New Hope for Better Mental Health Care

A legacy from the last 20 years is the large number of homeless mentally ill on the streets.

With county-sponsored mental health programs slashed, the afflicted have spilled onto sidewalks, alleys and public parks from Brentwood to downtown Los Angeles and from the beaches to the residential suburbs of the San Gabriel and San Fernando valleys.

A new proposal may change this gloomy situation. And it comes from where you’d least expect it, the state Capitol, where governors and legislators dismantled the mental health programs in the first place.

Even more surprising in this era of partisan stalemate, the leading players are the state’s most powerful Republican, Gov. Pete Wilson, and a handful of Democrats, including Assemblyman Bruce Bronzan of Fresno and Sen. Diane Watson of Los Angeles.

The plan would give counties half a cent of a 1.25% sales tax increase proposed by Wilson, along with proceeds from higher motor vehicle registration fees. In addition to making more money available for the mentally ill, the legislation would improve financing for medical services, welfare and programs for abused and neglected children.

“Does this solve the devastation of the mental health system?” Bronzan asked. “No. But in the worst budget crisis in the history of the state, it prevents the mental health system from falling off a cliff.”

We were talking late last Friday afternoon in Bronzan’s office on the fourth floor of the Capitol. He was wearing khaki pants, a Hawaiian shirt and a look of heavy concentration that comes from being point man on one of the Legislature’s most complicated issues.

Bronzan, chairman of the Assembly’s Health Committee, became a health legislative expert by accident. When he was elected to the Fresno County Board of Supervisors, his colleagues told him to supervise the various health departments, a tough, thankless job that most people avoided. In eight years on the board, he became intimately acquainted with the tangle of laws and bureaucratic regulations--and with diminishing state aid that made mental health care inaccessible to those who most needed it.

Bronzan got the health assignment again when he was elected to the Assembly in 1982. He quickly understood the difficulties of reforming the under-funded, overly bureaucratic system that had frustrated him in Fresno.

One obstacle was opposition from liberal Democrats who represented parts of Los Angeles County. What Bronzan saw as bureaucratic restrictions were regarded by these liberals as necessary rules that protect the county’s poor. Without the rules, the L.A. lawmakers feared, the supervisors would take money allocated for mental health and use it to buy more arms for the Sheriff’s Department.

A second obstacle was the governor. George Deukmejian opposed a tax increase and, uninterested in change, would not cooperate. Finally, mental health’s political constituency was weak.

In 1991, the climate changed. With the election of Gloria Molina, the Los Angeles County Board of Supervisors turned liberal. The pragmatic Wilson replaced Deukmejian. Finally, a strong constituency for mental health had developed. Mental illness had become a curse for middle-class families as well as the poor. A $30,000-a-year family simply could not afford psychiatric care for a schizophrenic child. They, as well as the homeless, had been abandoned by the counties.

Wilson and Bronzan agreed on a rough plan: Give the money to the counties, with some restrictions, but not very many. If some sharp workers at a neighborhood health clinic come up with an imaginative way to treat the mentally ill, let them do it without making them wade through forms and permissions, as they now must do.

The new mental health constituency endorsed the plan. These high-voting families, working through well-organized groups, lobbied reluctant legislators.

Watson and other L.A. liberals joined in, convinced that the new Board of Supervisors majority would spend the money on health programs rather than on law enforcement.

This week, Bronzan and Watson are pushing the plan through the Legislature. It’s likely to pass and be signed by Wilson.

If the plan works out, the ‘90s will leave a much brighter legacy for the mentally ill, whether they are wandering the streets or waiting for help in their middle-class homes.