Will 2024 be California’s Year of Mental Health?

Much is continually made of the poverty rate in this state, which is now over 13%. But most polls show voters see homelessness as an even bigger problem, with about 70 percent in all recent public polls naming it California’s biggest problem.

Meanwhile, about 47 percent of homeless people, academic studies show, 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 a much bigger effect on the state than even the U.S. Senate race, which includes 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 allocate significant bond funding for mental health treatment. It would create more than 11,000 treatment beds and other housing for people with serious mental and emotional problems, boost the treatment they can now get in some counties through the new CARE court system, and potentially eliminate some of the homelessness that is now so visible on the streets and in parks all over California.

In the few countries that already use it, the CARE justice system is too new for its success to be assessed. It allows people with severe mental illness to be detained and treated, sometimes without their consent.

It is true that this creates limitations on their freedom, but homelessness, often related to or caused by mental illness, has created limitations on other people’s freedoms: freedom to use sidewalks without fear or self-consciousness, freedom to use public parks, freedom to park locked bicycles in front of homes and many others.

Some figures cited in the preamble to the $6.38 billion Prop. 1, provide evidence of all this: one in 20 adults in California now lives with a serious mental illness; one in 13 California school-aged children suffers from a serious emotional disorder, one in 10 Californians has some type of substance abuse disorder.

These numbers help explain the extent and growth of homelessness, as each of these issues is a known factor that drives many families and individuals away from their former homes.

This makes Proposition 1 not only a mental health proposition, but also a possible powerful antidote to homelessness.

How urgent is the need for something like this? The $217 million the Golden Gate Bridge District just spent adding steel mesh to prevent suicides by jumping off the iconic bridge may be one indicator.

Another is the fact that California now houses about 150,000 mentally ill people in its prisons at a cost of about $100,000 per person per year. This cost alone exceeds what Proposition 1 would provide. So reducing the number of affected inmates by even a third would alone make voting measurement a superior investment.

If it improves mental health care in prisons, it would also save California $50 million a year in fines it now faces for failing to comply with a court order to fill mental health vacancies.

The corrections system explains its slow hiring by reminding critics that many prisons are in rural areas, where recruiting highly educated staff has always been more difficult than in large metropolitan areas.

Perhaps the biggest supporter of the bond proposal will be Gov. Gavin Newsom, who pushed hard for both the CARE courts and placing Proposition 1 on the ballot. No governor since Ronald Reagan in the 1960s has taken a greater interest in mental illness, and Newsom’s activities are almost the exact opposite of Reagan’s.

It was Reagan who signed the Lanterman-Petris Brief Act of 1967, which closed many mental institutions. Reagan promised to replace them with a system of treatment-based homes located in the community, but that never materialized, and California’s mental health problems and related factors such as high incarceration and homelessness have steadily increased ever since.

California’s high homeless population — about 180,000 people now sleep in public spaces every night across the state — has forced a shift in priorities.

Newsom and the Legislature are responding with a path that can help. Whether cash-strapped voters will follow suit remains an open question.

Email Thomas Elias at [email protected].

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