Mandated Care For Mentally Ill

Gavin Newsom’s mental health proposal released this past Thursday is the first workable, feasible and, dare I say, spot-on plan, that if enacted into law, could actually begin to solve a 50-year-old problem. 

Perhaps as Governor, Newsom is making amends for doing absolutely nothing to curb the mental health-homeless dilemma during his tenure as Mayor of San Francisco.

And, as I’m fond of saying, problems just don’t happen, people make them happen.

And, as I’m certain Newsom knows and understands, the main people causing the problem are who and what we call nowadays the “mental health-homeless-industrial complex.”

And, these are also the very same people who are at all levels of government, including right here on the home turf of Mendocino County. Nation-wide, they’re long-time gatekeepers of a bottomless rat hole down which billions and billions of dollars have disappeared over five decades of creating, recreating, and re-recreating mental health stabilization/wellness/recovery programs and connections to social services and housing programs. Needless to say, not a single one of these programs or plans have ever accomplished even the slightest measure of success.

Here in Mendocino County, the mental health-homeless-industrial complex has had a stranglehold on the mental health-homeless issues for over 20 years. 

Here’s the sad history of mental health care in Mendocino County as excerpted from columns I wrote back in 1999-2001:

A couple of weeks ago, I reported to you that the Supes — with the exception of Mike Delbar — caved in to Mental Health Director Kristy Kelley’s demand to permanently shut down the county’s Psychiatric Health Facility (PHF). I’ve said time and time again, the Board just doesn’t have the political will to tell the Mental Health Department to do its job: Provide acute psychiatric care for folks — some of whom are also caught up in the criminal justice system. For you anglers out there, you’re familiar with the old saying about when a fish stinks, it stinks from the head down. The Mental Health Department is stinking up the joint, and you can look no further than its head — Ms. Kelley — to find the source of the stench. The Supes, withe the exception of Dave Colfax, swallowed hook, line and sinker, Kelley’s pitch that the Board could utilize $900,000 in purported savings from the PHF’s closure “towards the development of a comprehensive and effective mental health system of care.” This new scheme would result in kinder, gentler “helping professionals” from the Mental Health Department reaching out and laying the healing hands on the troubled souls who no longer would require the services of the PHF unit. How’s the new system working? Several days ago, the helping professionals locked a troubled soul in a DMH vehicle for three hours on a sweltering day. The abandoned troubled soul kicked out the car’s window in order to relieve himself. It’s also way past time for the Supes to relieve Kelley — permanently — from her post.

… On the down side, closing the PHF and opening a CSU would increase various costs, such as case management and transporting mentally ill offenders to far away state institutions such as Atascadero or Patton. 

Colfax wasn’t buying the crisis argument. “Given the history of the agency you’re responsible for the (Ukiah PD) killing of (DMH patient Marvin Noble), plus two other jail suicides of (DMH) clients,” he said, “and all the potential impacts on other departments, like the Sheriff, Jail, DA, Courts and Public Defender, I want something in writing, on paper, from all those affected by this (closing the PHF) before we make a decision.” 

Captain Gary Hudson, who oversees the jail, told the Supes his facility had failed the last two inspections by the Dept. of Corrections. He said the jail was out of compliance with one-quarter of the positions vacant. If the PHF unit closes, it would place the entire operation at risk. “We are at our limits also,” Hudson stated. “With the inability of the PHF unit to function as a PHF, the jail could not operate as a jail.” 

Hudson was referring to the seriously mentally ill inmates who must be housed at the PHF because the jail is not equipped to deal with them. He told the Supes that transferring inmates from here to facilities in Patton or Atascadero would require 12 to 14 hours processing and transport time. That cost is multiplied each time the mentally ill offender is returned to Mendocino County for a court appearance. Furthermore, it would result in less street patrols since those deputies would be assigned transport duties.

Since we’re on the subject of how government treats humans, the situation with the County’s Psychiatric Health Facility is truly criminal. The PHF (pronounced “puff”) unit has been shut down since last December (1999). The PHF unit deals with the very, very mentally ill, some of whom are violent and/or criminal offenders. These folks require 24-hour attention in the special facility. The County Jail is neither equipped nor does it have the qualified staff to care for people who are charged with crimes but are also mentally ill. Likewise, harmless but mentally ill folks who wander the streets getting into mischief don’t belong in jail. They need care and treatment. But when the county’s Mental Health Department closes the only facility that offers specialized treatment, there are no good alternatives.

According to MH Director Kristy Kelley, her PHF staff is burned out and can’t handle the stress of their jobs … but allow me to say this: These are handsomely-paid professionals. One has to presume they went into their chosen profession with their eyes wide open. If they no longer can perform their jobs, they need to get off the County’s payroll and find something else to do … It was painful to witness, but at Tuesday’s Supes’ confab (August, 2001), the criminal justice types reluctantly threw in the towel. We’re speaking of the Board’s decision to permanently close the county’s Psychiatric Health Facility. You can’t blame the Sheriff, Public Defender, Probation Department, DA, or the Courts for running up the white flag. They all saw the handwriting on the wall months ago. … As you can imagine, that situation makes things a bit difficult for an already short-staffed Sheriff’s Office, which provides the out-of-county transportation for mentally ill inmates from the hospital to the courts. Likewise, defense attorneys are burdened with literally going the extra mile to meet with clients who may be in an Alameda County facility. Needless to say, family and friends of the mentally ill encounter the same sorts of difficulties.

But those are the prices that everybody pays when the county is working “towards the development of a comprehensive and effective mental health system of care.” When you think about it, closing the PHF is somewhat similar to the Supes’ decision to close all of the county’s landfills. Back then the Supes didn’t have the political will to deal with the dump issue. Now, we just ship the garbage out-of-here, out-of-sight, out-of-mind — it’s somebody else’s problem. Just like with our mentally ill.

* * *

OK, that’s enough history, let’s return to the present and look at Newsom’s plan. 

Newsom’s proposal appears to offer more absolutely needed services to homeless people with severe mental health and addiction disorders — the so-called “dually diagnosed” because they are on drugs and are crazy — even if that means forcing them into care, a move that many, especially the mental health-homeless-industrial complex, will oppose as a violation of civil rights, or some other equally specious argument. Keep in mind, their entire game plan is to maintain at all costs the status quo because that’s their gravy train.

Additionally, Newsom’s plan would require:

• All of California’s 58 counties to set up a mental health branch in civil court and provide comprehensive and community-based treatment to those suffering from debilitating mental illness.

• The mentally ill would be obligated to accept the care or face criminal charges, if those are pending, and if not, they would be subject to being held in psychiatric programs involuntarily or lengthier conservatorships in which the court appoints a person to make health decisions for someone who cannot because they’re mentally ill.

What a revolutionary concept.

Just imagine, no longer will people who are incapable of making rational decisions be able to refuse life-saving care.

Geez, if the California Legislature approves Newsom’s proposed law, we can actually look after the best interests of all those folks — mothers, fathers, sisters, brothers, spouses, friends, and maybe a few strangers — who can’t look after their own best interests themselves.

Why it’s almost like we could become a truly caring society, taking care of people who can’t take care of themselves.

(Jim Shields is the Mendocino County Observer’s editor and publisher, observer@pacific.net, the long-time district manager of the Laytonville County Water District, and is also chairman of the Laytonville Area Municipal Advisory Council. Listen to his radio program “This and That” every Saturday at 12 noon on KPFN 105.1 FM, also streamed live: http://www.kpfn.org)