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'Help for the Mentally Ill'

January 05, 1986

As chairman of the board of Portals House, an agency whose purpose for 30 years has been to help chronically mentally ill persons live independently, I agree with your editorial. Los Angeles must make a strong effort for one of the mental health resource projects being offered. If anywhere, the need is here.

A basic tenet of providing the necessary range of services in the community is a comprehensive system, a coordinated and organized plan for a service delivery continuum. However, what we've seen evolve over the past three decades is a non-system, often a piecemeal approach to community care.

What services did accompany the deinstitutionalization of the '60s and '70s were scattered and sparse. Similarly, local programs developed in the late '70s through legislation designed to provide a community residential treatment system--a continuum to help mentally ill persons progress to independent living--were parceled out throughout the county. These attempts have contributed to a fragmented system unable to provide all the types of services needed.

We would like to see a model system, a working, coordinated continuum, developed in one region of the county. Developing a continuum for the entire county at once would be impractical to attempt and impossible to achieve, considering the county's size. This system would include residential programs, vocational training, outpatient programs, hospital services, and social and recreational programs. And, it must include coordination with those services and agencies outside the realm of mental health that are needed by clients to maintain community living, such as law enforcement, Social Security and public housing. This system could be replicated in other areas of the county.

Creating this system does not necessarily mean simply adding to what already is in place. We agree with the county's mental director, Roberto Quiroz, that a re-examination of existing services is called for, possibly redirecting some current resources to better meet the community support needs of the deinstitutionalized.

Los Angeles may now have the chance to establish a model system--one that works--if it chooses to pursue this opportunity for a research project. But, it will take commitment and coordination on the part of all levels of our local government. We urge them to do so.


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