KQED | Hope on the Street : Public Policy Corner

A Lawmaker Attacks Mental Illness:An Interview With Assemblyman Darrell Steinberg
Hope on the Street producer Michael Isip sat down to discuss mental health reform with Assemblyman Darrell Steinberg (D-9th District), touted by many as the man leading California's first significant expansion of community mental health programs in more than a decade. Twice named Legislator of the Year by the California Psychiatric Association, Steinberg authored Assembly Bills 34 and 2034, which dedicated $65 million to comprehensive services for the state's severely mentally ill and homeless. The investment in these wraparound services, from mental health and drug and alcohol treatment to housing assistance and job training, has reduced the costs of hospitalization and incarceration of the homeless mentally ill by more than $20 million.

Q: Why are you so committed to mental health reform?

Assemblyman Steinberg: I came to the legislate chair actually campaigning on the issue because as a member of the City Council in Sacramento, I saw mental illness and homelessness as an issue that has been long ignored and desperately needed attention. And so for me, I always say as long as I am in the legislature, it will be my No. 1 priority. It strikes me as an issue that really hits at the core of what's wrong in some ways with our society. We become numb in many respects to the plight of people who are mentally ill and [who are] wandering our streets. I mean, we all leave the Capitol, leave our places of work, walk to lunch and walk by people who are, you know, muttering to themselves and who are obviously ill. And as a society, I think, we just sort of decided to go on about our business and go on about our day, and I think that's wrong. And I think that we're paying a huge price societally for ignoring the plight of thousands of people, many of whom are veterans, who with the right kind of treatment and help can turn their lives around.

Q: How did we reach this point where there are thousands of mentally ill and homeless people in California, and why are so many of us numb to that?

Assemblyman Steinberg: I think it's a lot of things. I think it is stigma. I think that people over time have become hopeless about the problem. They feel that really there is nothing that we can do when people have fallen to that state of life. And what we've proven through AB 34 and AB 2034 is that homelessness is not hopelessness -- that with the right kind of outreach and comprehensive treatment for people, we can alleviate this social condition. We can help save people's lives and provide real opportunity for people who had not had hope.

Q: What services were available to mentally ill homeless people in California, -- and how has legislation like AB 34 and AB 2034 changed that?

Assemblyman Steinberg: What generally happens is that there is a scattered shot of services for people; they may be brought into a county mental health facility on an involuntary hold and then released and given a prescription or a phone number of someone to call. The services, generally, have not been integrated. In other words, an individual will have to go one place to get medication, another place to find housing, another place to deal with an underlying drug problem. And, of course, that kind of system is a recipe for failure when you have people who obviously cannot manage their own lives.

What we've done with 34 and 2034 is provide genuine integrated services where the money can be used for a whole array of life needs that people who are suffering from mental illness and are homeless need in order to get back on their feet and to live independently and with dignity. It's amazing; it's not rocket science by any means. It's just a commitment to provide the right kind of outreach and support to people who have long been denied such outreach and support.

Q: And how successful have these programs been?

Assemblyman Steinberg: The programs have been amazing. In just two years the statistics are outstanding. We've seen about an 85 percent drop in hospitalizations; I believe a 77 percent drop in hospitalizations; significant increases in employment. We have seen dramatic turnarounds statistically, where the population that previously was homeless is now getting the kind of treatment provided for under the bills. It's making a big difference.

Q: What about the people who aren't voluntarily accessing the mental health system?

Assemblyman Steinberg: We believe that 75 to 85 percent of people will access these programs if the right kind of continuous outreach is made. But there are some people who are so ill that they won't even be amenable to assertive sorts of outreach. And we need to have programs for those people as well, and we need to look at our system as a continuum of care. But what's most important is that we build an array of services that respond to the very different needs of people with mental illness. And we need to start with building services for young people. We need to have a system in California that we can be proud of. The social cost -- the monetary cost of our failure over 30 years -- to deal with this issue -- can no longer be ignored. There's too much human suffering, too much cost to our society, in not making community mental health a major state priority. We have begun to make great strides, and we've brought, now, about $70 million to the system over the course of two years. And yet I know I'm not and others are not resting on their laurels here because it's just the beginning, and what we know works ought to be spread to every county in California and be funded to full capacity. And until that happens, we need to keep pushing, pushing and pushing.

Q: In harder economic times, are you worried that the mental health system may be at risk of losing funding?

Assemblyman Steinberg: I am, but again I think during the past two years there's been more public attention paid to this issue than ever before. There's much greater awareness, and I think we're beginning to see a reduction in the stigma because virtually everybody knows somebody, whether it's a family member or a friend, who is suffering from some form of mental illness. They are not all homeless, but everybody, in one way or another, is touched by this issue. And we're beginning to see it for what it is, which is an illness that can be treated if only we have the will and commitment to help people. We'll save lives, we'll save souls, and we'll save money in the short and the long run if we continue to move forward.

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