MENTAL HEALTH: Pilot Program Offers Treatment to Homeless, Inmates
A pilot program aiming to fill one of the "major gaps" in California's mental health system -- a dearth of services for homeless people and inmates who have a mental disease -- has offered encouraging results thus far, the Los Angeles Times reports. With over 50,000 homeless people and 15% of the state and county jail population suffering from severe mental illness, the cost to the criminal justice and health systems runs into the millions of dollars each year. In Los Angeles County alone, more than a quarter of the inmate population has some form of mental disorder. However, mental experts believe that most of these inmates were misdiagnosed in jail mental wards or given outdated medications. They argue that with proper medication and support systems, these people could lead "stable" lives. Armed with that knowledge, Assemblyman Darrell Steinberg (D-Sacramento) last year drafted and introduced AB34, which authorized a $10 million experimental program to offer treatment to members of the two population segments. AB34 workers scour hospital emergency rooms, shelters, parks and other areas common to homeless people to inform them about the program. In Los Angeles, the sheriff's office also allows AB34 outreach workers to visit the jail to enroll inmates scheduled for release. To date, 900 women and 1,200 men have enrolled in the voluntary program, and health officials estimate that hospitalization has subsequently dropped by 64%. Additionally, based on early data, the number of days spent incarcerated fell by 73%, and the number of days spent homeless declined by 58%. The results have garnered support for the program from Democrats, Republicans, mental health experts, patient advocates and law enforcement officials, and Gov. Gray Davis (D) increased its funding this year to $62.5 million to expand the effort beyond Los Angeles, Sacramento and Stanislaus counties. The program represents a "rebuilding of the mental health system in California," according to Steinberg. Brent Huff, an AB34 counselor at Hillview Mental Health Center, agreed, adding, "When you have an illness you feel isolated. We need to give them a sense of feeling worthy, a sense that they have a say-so in their own lives" (River, 6/9).
Authorizing Involuntary Treatment
Noting that the pilot program has already saved an estimated $20 million in reduced incarceration and hospitalization costs, a San Francisco Chronicle editorial lauds lawmakers' decision to offer increased funding. But, the editors note, "money is only one of the issues. It does not help to build all the treatment facilities in the world if the mentally ill do not visit them." While acknowledging that the 1969 Lanterman-Petris-Short Act brought an end to an "inhumane" approach to the mentally ill that kept them locked away in state mental institutions, the editors point out that it also has "made it extraordinarily difficult to hold even those with a long history of mental illness against their will or require them to take medication to stabilize the symptoms of their disease." A measure introduced by Assemblywoman Helen Thomson (D-Davis) would give hearing officers broader authority to order involuntary treatment for a longer period of time, but state Sen. John Burton (D-San Francisco) has opposed the measure, calling for an $87,000 study on the issue. But in the interim, the editors argue, "the untreated sit in jails and roam the streets at risk to themselves and sometimes others." The editors conclude, "Rather than kill the measure, Burton should be working to tighten the provisions for due process, one of his primary and very legitimate concerns. ... Liberation into a life of illness-induced misery is no liberation at all. ... The mentally ill not only need community- based places to go for treatment, they often need for others to recognize when they need help -- and to make sure they get it" (6/11).