Mental-Health Sham

California government has a new approach to the state’s mentally ill. It used to hide them. Now it hides from them.

There isn’t enough money to provide the community care that troubled people so desperately need, there is even less leadership, and there is virtually no systematic approach to mental-health commitment and care. The results: Violent people with psychiatric problems sometimes are released when they should be held and treated. Others aren’t treated when timely treatment would still help. And severely ill people often wander the streets without hope.

The cases that most often grab public attention are those of severely troubled people released from hospitals who weeks or months later commit acts of violence. For example, Daniel Lee Young had doused himself with gasoline in an apparent suicide attempt and was released from a mental-health center after the 72-hour evaluation period when a court-appointed referee found no cause to hold him. A year later he drove his car into a crowd of Westwood pedestrians, killing one young woman.

Do the criminal-commitment laws need changing? Not if present laws were properly applied. Marjorie Swartz, an attorney for the American Civil Liberties Union, says that state law now allows psychiatrists to use a person’s case history to show that he might harm others. But, as Times staff writer Paul Jacobs reports, officials with the Department of Corrections and the Department of Mental Health seem reluctant to invoke that law. At present, the corrections department has identified 150 to 175 violent, disordered people scheduled for release from prison who it says cannot be committed for psychiatric treatment.

That’s just the most dramatic part of the problem. As long as people pose no threat of harm, they can’t be held long enough for real analysis of their problems and meaningful treatment. They can’t be held, but they can’t function in even the most routine ways on streets full of potential threats. Downtown Los Angeles is full of these walking wounded.

Safeguards written into the law a decade and more ago to protect people from wrongful commitment were long overdue, and must be maintained, but the Legislature now must lengthen the legal period for which people can be involuntarily committed. It must also expand commitment criteria so that people whose condition will clearly deteriorate without treatment can get the help that they need. But it cannot do either until it provides funds to improve facilities for caring for them.

And what about people who aren’t troubled enough to need hospitalization but cannot handle their lives and haven’t the money for private treatment? Community mental-health programs were promised as part of the reform to end the hellish confinement in state hospitals; that promise was never fully kept.

The need for money for a full range of mental-health services is massive. Two years ago a group of experts devised a model mental-health plan for the state; it would cost $1.8 billion a year to put it into effect, double the current budget. Obviously the state cannot afford to do that all at once, but it can do more than it is doing now.

Indeed, Gov. George Deukmejian has proposed to increase state spending for mental health this year, and his Administration is working to equalize the amounts of money available to different counties for mental-health care. But even if his proposed increase goes through, state funding still will be less than it was five years ago, discounting for inflation. The governor’s budget also needs more stress on improving community mental-health programs.

California took what should have been a humane step when it deinstitutionalized many mentally-ill people years ago. That reform will remain no more than a sham foisted on those who cannot fully help themselves until the other half of the promise of continued care is fulfilled. Now is the time to start.