a mental health crisis. So, all of that unfolds in this one story.
Lora, I wanted to turn to you about the scale of this story – a big investment of time and resources. How does the newsroom decide what to cover on an everyday basis and then what to cover in a special way, like this project?
Lora Cicalo: I think, as somebody just mentioned, one of our charges is to reveal hidden truths and to get at the root of some of these things that are not maybe visible – or visible in an all-encoming way. I think in this particular instance, we realized pretty early on and discussed that these disparate ways in which we’re covering mental illness – whether it’s through the health care system, public safety or coverage of homelessness – that this is something that touches on a lot of the work that we’re already doing.
But we’re using a variety of factors every day to determine what we cover: relevance, impact in the community, proximity – obviously, we’re a local news organization, so we’re interested in what’s happening in San Diego County, first and foremost. We factor in timeliness, conflict, human interest, all of those things to judge where we put our resources.
Anytime we’re looking at a project, we’re using those factors along with some of these bigger-picture kinds of issues – What can we tell? What can we reveal? Are there ability factors involved? And in this instance, all of those things came into play in a pretty profound way. I think the people involved in this project, from beginning to end, felt as though that was an important project for us and a commitment of resources that was well worth the effort.
Jeff Light: Yes, job really well done by that team. I’m thinking of some of the recent projects that we’ve committed a lot of resources to – the murders of journalists in Tijuana; the Phenomenal Women project, about the history of women’s achievement in San Diego; the border life project by Sandra Dibble. What do we have coming up that you think we ought to be turning our attention to in the years to come?
Lora Cicalo: I think there are lots of topics that would warrant that kind of commitment of time and resources. One, and we’ve talked about this a little bit, I think there’s an important story to be told about rape and sexual assault in our community. To me, it’s a hate crime, among other aspects. I think it’s something that deserves our attention and our investigation. I think the rise in fentanyl use and deaths – and tranq (or xylazine), which just yesterday the federal government sent a warning about. Although it’s not yet surfaced in a significant way in our community, it’s definitely something to watch. And I think migrant deaths, which are a community story for us, warrant a lot of our resources and attention. Those are three that immediately come to mind.
Jeff Light: Yes, and a bunch that I think also were touched on in this project: homelessness, obviously a really critical issue; and a persistent theme, income inequality, which is seen in many different areas, currently in housing. A lot of equity issues that are really powerful inside the community. So, things to look forward to.
Congratulations, again, to Tarcy and Dana and to the entire team for a really extraordinary project. It’s out in print and online Sunday
Luis Cruz: Thank you very much, Jeff, Lora, Dana and Tarcy. You can read “72 Hours: Inside San Diego County’s mental health crisis” and watch the videos in the series on our website.
If you’re thinking of hurting yourself or know someone who is, you can call the national crisis hotline for help at any time at 988.
