Community Behavioral Health Services

ABSOLUTELY AWESOME! CBHS has been my singular mental health agency for nearly 15 years. I have a complex constellation of serious mental health illnesses (SMI) ranging from chronic depressive/​anxiety disorder to borderline personality disorder. I have been a client of both individual therapy and psychiatry services, and my SMI has made it very difficult to maintain stable employment. As my wellness has grown across time as a CBHS consumer, I enrolled in the very excellent CBHS/​Department of Rehabilitation Vocational CO-​OP. I received clerical training here, paid on-​the-​job training, and weekly job coaching. My psychological health continues to improve. I’m in another CBHS employment program– a two-​year employment internship where I am enhancing my skills, building my self-​esteem, and establishing a trusted, reliable reputation. This has never happened for me before! Of course, like anyone with a life-​long, chronic illness, I have setbacks, but CBHS provides me the supoort I need as it has all along. If you need excellent care and feel stuck or are unsure about your resources, contact CBHS and discuss your circumstances. You will be greeted by sensitive staff– often individuals with lived experience who can help you, who want to help you, and who believe that you can help yourself to improve your mental health in ways that are meaningful to you.

I wonder what their suicide and murder rate is? I’ve never seen such an unorganized office. It was described to me as a business. Mental health is a business? Not a practice?
Nobody answers the phone. When you do leave a message you’re lucky if they call you back 2 days later if at all. They are always late to see me. Making it a pain with my tight schedule. They tried to charge me 200 or so dollars because of mixed up financial records. They mix up and forget prescriptions.
I’m currently going through withdrawal because I was0 told I had a few more refills. Nope. Can’t get in touch with anyone.
I can’t wait until they go out of «business». Currently looking for a new office.
If you need mental help, stay away. They will make your problems worse.

Paul Q’s review is absolutely consistent with my own experiences with CBHS. I’m not privy to the inner workings of that organization, so I can’t vouch for everything Paul says with absolute certainty. But let’s just say that his comments would explain a LOT about my own extremely unsatisfying attempts to get treatment through them.
As far as I’m concerned, the so-​called mental health treatment that CBHS provides is nothing more than a self-​serving, cynical charade. From what I could tell, their real job is not to provide genuine mental health services to those who can’t afford private treatment, it’s to help the city of SF pretend that they’re doing so.
Sure, they’ll hook you up with a therapist (regardless of whether he or she is even remotely a good fit for you), and they’ll also give you a psych who’ll prescribe you generic antidepressants that relieve symptoms but do nothing to treat the core problem. What they WON’T do is to make any serious attempt to address the underlying issues that you’re dealing with. Trying to get treatment from them is the equivalent of having cancer or a tumor and going to a doctor only to find that he will only give you aspirin and a massage but refuses to do X-​rays or blood tests. And when you try to get them to figure out whether you have cancer or a tumor (or the mental health equivalent, as it were), they’ll give you the runaround. One particularly common stalling tactic of theirs was to whine, «That’s just a label. Why is it so important to have a label?»

«DO NOT GO GENTLE INTO THAT GOOD NIGHT,
RAGE, RAGE AGAINST THE DYING OF THE LIGHT» — Dylan Thomas

Community Behavioral Health Services is the alias of The Department of Mental Health of San Francisco. It is the city agency that provides mental health services to those who cannot afford private treatment. It got this bizarre, ambiguous appellation about a decade or so ago when, for budgetary reasons, the Department of Mental Health decided to subsume treatment for the mood disordered under treatment for substance abusers. Since there is disagreement as to whether substance abuse in a legitimate mental disorder, they changed their name to omit the word, «mental». (It’s true. I swear it.) Suffice it to say that the inane title reflects CBHS’s status as the homely stepchild of the Department of Public Health.
Mental health care has evolved dramatically in the past five decades but not in the civic bureaucracy. Rather than developing treatment modalities to reflect advances in medical knowledge, CBHS remains immured in the past. Position equals power/​money in civil service, and the rulers of established CBHS fiefdoms do not want to hear of any theories or practices that might detract from their status. Ergo, the only way that novelty squeezes into San Francisco Public Mental Health is as a subset of an already-​existing category of illness.
The effect of this can be seen in the unfortunates with mood disorders who fall within the orbit of the CBHS. Mood disorder is a recently established diagnosis and has no vested bureaucracy within the DPH. However, substance abusers, (Drunks and Hypes), is an historic civil service fiefdom. Hence, all mood disordered clients are treated as de facto substance abusers despite the fact that only about 30% actually are. These unlucky folks are made to undergo pointless substance abuse therapy led by zealous, take-​no-​prisoners, former substance abusers that not only is irrelevant to their condition, but makes it depressingly clear that no one cares.
Another untouchable class is adults with AD/​HD. The only drug that successfully treats AD/​HD is amphetamine hcl, a less potent family member of methamphetamine hcl. God forbid that the media should find out that the CBHS is giving their clients SPEED! How much more politically expedient to pretend that anything-​other-​than-​speed works. At 18 yrs. of age, speed is removed from the formulary for all clients. (Have a happy life. Goodbye.)
Imagine the case of a mood disordered client with AD/​HD and chronic fatigue syndrome. The Holy Office of the Inquisition was less effective when it broke sinners on the wheel. The exclusion of needed drugs creates a permanent underclass medicated into a state of lethargy that renders them too enervated to act out and disturb the public but whose underlying psychological problem remains untreated.
Predictably, millions of dollars in Prop. 63 money (intended, by statute, to extend mental health care to the untreated and undertreated [e.g., the Mood Disordered & Adults with AD/​HD and Chronic Fatigue Syndrome]) has been sopped up by the CBHS bureaucracy to no therapeutic effect. But the payroll is up!
Finally, there is the city budget. At the best of times, CBHS is inadequately funded since the Director of the Department of Public Health is not particularly interested in mental health. [Edit (Dec. 30, ’10): Mitch Katz will be gone in two days. Praise the Lord! Maybe his replacement will TREAT the mentally ill rather than just try to keep them out of sight (and off the books).] This accounts for the plethora of non-​profit private mental health agencies that have arisen in San Francisco principally to assure that the damage caused by inadequate and inappropriate treatment by the CBHS is minimized. When times are bad, the CBHS is pared back to maintaining its infrastructure for when times become good again. Patient care becomes even more notional (which has its pluses and minuses.)
Should you have the misfortune to find yourself under the supervision of the CBHS, do everything in your power, selling organs if needed, to return to the private system of mental health care. Remaining with CBHS will ensure that you remain sick, barely functional, and permanently dependent on the patronage of a capricious agency that is as effective as its title is descriptive.