Mental Health System in State

Jacobs’ three articles on the pervasive problems in the field of mental health are commendable in that they provide your readers with various points of view regarding the background and causes that gave rise to those problems.

In order to set the record straight, I must point out some inaccuracies in the statements attributed in the series to Michael O’Connor, state director of mental health.

It is far from the truth to say that California spends more than any other state on local mental health programs. This myth was exploded in the recently terminated six-week trial in the Los Angeles Superior Court.

In that case, Deukmejian, O’Connor, the state Department of Mental Health, and their counterparts in Los Angeles County, were sued for not providing adequate, community-based services and programs for the chronic mentally ill, including the homeless chronic mentally ill.

Even though Judge Max F. Deutz ruled in favor of the state, the evidence produced in that trial proved that what California considers to be “local mental health programs” consists largely of local psychiatric beds, either in the state hospitals or in county psychiatric hospitals. State financial assistance for those beds make up at least 70% of the mental health dollars spent for community mental health.

Mental health budgets, in most other states, do not include state hospital beds in local assistance budgets, as does California.

If the total amount of dollars spent for such beds were subtracted from the local mental health programs, then California would rank approximately 31st in the nation in per capita dollars spent for community mental health programs--which consist of day treatment, case management, activities for daily living, recreational, socialization and vocational programs, emergency crisis teams, appropriate supervised residential arrangements, crisis homes etc.

All such community programs are specifically designed to lower the costly, unacceptable, 60% revolving-door rehospitalization rate down to 5%, thus making most of the budgeted mental health funds available for necessary programs that enable the chronic mentally ill to remain successfully in the community.

California, by sleight-of-hand bookkeeping procedures, seeks to attain a position of eminence in the field of community mental health. The actual record of allocations and expenditures show that such a lofty position is not merited.

MAX SCHNEIER

Santa Monica