Debra is 24 years old. She says she has already tried to kill herself once for each year of her young life. She wears the scars on her arms from self-inflicted wounds like badges.
For now, she lives in a downtown Ventura motel, but she has lived on the streets off and on for the five years she has been in Ventura County since moving from Palmdale.
"It's, like, really bad news on the streets," she said, blinking her brown eyes hard and hesitating between phrases. "When you're a girl, you always have to carry a knife."
She was homeless when both her two children were born. One has been adopted and another is under foster care.
She hopes to get her second baby back someday, when she is more stable, but exactly when that will be remains unclear.
Debra suffers from schizophrenia, a disabling disorder that keeps her on the edge of society, out of work and away from her children.
With a complete shake-up under way at the Ventura County Mental Health Department, a reorganization that officials say will revolutionize the way they serve their mentally ill clients, at least some of Debra's troubles should be eased, officials said.
They hope the new system will help Debra and about 2,000 other adults with serious mental illness who depend on the county.
The county plan is to find them stable homes, some of them jobs, and for many, a way to re-enter the mainstream of society.
"The difference is like night and day," said Randall Feltman, director of the county Mental Health Department. "Almost nothing is the same."
Ventura is the only county in the state to win a $16-million grant over four years under a state law co-written by Assemblywoman Cathie Wright (R-Simi Valley) and Assemblyman Bruce Bronzan (D-Fresno). The money substantially augments the department's annual budget of $21 million, Feltman said.
He said officials hope to create a prototype for mental health care systems that could be used statewide.
"We will have four years to develop a better system of care than anything ever done before in California," Feltman said. "At the end of that time, the state will evaluate us."
Under the present system, clients must find their way through the maze of clinics and treatment programs, each offering a different service at a different time, with different staff, some within different departments. Each mental health worker carries a caseload of 75 to 100 people, an unmanageable number, officials say.
Under the new system, each client will be assigned to a team of 10 people. Each team, including a psychiatrist and other mental health care professionals, will follow about 75 clients. And each mental health social worker will be responsible for about 25 clients.
Two teams will be located in the Ventura area--one will be downtown and one on North Ventura Avenue.
Four teams will serve Oxnard's mentally ill, two at the county offices in east Oxnard and two in its poorer downtown section. The county will use its existing buildings in Simi Valley and Santa Paula and is searching for a location in Thousand Oaks.
The teams are forming now, Feltman said. The Santa Paula team may be the first to be operational, in May, but all will be set by the end of June, he said.
The teams will take care of a client's medical and counseling needs and the logistic problems in meeting them. They will shepherd them through the welfare system, if they need assistance, or help them get priority to receive the $640 per month in Social Security disability insurance to which they may be entitled.
In addition, the county is setting up support and resource groups. One will concentrate on finding jobs, probably part-time work, for the mentally ill. Employers will be assured that job coaches will help their clients get to work. The coaches will also find replacement workers for clients on the days when they cannot work or complete a shift.
Another support group is developing a program to find alternatives to county jail for those who commit minor crimes. The effort will include county probation officers working with the mental health workers to keep clients on the right track.
A third group will provide support for the mentally ill who are alcohol or drug abusers. A crisis team will be on call 24 hours a day for emergencies. A fifth group is assigned to find stable homes for the mentally ill, in community board and care homes or shared apartments.
A new home for the county's emergency shelter program for mentally ill homeless people is among the first visible signs of the county reorganization and influx of state money.
The program, which had been operating in offices scattered countywide, moved into a stately old Victorian house across from the privately operated Turning Point drop-in center for the mentally ill on Thompson Boulevard.
"It's a godsend," said Vikki Smith, coordinator of the emergency shelter program. "We deal with the people who are most resistant to county services. It's our job to entice them into the system."