California’s approach to people with severe mental illnesses isn’t working.
This we know.
Putting them in jails and prisons isn’t the answer.
Nor is leaving them to fend for themselves on the streets. You see them every day. The homeless men and women with nowhere to go and no one to care for them. The people with the gaunt, haggard faces, the ones whose mutterings are actually cries for help.
It doesn’t have to be this way.
Gov. Gavin Newsom believes he has the solution. We’re not sure the Care Court proposal he outlined last week will work. But it’s worth exploring. We could hardly do worse.
In Alameda County, 32% of homeless adults report having a serious mental illness. In Santa Clara County, 42% of unhoused people in 2019 reported having psychiatric and emotional conditions.
The governor doesn’t want to lock them up in institutions.
He seeks a middle-ground alternative to conservatorships, which force people into treatment, frequently in locked facilities. Newsom’s Care Court would mandate treatment while allowing mentally ill people to live in the community.
The challenge for Newsom is immense. Mental illness manifests itself in different ways with different people. There is no simple “cure” that, once applied, brings the patient back to immediate health. It requires frequent “check ins” with trained specialists. That requires a sufficient funding source to supply the necessary staffing levels of medical and non-medical personnel charged with managing the estimated 7,000-to-12,000 Californians who would be eligible for the program. It also requires that all 58 of California’s counties commit to doing their part to make Care Court work.
The governor’s program envisions a system of court-ordered mental health care for people who are unable to care for themselves. They would be brought before a judge, who would have the ability to mandate psychiatric treatment, medication and housing. Counties would be required to provide that treatment through funds granted by the state.
California’s behavioral health system has failed those with severe mental illness for decades.
Then-Gov. Ronald Reagan signed legislation in 1967 with the intent of closing the state’s mental health institutions and replacing them with community-based programs. But the state continually failed to provide adequate funding, leaving far too many of the mentally ill and their families on their own. In 2004, then-Assemblyman Darrell Steinberg pushed through Proposition 63, placing a 1% tax on the rich to finance better mental health care. But a 2018 report by the state auditor faulted the California Department of Health Care Services for “poor oversight” of the program, resulting in counties leaving hundreds of millions of dollars unspent. Later in 2018, approved approved Proposition 2, which was designed to shift $2 billion of Prop. 63 funds toward housing for the mentally ill. But court challenges and the high cost of housing have kept Prop. 2 from having the intended results.
The Legislature will be charged with writing the legislation to make Newsom’s proposal a reality. It requires careful vetting and buy-in from mental health providers in urban and rural counties in order to succeed.
The mentally ill and their loved ones deserve better from California.
Mental health disorders are physical diseases little different from heart or bone conditions except in our lack of understanding of how the mind works. They are treatable.
We can improve the lives of the mentally ill if we provide the treatment and secure housing they deserve.