Elias: California’s mental health Prop. 1 may help fix homeless problem

Much is made continually of this state’s poverty rate, now running above 13%. Most polls show voters rank homelessness as even more of an issue, though, with about 70% in all recent public surveys naming that as California’s biggest problem. Meanwhile, about 47% of the homeless, according to academic studies, suffer from some form of mental or emotional illness, from schizophrenia to post traumatic stress disorder and dementia.

That’s why the first proposition on the March 5 primary ballot could have far more effect on the state than even the U.S. Senate race featuring prominent Democratic candidates Adam Schiff, Katie Porter and Barbara Lee plus Republican Steve Garvey. The upcoming Proposition 1 marks the first time state voters have been asked to earmark serious bond funding for mental health treatment.

Prop. 1 would create more than 11,000 treatment beds and other housing for people with serious mental and emotional problems, reinforce the treatment they can now get in some counties through the new Community Assistance, Recovery and Empowerment (CARE) court system and possibly reduce some of the homelessness now so visible on streets and in parks all around California.

In the few counties already using it, the CARE court system is too new for its success to be evaluated. It lets those with severe mental illness be held and treated, sometimes without their consent. It’s true this creates limits on their freedom, but homelessness often associated with or caused by mental illness has created limits on other people’s freedoms: Freedom to use sidewalks without fear or self consciousness, freedom to make use of public parks, freedom to park locked bicycles in front of homes and much more.

Some numbers cited in the preamble to the $6.38 billion Prop. 1 provide evidence for all this: One of every 20 adults in California now lives with serious mental illness; one in 13 California children of school age suffers serious emotional disturbance; one in 10 Californians has some sort of substance abuse disorder.

These numbers help explain the extent and growth of homelessness, as each of those problems is a known factor in driving many families and individuals away from their previous homes. That makes Prop. 1 not just a mental health proposition but also a possible strong antidote to homelessness. How urgent is the need for something like this? The $217 million that the Golden Gate Bridge, Highway and Transportation District has just spent on adding steel netting to prevent suicides by jumping from the iconic span could be one indicator.

Another is the fact that California now houses about 150,000 mentally ill persons in its prisons at a cost of about $100,000 per person per year. This cost by itself tops what Prop. 1 would provide. So cutting the number of affected prisoners by even a third would by itself make the ballot measure a superb investment.

If the proposition improves mental health care in prisons, it would also save California the $50 million per year in fines it now faces for failing to follow a court order to fill mental health staffing vacancies. The correctional system explains its slow hiring by reminding critics that many prisons are in rural locations where recruiting highly educated employees has always been more difficult than in large metropolitan areas.

Perhaps the bond proposition’s biggest backer will be Gov. Gavin Newsom, who pushed hard for CARE courts and to put Prop. 1 on the ballot. No governor since Ronald Reagan in the 1960s has taken greater interest in mental illness and Newsom’s activity is almost directly opposite to Reagan’s. It was Reagan who signed the Lanterman Petris Short Act of 1967, which closed many mental health facilities.

Reagan promised to replace them with a system of treatment based community sited halfway houses, but that never materialized, and California’s mental health problems and associated factors like high prison populations and homelessness have steadily increased ever since. The sheer volume of homeless people in California — about 180,000 now sleep in public places every night across the state – has mandated a change in priorities.

Newsom and the Legislature are responding with a path that may help. Whether cash strapped voters will follow it is an open question..