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The following is an excerpt from the report: A generation ago, California decided that people with mental illness should live in their communities rather than locked in institutions. They had a right to a more everyday life, and it was determined they would benefit from community-based treatment. It is painfully clear that we have failed to follow through with all that was required by this noble decision. Mental health clients have, in fact, been integrated into our communities; we see them on the street corners and sleeping in parks. They are integrated into our jails and prisons; many are behind bars on what officers call "mercy bookings" -- jailed for their protection, not the public's. They are disproportionately represented among the poor, the victims of crime, the unemployed and the homeless. A majority of people erroneously sees them as "dangerous, dirty, unpredictable and worthless" -- better shunned than embraced. Many of us are uncomfortable with what we see and are not sure how to respond. We too often avert our eyes from the face of mental illness. And our public policies reflect this discomfort: Mental health programs are the chronic losers in budget debates. Community officials verbally scuffle with service providers. Neighbors complain about programs sited near their homes. And funds are increasingly siphoned away from the hundreds of thousands who want help leading productive lives to address the small minority of those who are ill and also dangerous. An estimated 1.5 million Californians are in need of help, but do not receive it. Many of those who need help do not reflect the stereotypes. They struggle to hold jobs, maintain friends and care for children -- often burdened as much by stigma as disease. Fortunately, the plight of those with mental illness -- and their families and the neighborhoods where they live -- are receiving renewed attention. And in these times of plenty, leaders are able to commit more resources to provide help. The neglect of the past provides the opportunity of a generation to implement fundamental reforms to the community mental health system -- reforms that may outlast the current empathy and budget surplus. The overriding goal of reform is clear: No one who needs mental health care should be denied access to high-quality, tailored services. To transform this system, California needs to develop leadership capacity at two levels. First, community leaders need to define for the state a public commitment to serve those with mental illness and advocate for that commitment until it is fulfilled. What sets mental health apart from other social and medical causes is that we do not share a collective expectation or sense of responsibility -- and as a result there is little outrage when mental health programs fail. Second, we need to fortify institutional leadership -- at the Department of Mental Health and in communities -- to create a system where barriers to improvement are identified and lowered, where the best strategies are replicated and improved, and where the public and state and local leaders are confident to invest additional resources.
Download the rest of the Little Hoover Commission report. For a progress report on reform efforts, watch for the commission's biennial statement, to be released in January 2003. back to public policy main page
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© 2002 KQED, Inc. All Rights Reserved.
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