A Slight Understatement

Corrections Secretary Jeffrey Beard: "As a society, we just have not done a very good job of dealing with the mentally ill."

by Brian Leubitz

Dan Morain has a very thought provoking column today taking off from the recent discussion about the prison health care litigation. Long story short, Gov. Brown is working to once again attempt to emerge from the litigation that has upped the prison health budget from $732 million to over $2bln. He makes a fair point:

"That money is coming out of the university, it's coming out of child care. It's a situation you wouldn't dream anyone would want."(SacBee)

Our spending on prison health care is high, very high, but the problem is that we are spending money in the wrong place. Kind of like our health care system spending big money in ERs, rather than setting up more primary care clinics, we are pushing the mentally ill to the most expensive "treatment" facility available, and one with a poor track record of success. This  spending is really a symptom of the much larger issue of our failing on mental health care in general.

Morain does a good job explaining the process of closing the state hospitals that had been "caring" for the mentally ill. I have no doubt that the decision was completely justified at the time, but the funding necessary to really create a more just and humane system never really appeared. From Reagan on down through the years, the governors and legislators just never felt a high priority on mental health spending. There are many other (completely valid) competing priorities and the mental health lobby is comparatively weak. But on the flip side, there is a large lobbying infrastructure for prison dollars. And nobody wanted to become the politician that was "soft on crime," so the prisons grew.

In just a few years from the great exodus of the hospitals, homelessness had markedly increased, and we were on our way to a crisis in mental health care. But the bottom line is that the cuts to mental health care, have a remarkably poor return. They boomerang back on us with higher prison and law enforcement cuts rapidly. Back in 2004, Californians voted for Prop 63, which increased taxes for mental health care. However, though the law required that the money not replace what was already being spent. But when the cuts came in earnest over the past 5 years, that part of the law was tossed aside, and mental health lost big. And, predictably, while the numbers are kind of fuzzy on this, the numbers of mentally ill finding themselves in prison increased.

At this point, whether or not we have a receiver for the prison health care system seems mostly beside the point.  It doesn't address the point upstream where resources could have the most chance of being effective in the reduction of mentally ill inmates. There are plenty of recriminations to go around, but in the end, all of California's leaders, for decades, have failed our mentally ill population.  

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