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Mental Health Care

January 11, 1987

The profile of San Diego County's mental health director was well-written by Mr. Daniel M. Weintraub. The future of our mental health delivery system is in jeopardy.

California's system design, which allows 58 counties significant authority in types and implementation schedules of services, in my opinion, violates the equal protection rights of mentally disordered adults. The state Department of Mental Health should administer services, which would eliminate the use of two costly government bureaucracies overseeing the same delivery system, insure consistency in quality and implementation of new services by standardized management, and protect consumers and consumer advocates from being shuffled back and forth from state to county, as each administrative unit blames the other for deficiencies.

Supervisor George F. Bailey is right to pursue a lawsuit on behalf of equity funding for San Diego County. Someone needs to pursue the constitutional rights of mentally disabled adults in San Diego County to receive equal treatment by availability of service, as is provided to mentally disabled adults in other counties. Those counties have been providing services funded under Assemblyman Bronzan's homeless legislation and the supplemental funding for community care home services for several months, while San Diego County administrators find several excuses for not implementing these same services.

Our mental health advocates have had a fine demonstration that more money is not the answer. Our local department personnel have no incentive for improving our system. There is no consistency in fiscal reporting requirements. Contractors are provided with no incentive for their cost-saving methods. County-operated programs do not furnish line-item budgets for our Board of Supervisor's review. There is no consistency or standardization of identifying overhead, community service and other areas of cost among contractors and/or county operated services.

Instead, our decision-makers and managers carry on with their own personal agendas, as the system around us fails. As we project the need for "innovative" programming, the practical and obvious needs of the mentally ill for food, shelter and clothing go unmet. Someone needs to look closely at how the services for the developmentally disabled are managed in this county and give thought to a redesign of the mental health delivery system.

JOYCE E. SWINEHEART

Chief executive officer,

Project Motivate Inc.

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