Communities Slamming Doors on Facilities for the Mentally Ill

To family and friends, Tommy Lennon will always be the golden boy who loved to surf and showed a flair for drawing in the years before mental illness engulfed him.

But strangers define the 32-year-old Ojai man by his troubling diagnosis: bipolar disorder complicated by substance abuse. And they see him as a threat to their rustic Ojai Valley neighborhood.

Worried about rising crime and plunging property values, a citizens group is fighting efforts to convert a shuttered Ventura County jail into a treatment center for the mentally ill.

Opponents say it is too risky to allow mentally ill adults in a residential neighborhood close to schools and senior housing. It doesn’t matter if the facility is locked or unlocked -- either is unacceptable, they contend.

“My retirement is wrapped up in my property value, I’m sure you can understand that,” resident Doug Volpi told a crowd at a recent meeting on the issue. “I’ve worked hard my whole life to live in a community like this and now I feel like this is being rammed down our throats.”

The battle is similar to uprisings in other parts of California, a state official said.

Fear of crime and plain old NIMBY-ism is making it difficult for counties to create enough housing for the mentally ill, said Stephen Mayberg, director of the state Department of Mental Health.

California had 3,200 beds for psychiatric patients in the early 1970s when the state began closing institutions in favor of smaller, community-based treatment. Today, there are just 800 state hospital beds, even though the state’s population has grown from 22 million to nearly 34 million.

Counties were supposed to take up the slack, but promised funding has never been adequate, officials say. Neighborhood opposition also presents a formidable challenge, they say.

Ventura County is not yet planning a specific project. But the Board of Supervisors has ordered a study about putting some type of secured mental health housing at the 144-acre site 10 miles north of Ventura.

A report is expected in January.

Advocates for the mentally ill are worried that if the county backs off, it will be harder for psychiatric patients to get help. Ventura County has no locked housing for the mentally ill, causing up to 50 residents to be sent to other counties for treatment, at county expense.

Although the Lennons have found a bed for their son 75 miles away in Sylmar, they would like to bring him closer to their home. The now-deserted Ojai Honor Farm, formerly a women’s jail, is minutes away.

“I’ve heard people say the county wants to bring in the criminally insane. That is such a fearful expression,” Thomas Lennon said. “They are human fears. But we would hope people would listen to reason and facts before making a decision.”

In a report this spring, the California Mental Health Planning Council found that 50% of counties surveyed pay to send mental health patients to out-of-county facilities because treatment is not available locally.

Spiraling land costs, low reimbursement rates and the high cost of employing skilled nurses and therapists were cited by the council as barriers to increasing the number of beds. There are shortages in virtually every type of facility, from board-and-care homes to specialized treatment centers, the report said.

But the NIMBY factor was so significant that the council included Web sites that county officials could refer to for tips on building community support.

At the state level, a public education campaign is being prepared to dispel myths about mental illness and violence, Mayberg said.

Too many people believe that people with mental illness are also violent, even homicidal, the mental health director said. The stigma is fed by negative stereotypes of the mentally ill in movies and other media, he said.

One study showed that 85% of news stories about mentally ill people portray them as violent, a “gross misrepresentation” of the facts, Mayberg said.

Statistics on violence by people with mental disorders are often vague and contradictory. But researchers reporting in the July issue of the American Journal of Psychiatry cited a recent large-scale study that found mentally ill people were no more violent than those without mental illness -- as long as they were complying with treatment.

Annual violence rates climbed higher than in the general population -- 12% compared with 2% -- when major affective disorders, such as schizophrenia, were not treated, the authors concluded. The highest rates of violence, about one in three people, occurred when a major mental illness was combined with substance abuse, the report said.

Mayberg contends the numbers show that the safest place for people with major mental illnesses is in a secured facility, getting the medications and therapy they need. If people know the facts, they will be less afraid to have this type of housing in their neighborhoods, he said.

“Unfortunately, the resistance usually comes from communities that have some degree of affluence,” Mayberg said. “They just don’t want anything that jeopardizes the idyllic nature of their lives. And they have the political and economic clout to fight these things.”

That dynamic recently played out in Contra Costa County, a growing suburban region east of San Francisco Bay. Officials there reluctantly approved an 80-bed, unlocked mental health treatment center in July after a yearlong battle over whether it could be operated safely.

Then, as the center was preparing to open last week, the Pleasant Hill City Council unexpectedly voted to reconsider its approval, touching off a legal battle with the facility’s private operator. Mayor Sue Angeli said she asked to revisit the issue to make sure the facility’s operator, Stockton-based Crestwood, would adhere to a condition banning the admission of any patient convicted of a drug crime.

Angeli said her own research convinced her that a well-operated facility posed no serious risk to the leafy Poet’s Corner neighborhood surrounding it. But she asked for a new hearing after worried residents besieged her with calls, Angeli said.

“It’s just another way to try to satisfy all the homeowners and residents and make them comfortable that we have done everything we can to make this a safe place,” Angeli said.

Such resistance means that facilities for the mentally ill often end up in isolated areas or poor urban centers, Mayberg said. That is not healthy for patients trying to normalize their lives, he said.

“I don’t think it’s normal for anyone to live in a large institution where they are insulated,” he said. “How do we expect them to transition back into the community if they are locked away?”

The Lennons know how difficult that can be. Their son has been in and out of prisons for the last 15 years on drug-related charges.

They believe that his underlying mental illness, which went undiagnosed until three years ago, triggered Tommy’s downward spiral beginning at 17.

Each time he was released, the family hoped that this would be the turning point. And each time, Tommy quickly slipped back into sickness, Debbie Lennon said.

He finally was admitted to Foothill Health and Rehabilitation Center in Sylmar in June. It is the first time he has gotten long-term therapeutic treatment, Debbie Lennon said.

Since then, his delusions have disappeared and he is attending five classes a day, she said. After completing six months of therapy and drug abuse programs, he may qualify for release in December.

The Lennons are hoping for the best for Tommy.

“If mental illness is treated in the beginning, it can be a success,” Debbie Lennon said. “That’s why people need to be educated about what mental illness is and not to be afraid of it. The disease picks them. They don’t choose it.”