Part II: The Bait and Switch
By Sharon Byrne
It can happen to you.
It can happen to me.
It can happen to everyone eventually.
There’s a crazy world outside
We’re not about to lose our pride.
—It Can Happen. Written by Yes, Released on the album 90125 in 1983.
Untreated mental illness is the leading cause of disability and suicide and imposes high costs on state and local government . . . . State and county governments are forced to pay billions of dollars each year in emergency medical care, long-term nursing home care, unemployment, housing, and law enforcement, including juvenile justice, jail and prison costs.” —From the California Mental Health Services Act, passed in 2004.
A decade after the Mental Health Services Act’s passage, I saw a homeless man wandering my street, screaming to no one about media lies. I walked my dog that night with a neighbor. As we passed by Chapala One, I saw this same homeless fellow sleeping in the garage entry. He raised his head as my dog approached him. He was intoxicated. My dog accepted a pat on the head and moved on to resume processing the evening’s peemails.
I wondered again why this man was in my neighborhood, obviously in need of mental health assistance. And what should I do? For the second time that day I questioned whether I should call the police. The guy is trespassing, and I am pretty big on the neighborhood watch thing.
But what’s this going to accomplish, really? What would the police do with him? Cite and release? Book him into jail? Relocate him to some other neighborhood?
None of those are a solution.
From the Mental Health Services Act:
(d)In a cost cutting move 30 years ago, California drastically cut back its services in state hospitals for people with severe mental illness. Thousands ended up on the streets homeless and incapable of caring for themselves. Today thousands of suffering people remain on our streets because they are afflicted with untreated severe mental illness. We can and should offer these people the care they need to lead more productive lives.
(e)With effective treatment and support, recovery from mental illness is feasible for most people.
(f)By expanding programs that have demonstrated their effectiveness, California can save lives and money. Early diagnosis and adequate treatment provided in an integrated service system is very effective; and by preventing disability, it also saves money. Cutting mental health services wastes lives and costs more. California can do a better job saving lives and saving money by making a firm commitment to providing timely, adequate mental health services.
Sounds good, doesn’t? The voters in 2004 thought so too….
So if we have the ability to provide ‘timely, adequate mental health services’ from taxing millionaires in this state, then why is that homeless man shouting the odds in my street, clearly in need of mental health services?
The act provides for oversight with a committee comprised of 16 individuals including a small business rep, large business, county sheriff, labor union, 2 persons with severe mental illness, a mental health professional, a school superintendent, a physician specializing in alcohol and drug treatment, and a rep with a heath services insurer.
Santa Barbara County Sheriff Bill Brown sits on this oversight committee.
In 2009 Rose King, an author of the original act, filed a complaint against the state Department of Mental Health. Moving far away from the promise of acute mental health care, MHSA spending was turning into a boondoggle for mental health service providers. King says, ‘They produce films, PSA’s, fund lots of conferences, and distribute grants to every interest group, which succeeded in getting them all on board with program: NAMI CA, Children and Family Advocates, Mental Health Associations, of course. And they all conduct conferences, trainings, promotional campaigns, etc. Lots of money spent on “planning.” “
Services to be provided under the MHSA are at the counties’ discretion to plan and execute. The state’s Department of Mental Health (Mental Health) and the Mental Health Services Oversight and Accountability Commission (Accountability Commission) were supposed to provide oversight and direction of county implementations of the MHSA. So how did counties move from funding acute mental health to putting on conferences and de-stigmatization campaigns?
The act was further weakened legislatively. On March 24, 2011, Governor Brown signed Assembly Bill 100 (AB 100) into law. Changes to the MHSA included the elimination of review and approval of county MHSA plans by the Department of Mental Health (DMH) and the MHSOAC. So there went oversight. Open season! Come all takers!
The Department of Mental Health was then eliminated by Governor Brown as part of his budget reforms in 2012-2013. Their services were transferred to other departments, mainly the Department of Health Care Services.
We’re still collecting money for Prop 63. Oversight has been weakened. So who’s in charge, and where is all the money going?
The answer in Part III.