Next year, mental healthcare programs statewide will split more than $600 million in additional revenue, thanks to Proposition 63, which gave rise to the Mental Health Services Act (MHSA). The November 2004 ballot measure, approved by 54 percent of California voters, levies a 1-percent tax on personal income exceeding $1 million. Although only 46 percent of San Diego County voters supported Prop. 63, the county Department of Mental Health expects to get roughly $40 million extra in 2006.
For San Diego County's chronically under-funded mental-health system, the additional money should be great news. The state has estimated, though, that there are roughly 19,000 people in San Diego County alone who are eligible for public mental-health services but, for some reason, haven't been able to get the help they need. A large number of those people are homeless.
Last Friday, Dr. Piedad Garcia, director of the county's Systems of Care program, met with a group of homeless-service providers at St. Vincent de Paul Village downtown to get input on how the additional funds should be allocated to better serve homeless people.
“We understand $40 million isn't going to be a lot of money for San Diego County, even though it sounds like a lot of money,” Garcia told attendees. “The idea is to stretch that $40 million.”
The meeting was the 30th such forum Garcia has held since March. At least 20 more community meetings are planned, she said.
Before the state divvies up the money, each county must submit a plan detailing how it will spend its share. Garcia said San Diego County will submit its plan in November. The state Department of Mental Health demands that Prop. 63 money produce results, Garcia said-a reduction in hospitalizations related to psychiatric illness, a reduction in the mentally ill jail population, a reduction in homelessness and a reduction in child welfare placement.
Garcia told the St. Vincent de Paul group that the homeless community was one of the top-three priority groups. Some of the service providers urged her to make mentally ill homeless the No. 1 priority group, especially given MHSA's focus on reduced incarcerations.
Last year, roughly 9,000 jail inmates in San Diego County were diagnosed with some form of mental illness; one-third were diagnosed schizophrenic. Tracking numbers show that none of those individuals sought county mental health services upon release, Garcia said.
Margaret McCahill, a psychiatrist and clinical director at St. Vincent de Paul, said homeless clients she's counseled tell her that jails hand mentally ill homeless $200 and a list of local shelters upon release. “But they're still pretty seriously ill,” she said. “If they need to be hospitalized, they face a brick wall.”
If you're homeless and you're mentally ill, you should automatically be eligible for services, McCahill said, or else the jail system's revolving door for mentally ill homeless will persist.
Attendees also pointed out that homeless kids, especially those with drug or alcohol addiction, could benefit from targeted services. They also urged Garcia to allocate funds to recruit and train psychiatrists and social workers who want to work with needy mentally ill populations. “We've got lots of psychiatrists in La Jolla who'll see you if you have lots of money,” one person pointed out. “Not one psychiatrist in San Diego County will take a new Medi-Cal [patient].”
To offer input on how the money should be allocated, e-mail firstname.lastname@example.org or call 888-977-6763.