July 3, 2007

County Report

Mental health programs are a county priority

By Supervisor Ken Yeager
Special to the Times

Mental illness has been a silent disease for centuries, condemning sufferers to a life of shame, disorientation and despair.

Thankfully, today there is much more knowledge of and better treatments for mental illness, leading to productive lives.

With awareness has come the realization of how widespread mental illness is. The National Institute of Mental Health estimates that approximately one in four adults suffers from a diagnosable mental disorder. It is probable that all of us know of someone in our immediate family who is afflicted by such a disease.

Treatment can be expensive, especially for those without health insurance or private means. When an individual cannot pay for care, it is left to us as a society—in this case, Santa Clara County government—to provide care. The average cost to the county to provide mental health care is approximately $2,500 per patient.

The county executive has proposed to slash more than $31 million from the system of mental health outpatient services for adults and children. However, I strongly feel that we must preserve as much of our county’s mental health safety net as possible, taking our current budget deficit into consideration.

I believe that it would be medically disastrous and ethically reprehensible to abandon the almost 6,000 adults and older adults who are currently receiving mental health care and the 2,000 additional adults expected to need care in the upcoming year. These individuals would need to go elsewhere for care, yet there are not community resources available to accommodate them.

Without any care, a small number of these clients will somehow be able to cope or find other means. A far greater number will be significantly worse off. Without medical treatment, these individuals cannot function in society.

Many will lose their jobs, their homes and their financial security, ending up homeless and on the streets. Others will engage in inappropriate behavior in public, leading to police response and possible altercation and arrest, impacting an already overcrowded jail system. Still others will end up in hospital emergency rooms, having no alternative but to seek psychiatric care at the most expensive and inefficient levels.

Likewise, nearly 800 children and adolescents would lose mental health services under the county executive’s recommendation. Many of these young people will slip into truancy and ultimately fail in school. Others will engage in delinquency, often leading to more serious criminal behavior, and wind up in the juvenile justice system. These kids will have much less hope of a promising adulthood.

For these reasons, I proposed to my colleagues on the Santa Clara County Board of Supervisors that we restore the adult and older adult outpatient treatment system. This will include maintaining the operation of all seven county mental health clinics as well the funding for the adult and older adult outpatient treatment that is provided through the county’s network of contract community-based organizations.

I have also proposed to continue community outpatient services to children and adolescents and their families. We must support these kids in their efforts to learn and grow and become independent, productive adults.

In addition, I proposed that we maintain the current staffing of the Mental Health Department 24-Hour Call Center, which receives almost 17,000 calls per year from individuals and service providers seeking mental health treatment and information. This service is the lifeline by which many mental health patients access care.

During the May budget workshops, I asked the board to consider alternatives to the recommended $31 million in devastating cuts to mental health services. My proposal reinstates approximately $16 million to the mental health budget, recognizing that the county is facing a $227 million budget shortfall this year and that cuts still must be made.

The remainder of the cuts to mental health will be absorbed through the redesign of current programs, in an effort to maintain service levels while realizing cost savings.

The board will not vote on the budget until the week of June 11, during final budget hearings. Between now and then, I will keep working to keep as many services as possible.

It is only through a combination of such creativity and a commitment to our funding priorities that we will sustain our county’s mission of serving the needs of these individuals, their families, and our community.