Mentally Ill Find Dramatic Success in State Program

An innovative mental health program that helps people living on the streets and those recently released from jail has shown dramatic progress in reducing hospitalizations, jail time and homelessness, according to a new state legislative report.

Since its inception in November of 1999, the Community Mental Health Treatment Program has enrolled more than 1,100 people in Los Angeles, Sacramento and Stanislaus counties.

Using a new generation of less debilitating medications, aggressive outreach and the promise of housing and job training, the state program has been able to get people off the street and, more important, induce them to stay in treatment. The program provides patients with intensive counseling and medical attention, group therapy and even a money manager who will hold their government benefit checks and help them pay their bills.

The report found that hospitalizations for participants dropped 77.7% from the previous year; the number of days they spent in jail declined 84.6% and the number of days spent homeless fell 69%.

The money saved from reduced hospitalizations and jail time exceeded $7.3 million, according to the new report. Those gains prompted state officials this year to expand the project to 32 other cities and counties and to increase funding from an initial $14 million to $55 million.

“What we’re doing is beginning to fulfill a promise of a generation ago to actually build a community-based mental health care system,” said Assemblyman Darrell Steinberg (D-Sacramento), who wrote legislation creating the program, which is also called AB 2034 after that bill number. “Beyond the statistics are the individual stories that really get you, meeting people who a year or two ago had virtually no hope in their lives and now are productive citizens.”

Nancy, 53, a patient at the San Fernando Valley Community Health Center, had lived on the streets of North Hollywood for four years, abusing drugs and prostituting herself to survive, before she enrolled in AB 2034. She found out about the program in the county jail, where she was diagnosed with severe depression.

“It sounded like the only chance I might have to get better,” the mother of two teenagers said in a phone conversation from the Van Nuys facility. She asked that her last name not be used to protect her privacy.

She said that during her slide into homelessness, none of her private physicians correctly diagnosed her mental illness. She lost her family and her job as a schoolteacher. But AB 2034 helped her obtain government disability benefits and a subsidized apartment in Reseda. Last week she reunited with her 16-year-old daughter and 18-year-old son for the first time in four years.

“I feel like I’m back to my normal self,” said Nancy. “Not every day is easy, but I feel really blessed.”

Among the more than 800 program participants in Los Angeles County, homelessness declined 55% from the previous year and jail time decreased 82%. Full-time employment increased substantially, by 155%, according to the study.

The program’s success in shrinking the numbers of repeat offenders led Los Angeles County Sheriff Lee Baca to overhaul the system of discharging prisoners. All, including the mentally ill, are now screened so that they can be linked with appropriate community-based mental health, substance abuse and supportive services.

“Our goal is to not have people leave county jail on a lonely journey out on the streets with no one there to help those who are the neediest, or even a family member to pick them up, so that they don’t fall back into the circumstances they were in,” said Baca.

An estimated 50,000 homeless people in California and 15% of the state’s jail and prison population suffer from severe mental illness, costing the criminal justice and mental health systems millions of dollars each year.

One major advance is the program’s ability to assemble effective outreach teams of law enforcement, social workers and former homeless people, said Rusty Selix, executive director of the California Mental Health Assn.

“About 80% of the people who we approach are enrolling in the program, [and] 90% of those are staying in,” he said.

Besides expanding the program for the homeless and jailed, funding this year provided more services for young adults coming out of foster care. Steinberg has introduced a bill that would add more localities to the program and increase outreach in hospitals.