Poorly tracked mental health services funds aren't reaching patients with severe psychological illness
MISSPENDING OF FUNDS DESIGNATED FOR PREVENTION?
Under the MHSA, only a specified population may receive treatment using these funds. Patients must have been diagnosed with "serious mental illness," amounting to psychological problems that are severe enough to prevent an individual from functioning independently without assistance should they go untreated.
But critics like King and DJ Jaffe of the Mental Illness Policy Org. (MIPO), a national think tank that has been critical of California's management of MHSA monies, contend that the 20 percent of MHSA funds designated for Prevention and Early Intervention (PEI) programs are instead being funneled into programs with little connection to mental illness treatment.
The MHSA specifically limits PEI dollars to programs that "prevent mental illnesses from becoming severe or disabling" or that "limit the duration of untreated mental illness."
Yet King contends that these funds have been used instead to underwrite social service programs ranging from domestic violence prevention and parenting classes, to social skills for disadvantaged youth — all good causes that are nevertheless "not legitimate recipients" of money intended for mental illness treatment, King says.
Jaffe's organization has seized on the PEI expenditures as a violation of the MHSA, turning a skeptical eye on the 16-member Mental Health Services Oversight and Accountability Commission.
In 2011, according to a MIPO analysis, more than $23 million in PEI grants went to advocacy organizations and service providers with direct financial ties to both OAC commissioners and committee members. MIPO characterized it as "insider dealing" and a violation of California conflict-of-interest laws.
OAC committee member Rusty Selix, a lobbyist and Prop. 63 co-author, dismissed the MIPO report, saying, "I don't see any conflict."
Selix added that unpaid OAC board members recuse themselves from voting whenever it's deemed to be necessary. And he defended a system where stakeholders, such as consumers and family members, also serve on committees, saying, "You can't expect to include them in the process without crisscrossing some stakeholders who also receive MHSA grants."
Jaffe took a different tack. "The problem, besides the blatant conflict-of-interest," countered Jaffe, "is how these PEI monies are being spent. And they're not being spent to help the seriously mentally ill," he continued. "Yet year after year, they're getting approved. Millions and millions of taxpayer dollars that were supposed to go to treat the sickest among us are being spent on social programs."
NOT ENOUGH BEDS
Some believe the broad issue of funds not making it to the intended target population might be playing out within the microcosm of San Francisco. In 2010-11, the most recent available data, San Francisco County received $23 million in MHSA funding, 75 percent of which was earmarked for direct services.
But that money hasn't gone toward ensuring that there are enough beds for treating mentally ill patients, according to Geoff Wilson, president of the Physicians' Organizing Committee. Wilson's organization reported that as of August, San Francisco General Hospital had dropped to 19 emergency psychiatric beds, down from 88 two years ago.
"It's unconscionable. We've got the highest 5150 rate in the state," Wilson told The Guardian, referring to 72-hour psychiatric holds imposed by law enforcement. We're not saying 'lock everyone up,' we're just saying that for people who need it, the beds need to be there, and there's barely any left in the city."
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