Column: Half a century after failing to reform mental health care, California tries again


In the state legislature, there is a bipartisan attempt to finally end the mental health reform that Gov. Ronald Reagan and lawmakers started 56 years ago. Back then, they ruined their jobs.

Their failure is the main reason why many homeless people live on the streets of California today.

The 1967 reforms were a great idea. It was not implemented as promised. Now it needs to be updated—changed to address the realities of mental health care—and given more money.

Reagan Administration Reforms Eliminated psychiatric warehousing in depressing and oppressive state hospitals. Everyone was told that patients could be better treated in the community, closer to family and friends.

Great concept, except neither state nor local governments put enough money into treatment. Thousands of former and former patients have fallen asleep in downtown streets, city parks and under freeways.

The reform also opposed mentally ill patients receiving treatment, as it became much more difficult to enforce treatment. Most of the time they had to volunteer. And many were unwilling or unaware that they were ill.

The bipartisan authors of the 1967 Act — conservative Congressman Frank Lanterman (R-La Canada), liberal Senator Nicholas Petris (D-Oakland), and centrist Senator Alan Short (D-Stock) Ton) — had good intentions. But as usual in Sacramento, legislation was enacted with virtually no follow-up.

I thought, then and now, that Reagan’s main motivation was to cut state spending. But he wasn’t going to send more state money to the county for local care.

Many succeeding governors have failed to dedicate much-needed funding to local mental health care.

But Governor Gavin Newson wants to change that.

He proposes a bond measure ranging from $3 billion to $5 billion to create housing and treatment facilities for more than 10,000 people with behavioral health problems. If the bill is approved by Congress, it will be put to state votes next year.

Newsom is also proposing to divert $1 billion annually from its so-called millionaire tax to run the new facility. It stems from his 2004 voting initiative designed to help fund local mental health services. Generates approximately $3.3 billion annually.

Republicans had a better idea last year than Newsom’s bond bill, which requires interest payments. They proposed spending $10 billion of the state’s then nearly $100 billion surplus on facilities that provide mental health and substance abuse treatment for homeless people. But the Republican Party has no clout and currently has an expected deficit.

Last year, the state legislature approved Newsom’s proposed CARE court. This allows families and medical professionals to petition a judge to order an evaluation of the mentally ill or addicted and suggest a treatment plan. However, it does not force anyone to seek treatment. It will be voluntary.

A coalition of disability and civil rights groups has called on the California Supreme Court to scrap the CARE court program, saying it violates its constitutional rights of due process and equal protection. A court recently denied the request, and the program is expected to begin this fall.

The legislative advocate for re-reform of California’s mental health care program is Senator Susan Talamantes Eggman (D-Stockton), the new chairman of the Senate Health Committee.

She promotes Newsom’s CARE court bill through the state legislature and also processes his bond bill.

But her main bill this year would make it easier for people with extreme emotional distress who need medical attention to be involuntarily detained by police, crisis teams and mental health care providers. is what you do. Bill SB 43 passed two Senate committees. unanimously.

Current law allows involuntary detention only if it poses a danger to oneself or others or is deemed to have a “severe disability.” But all of that is hard to prove. Eggman’s bill would drop the bar significantly “so that sick people don’t fall through gaps or splatter onto sidewalks,” she says.

The same coalition that fought the CARE Court also opposes SB 43, arguing that it deprives people of their “fundamental rights and freedoms.”

“I’m sick of people dying on the streets with their rights on,” Eggman retorts.

“Often they don’t even realize there’s something wrong with them. If they don’t want treatment, they don’t have to. , beaten, raped and victimized.

“It is unprogressive and unsympathetic to allow people to suffer as much as they see on the streets. It is not good for public health. It is not good for the public.”

Eggman’s Aunt Barbara was also one of the victims.. “It was part of my childhood,” she recalls.

Her aunt was released after being held for 72 hours for observation and received no long-term support. It happens often. After being detained for a short time, she was gang-raped and soon died of AIDS.

Eggman’s bill is strongly supported by two Republican leaders in Congress, Sen. Brian Jones of Santee and Rep. James Gallagher of Yuba.

“The goal is to stabilize people and eventually get them back to productive lives,” Gallagher says. “They need shelter and services — treatment, job training, temporary housing — as opposed to putting someone in a hotel room without services and hoping they will get better.”

What we’ve been doing for decades isn’t working very well. Should try something different. It is long past the state keeping its half-century-old promise.



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