Your editorial (May 5), "A Boost for Mental Health," put the mental health system in California and Assembly Bill 2541 in proper perspective. I agree that mental health care is a "system that has suffered too long from indifference in Sacramento." We in the Alliance for the Mentally Ill certainly do support AB 2541, realizing that, as Assemblyman Bruce Bronzan (D-Fresno) is quoted, "This bill is just the beginning. The whole system needs to be built up."
I also agree that many people do not know that the mental health system exists. The mentally ill need an advocate to help them get the service they are entitled to and desperately need. One area of the system that needs building up is case management. These people are supposed to be advocates for the patient. Those who are most seriously ill gain little insight to their illness even after receiving treatment that reduces or eliminates their most florid symptoms. Even when treatment by anti-psychotic drugs is successful the mentally ill frequently do not appreciate the dimensions of their illness. They need a caring, dedicated, knowledgeable advocate. The case management system of the Department of Mental Health is supposed to provide this. Due to lack of funding and other higher priorities, effective case management does not reach those that need it most.
One of the major benefits of a case manager would be to convince the schizophrenics that they should continue to take their medications. This is not an easy task. However, if successful it might prevent rehospitalization and save great costs in suffering and in dollars.
One resource relatively untapped is the family as case manager. I believe that many families are acting as case managers in spite of the obstacles of stigma, of lack of appreciation by mental health professionals, of lack of training and education and also lack of information on the patient's diagnosis and prognosis due to misapplication of confidentiality. The families are frequently given a bum rap for not being caring. Some professionals still accuse the family of inducing or even of being the cause of the illness. In spite of this families have gotten together to form an Alliance for the Mentally Ill to educate themselves and others.
We in the Orange County Alliance sponsor three weekly family crisis-intervention meetings, each chaired by a volunteer mental health professional. We call them Share and Care, but they are much more than people sharing their troubles. In these meetings we learn to cope, to take care of ourselves and thus are better able to advocate for and take care of our mentally ill loved ones.
I believe that our movement for self-help should be evaluated by the state as a resource. If encouraged, the family as a trained, respected adjunct case manager would make the system more effective and thus less costly in the long run.
FRANKLIN J. OLSON