Finally, a dialogue about mental illness

Tragically, suicide is the second leading cause of death of young people in the United States, and yet only now are national leaders initiating a conversation about the problem of mental illness.


President Obama singled out the issue in a summit earlier this month, with A-list stars, health providers and academics spotlighting the need for education, intervention and prevention while calling for an end to the widespread stigma attached to mental illness.


I’m heartened to see this dialogue about mental illness. It is about time we come together as a nation to tackle diseases that shatter families, cost lives of the young and old, and put an enormous strain on taxpayer-funded services. More importantly, I’m proud that California is uniquely poised to help chart a course for these efforts.


Voters nearly a decade ago approved Proposition 63, an investment in building a continuum of care in the public community mental health system. With that, California broke ground in approving and implementing Proposition 63’s wholesale changes to a fragmented and inadequate mental health system.


In addition to providing improved comprehensive services to our state’s very ill, voters mandated that 20 percent of the funding be used for prevention, education, and early intervention. Since 2004, the California Mental Health Services Act has delivered exactly what voters demanded: a community-based mental health system that has created a game-changing roadmap for the prevention and treatment of mental illness.


To be sure, housing, job training, medical services and ongoing care are essential to create cost savings and quality care. Yet voters were deliberate in choosing to transform California’s mental health system by reaching out to individuals in need of mental health services before they reach the crisis point.


California is delivering on that promise to voters. We are helping to quell the social difficulties for children who have suffered trauma or loss. We are easing depression that often sets in the elderly. And we are helping mothers and fathers whose homes have been torn apart by mental illness.


Research shows that the majority of adult mental illness begins early in life. More than half of mental health issues begin by age 14. Yet most children and youth don’t receive help during this critical period. If mental health issues go unaddressed, the social and fiscal costs skyrocket. Unaddressed mental illness results inf sufferers droping out of school, going to jail, and becoming homeless.


Suicide is epidemic in California that affects all age groups. In 2009, nearly 3,800 Californians died by suicide and nine out of 10 people who die by suicide have a diagnosable mental illness at the time of their death. Early intervention is not an optional part of tackling mental illness; it is essential to saving lives.


I like to compare our prevention efforts to public health smoking cessation campaigns. Preventing young people before they ever even start to smoke, educating people about the health consequences of smoking, rather than waiting to treat late-stage complications of smoking, saves lives and money.


Proposition 63 is built around a transparent and robust process of community involvement and local-decision making. We have equipped our communities to deploy prevention and early intervention strategies, allowing each county to determine their own local needs and the best approaches to meet them.


We are seeing success in every corner of our state.


In San Bernardino, preschool children participating in the prevention and early intervention program who had recently experienced a significant trauma or loss made significant social and emotional gains and even outperforming their peers in some cases. In Los Angeles, programs for children and parents with traumatic stress, anxiety and depression have shown measureable improvement in their ability to effectively parent and in their children’s disruptive behavior.


Butte County has sharply reduced its six-month readmission rates to its psychiatric health facilities since implementing a program in 2011 that helps individuals and families connect with outpatient care and community resources. About 11 percent of individuals discharged in December, 2010, were readmitted within six months.  In just a year after implementing the program, the rate of those readmitted within six months fell to 5.5 percent.


In California, we aren’t sitting back and waiting. Our conversation started years ago, and we now are witnessing the positive results.


With effective prevention and early intervention strategies, California is leading the way in saving lives and dollars by reaching youth at risk of mental health challenges, breaking down the barriers that prevent people from accessing life-saving services, and reducing suicides that shatter families.


Through Prop 63, California counties are working together with the state to deliver the best value for our dollars and to reduce the severe impact untreated mental illness has on our emergency rooms, jails, and homelessness in our communities.


Hopefully, President Obama and others will take notice.


Early intervention and prevention is where our national discussion must begin, and we must find ways to reduce the fear and discrimination against people with mental illness across our nation. The result will be stronger families, more productive members of society and, most importantly, saved lives.


Those at the national level need look no further than California for the tools to begin.

Ed’s Note: Clark is Board President of the California Mental Health Services Authority and Mental Health Director of Monterey County.




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