Care for the Mentally Ill

The article “Feud Threatens Touted Mental-Health Model” (March 8) credits Ventura County’s approach with helping thousands of mentally ill people regain a more “normal life.”

“Instead of languishing in locked psychiatric wards, the mentally ill are now living in the community, holding down jobs and forming friendships,” it reads. Where is the evidence for this statement?

For years, county officials have turned a deaf ear to the many requests from advocates for statistics on the success-failure rate of placements. Neither is there documentation for the number of people who may have been restored to jobs or become homeless or died.

To be more precise, advocates see that the county’s practice of cutting funds for acute and subacute care beds has forced the care of many seriously ill [people] either outside the county or upon unlicensed room-and-board homes, a practice that endangers the well-being of clients.

We hope the “Cadillac of care” description of the 30-bed Camarillo residential facility did not give the impression that Las Posadas is too expensive. It is, in fact, a cost-effective facility, worthy of emulation. Because Medicare and Medi-Cal pay for the major costs, actual charges to the county for Las Posadas amount to a fraction of the costs that we pay for our county jail to incarcerate the same population.

Although this article reported one of our board members’ satisfaction with the treatment her 22-year-old son receives by the team system, it neglected to mention the potholes in the road this parent traveled as she sought help for her son. The reporter omitted this parent’s comments that she was upset when her son was released from the hospital to a downtown hotel while she and her husband were out of town, causing a serious lapse in his care. And when her son was passed over for a promised housing placement in lieu of someone whose problems were more critical, this parent was again upset but able to maximize the system through strong advocacy. Indeed, she now has reason to hope that her son may one day work and live independently because he now resides in a specialized program that [has] one of only six licensed beds in the entire county.

It would be a distortion to portray this success story as representative of how well the system works for the more disenfranchised. The National Alliance for the Mentally Ill (NAMI) of Ventura County has the obligation to advocate for people who do not know how to navigate the system to their benefit, and who are consistently told “no vacancy.”

“Instead of languishing in locked psychiatric wards,” it would be more precise for proponents to say the mentally ill--who account for 20% to 30% of our jail population--now “languish in locked jail cells.”

It’s time to take a look beyond the hyperbole of people who find it necessary to defend a merger that failed and a system that may not live up to its “model” reputation. It is time to open a new chapter. We request officials to give the new administration a chance to salvage what the proponents have themselves shredded.

ED NANI, President

LOU MATTHEWS

JIM MATTHEWS

CAROL LUPPINO

LOUISE OSEGUERA

JANE SHEENAN

MONA NANI

BETTY RYERSON

IRENE KING

KATHLEEN PAYNE

SUSAN VINSON

Board Members, National Alliance for the Mentally Ill, Ventura County Chapter

*

As mental health professionals, each with more than 25 years providing public and private mental health services, we have watched with growing alarm the recent developments involving the Ventura County Behavioral Health Agency. Our concern centers on the shift from the bio-psycho-social model of mental health treatment to a return to the traditional--and inadequate--medical model.

The medical model, with its overemphasis on pathology and the disease process at the expense of the whole person, began to be replaced 30 years ago. It was replaced by the bio-psycho-social model, which emphasizes individual treatment focusing on individual strengths, including family and social supports, skills, talents and response to medical treatment. This allows for interdisciplinary teamwork; the team has a facilitator chosen for his or her ability to coordinate an array of services appropriate for each client.

Our concerns are these:

* The medical model alone is not sufficient to meet the long-term needs of mental health clients.

* Under the medical model, we fear that there will be de-emphasis on educational training, social skills development, housing needs, family counseling, employment training and coaching and interagency networking.

* Cultural concerns and issues of mental illness and poverty would go un-addressed.

* There are not enough psychiatrists to implement a medical model.

It was in the interest of developing comprehensive services for the mentally ill that the agency merger was being developed. The intent was not to eliminate the provision of services by psychiatrists. We suspect that the success of the merger was undermined by political maneuvering--perhaps at the cost of service delivery to the mentally ill.

JUDY ALEXANDRE, Ventura

IRENE DI RAFFAEL, Moorpark

MARIANNE SLAUGHTER, Camarillo