Poorly tracked mental health services funds aren't reaching patients with severe psychological illness
Laura's Law isn't without its detractors. "Where does it end?" asked Dan Brzovic, an attorney based in the Oakland office of Disability Rights California. "Pretty soon, we'll have people saying that anyone with a mental illness cannot think for themselves."
"The moral issue is that people who are competent to make choices for themselves must be given that right," he continued. "That's if they have the capacity. If they don't, then there are involuntary treatment options already on the books, like conservatorship."
But the debate surrounding Laura's Law and mental health service delivery goes deeper, since underlying questions remain about whether dedicated funding has translated to sufficient levels of care. Each of the three mothers told the Guardian that their sons — all deemed to be suffering from "serious mental illness" — never received adequate treatment as they moved through California's fragmented and broken public mental health system, despite the advent of Proposition 63, the 2004 ballot initiative that created California's Mental Health Services Act.
A staggering report released in mid-August by State Auditor Elaine Howle brings this claim into focus. According to the audit, the California Department of Mental Health and the Oversight and Accountability Commission have exercised such "minimal oversight" since MHSA went into effect that the state has "little assurance" that $7.4 billion has been used "effectively and appropriately." That amount represents the total funding generated by the MHSA — which imposes a 1 percent tax on personal income in excess of $1 million — from 2006 to 2012.
In response to these revelations, Rose King, a co-author of Prop. 63 who previously served as a consultant for then-Attorney General Bill Lockyer, stated, "No county has been required to demonstrate its accountability for any spending or program choices. The public — and state officials — have no idea whether counties have improved county mental health systems, whether spending complies with the law, and whether private contractors have delivered promised services."
"WASTE, FRAUD, MISMANAGEMENT"
The MHSA ramped up services for some 600,000 adults and children in the public mental health system, bringing in $1 billion per year in dedicated funding for the treatment of serious mental illness.
But beyond patients tracked via Medi-Cal, no one tracks the true number of uninsured patients served. There isn't a data system capturing all the clients or services tied to MHSA funds, making outcomes impossible to track with accuracy.
Some funding has gone to client advocacy groups who actively oppose Laura's Law. Disability Rights California and the California Network of Mental Health Clients, both opponents of AOT, received $3 million and $1.5 million in MHSA grants respectively. These groups believe voluntary services should be the only programs to receive funding through MHSA and have actively threatened to sue counties that have tried to implement Laura's Law.
Some of the very people who campaigned hardest for MHSA have since become watchdogs monitoring its implementation. They include King, who lost both a husband and son to suicide due to lack of treatment for their severe mental illnesses, and Pasquini — whose only son is languishing in NSH with a diagnosis of schizophrenia and a felony charge for an alleged assault on a fellow patient while on the incorrect medication.
These embattled mothers say they've observed a system awash in "waste, fraud and mismanagement." They also charge that the system results in disproportionate services for what King terms the "worried well" — people merely experiencing life's ups and downs — in many cases to the neglect of those struggling with what's classified as "serious mental illness."
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