Abandoning the Mentally Ill 

Cuts in state program will severely impact local homeless.

Six years ago, a homeless man often seen wandering the streets of Berkeley would yell, talk to himself, and shout at people he thought were after him. He drank heavily and resisted help from social service workers. He was described by staff at the Berkeley Mental Health Clinic as "bizarre and dangerous."

Since 2000 though, Carl — whose name has been changed for privacy reasons — has been in and out of stable housing, takes medication regularly, and has frequent visits with his family. The state program that helped him, courtesy of Assembly Bill 2034, has long been heralded as an effective system that helps mentally ill homeless individuals become functioning members of society. But in August, as part of California's budget cuts, the program was dissolved, leaving many wondering how services will continue.

"There's a serious shortsightedness of this de-funding and the impacts it's having on the members of the program," said Rick Crispino, director of Oakland's Bonita House, which shelters the homeless. Crispino and other mental health workers are now trying to figure out how to continue providing services to Carl and 91 other clients, without the $1.2 million the state program gave them the year before.

The law, passed in 2000, provided California's mentally ill homeless population with comprehensive services, including housing, outreach, substance abuse counseling, employment, and mental and physical health assistance. Berkeley and three cities near Los Angeles were the only cities to receive funding; the rest was dispersed to counties. The bill provided more than 10 percent of the Berkeley Mental Health Division's annual budget. The hope was that by providing these services, cities and counties would see declines in prison inmates, hospital patients, and homeless.

For Carl, that meant having a case manager who would take him to buy groceries, or a warm bed at a local motel. He helped cook meals at Berkeley Mental Health's Drop-In Cafe. Carl established a regular income through the federal Supplemental Security Income, and was able to reunite with his family.

According to Harvey Tureck, manager of Berkeley's Mental Health Division, the program helped serve more than 4,700 mentally ill homeless or incarcerated individuals in 34 counties across the state. In Berkeley, the funding "helped transform Berkeley Mental Health services in a new direction," said housing coordinator Dan Ezekiel, who also coordinated the program. "We could speak the language of 'food, shelter, clothing' better than we had before."

The annual reports sent to the state by local clinics confirmed the program was working, Ezekiel said. In 2003, across the state there was a decrease in incarceration (72 percent) and hospitalization (56 percent), and an increase in employment (65 percent) and housing.

According to the California Mental Health Directors Association, the program found housing for nearly three-quarters of its clients since it began. One of those, Stephan Benjamin, said he used to often check himself into psychiatric hospitals just to receive clean clothes, food, and a place to sleep for a few nights. He said he hasn't been back to the hospital in nine months because "having my own place helps."

In August, when Governor Arnold Schwarzenegger was faced with a $750 million deficit, he cut the $55 million program. The governor suggested the funds could be replaced with a one-time grant of surplus monies from the Mental Health Services Act, passed by voters in 2004. The ballot called for expanding state mental health services by taxing individuals who make over $1 million a year. According to the California Health Care Foundation, this revenue continues to grow every year, and is projected to reach $1.7 billion for fiscal year 2007-08. The state Department of Mental Health, foreseeing possible income declines, maintains a prudent reserve to sustain a consistent level of funding every year, and the potential funding for the mental health homeless program would come from this surplus.

But according to Harvey Tureck, "it's not a done deal yet." He said that even if the money does come through, it will only be in one lump sum — $916,000 for the city of Berkeley — and then the funding will end. In the meantime, mental health workers have to figure out ways to keep their programs running, or shut them down.

Tureck said he hopes Berkeley's Mental Health Division finds ways to continue services. While they're no longer accepting new clients using the program's funds, Tureck said he plans to negotiate an individual transition strategy with their existing ones. Of the roughly 250 Berkeley clients who have used this funding in the last seven years, only around 100 were provided with the funds at any time. "Some reunited with family on the East Coast," Tureck said. "Some left the program on their own, or got a job and moved on with their lives."

Although public mental health services have suffered as a result of these cuts, Bonita House's Crispino has hope. "The program has so many supporters, like the county sheriff's department," he said. "There will be a financial fix to this because it's a program that's shown itself to be efficacious."

Meanwhile, the governor's decision may be challenged in court. Clinics and organizations are only supposed to use money from the 2004 ballot initiative for expanding and funding new services, not for replacing cuts in other programs. Said Tureck, "There is a serious question whether or not the governor's action was legal."

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