In California, the state that led all others in the failed social experiment of emptying psychiatric hospitals, the pendulum clearly is swinging.
Not that California Gov. Gavin Newsom aims to return to the days when forgotten souls were locked away in large asylums. But in a proposal to be detailed on Sunday, Newsom will call on legislators to place a $3 billion bond measure before voters in 2024 to pay to house thousands of people with severe mental illness.
Additionally, Newsom will ask legislators to rewrite a 2004 initiative, Proposition 63, that raised income taxes by 1% on individuals with earnings of $1 million or more to help people with mental illness.
That tax generates $4 billion annually. Under Newsom’s revision, 30% of that sum – more than $1 billion each year – would be used for housing for people with mental illness and addiction issues, with much of the rest earmarked for services for those recipients. That will also need voter approval in 2024.
The author of Proposition 63, Darrell Steinberg, was a state legislator when he co-authored that initiative. Now, as Sacramento’s mayor he is dealing with the seemingly intractable problem of homelessness. He will join Newsom in announcing the planned revision of the measure, known as the Mental Health Services Act.
“We want more money going toward alleviating the condition on the streets,” Steinberg said.
No other state is contemplating such spending to confront mental illness and the related issue of homelessness. But California has 30% of the nation’s homeless population, with 115,000 living on the streets on any given night. A fourth, maybe more, are mentally ill.
In an interview, California Health & Human Services Secretary Mark Ghaly cited a recent Rand Corp. study that California needs at least 2,800 beds for people who are making a transition from locked wards or jails or prisons to the outside world. The state is short by another 3,000 beds for people who can live in less structured settings but still need supervision.
As contemplated by Newsom and Ghaly, some people would reside in cottages in residential neighborhoods. Some would live in campuses of a few hundred people. All would receive supervision.
No other state is contemplating such spending to confront mental illness and the related issue of homelessness.
Harkening to the 1960s and 1970s when California all but emptied its state hospitals, Ghaly told me: “There was this promise that something would replace it, something that is more humane, something more community based.” This new proposal “is saying we’re going to finally build that up.”
On the national stage, Newsom gains attention as a partisan warrior on such issues as abortion. In California, however, he often returns to the knotty problems of untreated mental illness and homelessness, issues he has been grappling with since he was a San Francisco supervisor.
When I met him 20 years ago, Newsom told me 183 homeless people died on San Francisco streets in 2000. The problem has only grown worse. Among the more recent deaths, a baby was stillborn in a latrine in January at a homeless encampment near San Francisco City Hall, as first reported by the San Francisco Standard.
Newsom has focused on the issue more than any governor before him, earmarking billions for housing, early intervention, and care for people with mental illness. Last year, he won legislative approval to create a new court system in which judges could compel treatment for individuals who are severely mentally ill and chronically homeless. In reflection of voters’ insistence that government deal with homelessness, the measure received only two no-votes in the Legislature.
Democrats often blame Ronald Reagan for problems associated with untreated mental illness. It’s an easy out. He hasn’t been governor since 1975. Besides, California started emptying state hospitals during the administration of Gov. Edmund G. “Pat” Brown. In 1967, the year Reagan took office, there were 26,000 people in 10 state hospitals, down from the high of 37,489 in 1959, the year Pat Brown took office.
Democrats often blame Ronald Reagan for problems associated with untreated mental illness. It’s an easy out.
In 1967, responding to abuses that went back decades, Frank Lanterman, a Republican assemblyman from La Cañada Flintridge, and Democratic Sen. Nicholas Petris of Oakland, later joined by Sen. Alan Short of Stockton, joined to rewrite the law governing the treatment of people deemed to be mentally ill. The resulting law, which remains in effect, guarantees that people can’t be held against their will unless courts deem them to be gravely disabled and dangers to themselves or others.
Although the issue was not among Gov. Reagan’s priorities, he signed the legislation, after gaining assurances that it would not cost the state money, internal memos buried in state archives in Sacramento show.
“The bill makes badly needed procedural reforms but does not enact new financing or administrative changes on the state or county level,” Short wrote in a letter urging Reagan to sign it.
It was an exercise in magical thinking: There’d be “reform” and former patients would find care, but neither the state nor local government would be obligated to provide services.
When Reagan left Sacramento in 1975, only a few thousand patients remained in state hospitals. One was my brother, Frank.
Frank had suffered a devastating brain injury when at age 22 he drove his car off a road in the San Francisco suburb of San Mateo coming home from work one night in June 1969. Unable to care for him at home, or find care in community settings, our parents turned to the state. Frank spent most of the rest of his years in state hospitals. It was a rough existence. But over time, largely because of our parents’ persistence, conditions improved.
Starting in 1985, the administration of Gov. George Deukmejian, a Republican who was one of Reagan’s closest allies, funded a special ward at Napa State Hospital where Frank and people like him with severe brain injury received intensive therapy. It helped. Some of his impulsive and destructive behavior subsided.
Looking back, perhaps he could have lived outside a locked ward if he had supervised care of the sort envisioned by Newsom. That was not to be. In the recession of the early 1990s, the state ended funding for the brain injury ward. He died in 2000, having lived in his final days in a locked nursing home in Oakland.
Helping people whose brains are damaged by disease, injury or addiction isn’t cheap. It’s fitting, then, that voters will decide whether to spend more billions. But as we Californians see each day, the cost of ignoring the problem is greater.