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Representative's View: California is failing people with mental illness

The Press-Tribune - 1/27/2018

Mental illness is on the rise in California. And we are not doing nearly enough to get help to those who need it.

This epidemic affects one in 20 adults and one in 13 children, tearing at the fabric of our community in countless ways: from the silent suffering of millions to the louder impacts on crime, poverty, and a growing homeless population. Yet at least half of Californians with mental illnesses are untreated; when treatment is provided, it is often in a jail or prison; and the effectiveness of such treatment is mixed, at best.

This treatment gap is startling, because our state has made mental health funding a priority. In 2004, voters passed Proposition 63, dedicating roughly $2 billion a year on top of existing mental health spending. This revenue stream is untouchable, enshrined in the California Constitution. Yet more than a decade later, the state has little to show for it. Despite isolated examples of high-performing programs making a difference in some counties, there is scant evidence of any overall reduction in mental illness or the social problems associated with it. What went wrong?

Bureaucracy, for one. Responsibility for a statewide mental health strategy is divided between three separate agencies, as documented by the leading government watchdog known as the Little Hoover Commission. Shared responsibility has turned into collective neglect, as no individual agency accepts leadership for evaluating programs, assisting counties, and implementing a long-term vision.

The largest of these agencies, the Department of Health Care Services (DHCS), even admitted to auditors that efforts at oversight are "not very robust." That may be an understatement. More than half of California's 58 counties no longer even bother to submit their annual reports to DHCS on how they are spending mental health funds, even though the law requires this as a condition of the funding. As a result, failed programs continue, successful ones are not scaled up, and many suffering Californians fall through the cracks.

It is time for the Legislature to show leadership on this vitally important issue, rather than simply await a self-correction from the bureaucracy that will never come. That starts by removing the responsibility for oversight from DHCS, and creating an independent Mental Health Care Commissioner who is directly accountable to the Legislature, and whose sole responsibility will be effectively using mental health funds to fight the scourge of mental illness.

For the sake of millions of Californians who are suffering, we must do better.

Assemblyman Kevin Kiley represents the 6th Assembly District, which includes parts of Placer, El Dorado and Sacramento counties.


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