SACRAMENTO — Even if Gov. George Deukmejian gets the substantial boost in funding for the mentally ill that he has called for this year, state financial support for mental health will be less than it was before he took office.
That is one reason that Deukmejian's highly touted mental health initiative does not satisfy critics of the state mental health system, who charge that programs remain woefully underfunded.
The increases would, however, help reverse a slide that began when Edmund G. Brown Jr. was governor and that was speeded along by Deukmejian when he vetoed $30 million for mental health in his first year in office.
"My impression is that the governor has been more interested, more committed, more involved in mental health than we've seen in a long time," said John Ryan, Riverside County mental health director. "But I think there is still a reluctance to acknowledge the magnitude of the problem that exists out on the line. I don't want to look a gift horse in the mouth, but it isn't sufficient."
Ryan recently asked the state Department of Mental Health to estimate the cost of funding what he and other health officials regard as a model mental health program for the state.
Dubbed the California Model, the proposal calls for developing in each county a full range of treatment services for the mentally ill--a spectrum that includes lolg-term care for the hopelessly ill and a range of treatment programs for others as they move from crisis to full recovery.
The plan--developed two years ago by a group that included legislative staff, county and state mental health officials, health professionals and patient and family organizations--spells out the minimum services that participants agreed every community ought to have to treat its mentally ill population.
For example, instead of the 2,200 hospital beds now in place in the public mental health system statewide for short-term care of patients in crisis, there would be 3,900. Instead of 1,800 beds for long-term rehabilitation, there would be more than 10,000.
The controversial plan would be costly.
Spending Would Double
Mental health spending would more than double from the $746 million budgeted for the current fiscal year to $1.8 billion if the California Model were now in place, according to the department's estimates.
However, no one ever expected the proposal to be put into place overnight as written, said Henry S. Basayne, executive director of the state Mental Health Assn., the nonprofit group that directed the model plan workshops. Instead, it was intended as a goal for the state, he said.
But the Department of Mental Health has not endorsed the plan. "They have waffled," Basayne said. State officials' lack of enthusiasm "is like being in Alaska and not liking snow," he said.
"We do support a system that is, in fact, a system," said Dr. D. Michael O'Connor, state mental health director. And while he applauds the range of services recommended in the California Model, he argues that the proposal is not the only way to take care of the needs of the mentally ill.
Concerned About Cost
O'Connor is concerned about the cost and worried about imposing too many requirements on local government. "One of the real emphases of this Administration has to do with our attempt to transfer flexibility and control to local governments," O'Connor said, "and not just (require) an array of services--so many of these (services) for so many of those patients."
The governor, O'Connor added, is expressing "a real, sincere concern about people who are mentally ill in hospitals and in the community. And he wants to make a commitment to make the system better."
The Administration is committed to spending more than $133 million over five years to upgrade state mental hospitals--a plan that could make California the first state to have all of its mental hospitals meet national standards.
But there has been no similar, specific commitment to upgrading community mental health programs in the long term.
A 30% Increase
The governor's latest budget proposal does call for increases that would add significantly to mental health funding, bringing the total added since the 1983-84 budget to $160 million, an increase of 30%.
"If we can show the governor and the Legislature that there is an ongoing need there that is not being met, if we're spending our money wisely and if the economy permits, we should expect a multi-year investment," O'Connor said.
"Part of the mental health constituency raised so much hell that the governor decided he had to do something," said Dr. John Richard Elpers, former director of mental health for Los Angeles County. "It will take a long time and many more restorations to get the program back to where we were in the mid-1970s. And we were not in good shape then."
Elpers believes that the only way for mental health services to get their due is to establish a politically independent state authority to run the mental health system.
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