Mental-Health Funding Is Already Anemic; Bleeding It Further Would Be Lethal

Gov. Deukmejian’s proposed budget calls for a $23- million cut in mental-health funds. This would close all but a handful of community mental-health centers and wipe out psychiatric services for all but the most grossly impaired.

Anyone who has encountered California’s fast-growing population of the homeless mentally disturbed--and who has not?--would see the folly in such a proposal. It is obvious that we need more mental-health services, not less. Unfortunately, it took the slaying of a counselor, allegedly by a client, in her Santa Monica office, to focus public attention on the inadequacies of the mental-health structure in our state. How can we even think of cutting it back?

The present situation grew out of good intentions. In the 1960s and ‘70s, the deinstitutionalization of many of the state’s mental patients was touted as a humane way to help them and to reduce costs. The people of California were promised that the mentally ill would continue to receive out-patient care in the community, and not just be turned out on the streets.

Now the political powers that be are planning to eliminate even the community services for all but the most severe cases. Don’t they realize that they are talking about human beings whose problems cause them intense emotional pain? Don’t they understand that mental illness very often is an up-and-down problem--that the tractable patient of today may exhibit disturbing (or worse) behavior tomorrow if not given steady support?

Even without the proposed cuts and closings, mental-health services are none too great. The UCLA Center for Child and Family Policy Studies recently surveyed 48 mental-health service providers at the Los Angeles County Mental Health Department. They reported serious job stress caused largely by heavy caseloads and inadequate funding. Many complained that their work was always in a state of flux, and that high turnover resulted in constant policy shifts, leaving the staff off balance. A common feeling among the social workers is that priorities like “Star Wars” or the Contras are gobbling up federal funds that would otherwise be available for essential mental-health services.

The survey also revealed that facilities and backup support for staff were wanting. Social workers said that in some locations there was not enough privacy or space to do group therapy, and that drab, dreary surroundings reduced morale. And they complained that responsibility for financial scrutiny cut deeply into time available for clients’ problems. The issue of paper work, forms and red tape came up time and time again in the interviews.

Social workers also noted that they were called on to do a lot more for their clients than simply talk them through their mental and emotional problems. They had to find help for them in a wide range of services--vocational training, public assistance, legal aid, recreational opportunities, medical treatment. Many patients are incapable of negotiating these supports on their own. Yet community agencies are just as likely to turn a deaf ear to the mentally ill as to extend a welcoming hand. Some have long waiting lists. Others are understaffed. Most have experienced severe cuts in funding.

So the Mental Health Department is not the only agency plagued by a funding deficit. Resources are inadequate for a variety of services needed as backup by social workers in their efforts to keep their patients psychologically stable.

Social workers pointed to a lack of facilities for those clients with dual diagnoses, such as those who are mentally ill and also have chemical dependencies. Other multiple-problem situations include mental illness combined with illegal alien status, homelessness of women with children and so forth. One respondent stated, “It’s completely impossible to find placement for people with double diagnoses. A mentally ill person with AIDS, for instance, no one will touch.”

As mental-health workers struggle to cope with these failures in funding for human services, the condition of a client can deteriorate or even explode. The community instinctively reacts with horror when news of something like the brutal murder in Santa Monica is broadcast. But, of course, the ultimate decisions about funding and policy for mental-health services are firmly in the hands of the public. If the public is alarmed, the time to speak out is now.

The consequences of the proposed budget cuts could be felt by every member of the community, not just the mentally ill. Cuts almost certainly will mean more homelessness and more “acting out” behavior on the part of society’s troubled.

With current rates of family violence and drug abuse already disturbingly high, does it make sense to diminish the mental-health resources that aim at ameliorating these problems?

At the very least, funding must be found to preserve the semblance of a mental-health system that the state and county now have. Then, mental-health services should be built up until the promises of community care made decades ago are fulfilled.