We, the Mentally Ill

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“Roger, on a scale of one to five in intensity, how would you rate the last week?” asked John Gaddis, a counselor with the Sanctuary Psychiatric Centers.

“It’s been a four in both directions. In the same day, I’ve had feelings of total euphoria followed by thoughts of hurting myself. But I’m not worried yet. It’s not a five.”

“You’re not worried?”

Or maybe I’m worried. Maybe these budget cuts to mental health in Santa Barbara County will adopted. Maybe my treatment will end. Maybe my housing will be revoked. Maybe I’ll be a five and find myself without help and on the streets. Maybe then I’ll be dead.

Four years ago, I graduated from UC Santa Barbara at the top of my class. Three years ago, I started a company and purchased a home. Two years ago, I became severely bipolar followed by divorce, foreclosure, bankruptcy, and shame. But today I realize there is nothing shameful about mental illness, there is only shame in how we treat the mentally ill. Four months ago, I held a gun to my head but between my finger and the trigger was the overwhelming support from Sanctuary Psychiatric Centers and its staff. These are the same services that Dr. Ann Detrick, the director of the Santa Barbara County Department of Alcohol, Drug and mental health Services, proposes we cut. She reassures us that, “We’re trying not to completely cut someone off from the services.” To Ann Detrick I, along with the mentally ill and homeless of Santa Barbara County, respectfully reply: try harder. Without these services, I would not be alive today. I see no greater cause for which to fight. Our lives are enough of a struggle without tossing our treatment and housing into uncertainty.

The lives of the mentally ill have always been a struggle. When a budget crisis emerges, services for the mentally ill are generally the first to be axed. Money initially saved is quickly overcome by bigger jails requiring larger budgets. In Miami, Florida, where there is one of the largest jails in the nation, nearly twenty percent of its inmate population suffers from mental illness. The problem of caring for the mentally ill will not go away once the budget to care for them is substantially reduced. Instead, the means of care will be unavoidably replaced by existing services – behind bars or in hospitals at far greater expense.

Society has never fully decided what it should do with its mentally ill. For centuries, we endured vile conditions and crippling stigmas. During the Middle Ages, we were branded as witches, tortured and then burned at the stake. The first known psychiatric hospital in Europe, the Bethlem Royal Hospital, was founded in London in 1247. By the 18th century, the hospital was notorious for the shameful treatment of its patients. Outsiders could pay a penny to come and watch patients as a twisted form of entertainment.

As recently as the 1950s, doctors in the United States treated the mentally ill with crude and radical procedures. They were called “quick-fix solutions.” Rosemary Kennedy, the sister of President John F. Kennedy, complained of moodiness at the age of 23. She was given a lobotomy – a procedure which involves drilling holes in the patient’s head and destroying tissue in the frontal lobes by injecting alcohol. 40,000 of these were performed in the United States alone. They generally left patients incapacitated for life. Their verbal skills were rendered to unintelligible babble and as a result their subsequent behavior mirrored mental retardation. In 1968, Rosemary’s sister founded the Special Olympics in her honor. Next time you think of the Special Olympics, reflect on why it exists. It exists because a bipolar woman named Rosemary Kennedy was rendered so incapacitated by anachronistic treatment that she would’ve qualified to participate.

Society has a moral obligation to its fellow man. Hubert Humphrey wrote that, “The moral test of government is how it treats those who are in the dawn of life… the children; those who are in the twilight of life… the elderly; and those who are in the shadow of life… the sick… the needy… and the disabled.” Well, I, along with many others, linger in the shadows of life. The proposed budget cuts will force hundreds on our streets, in our jails, and in our emergency rooms. It will be harmful to tourism and burdensome to taxpayers. Some of those in the shadows are too ill to speak out, too symptomatic to raise a voice, too ashamed to be exposed, too confused to be understood.

But not I. It is my civic duty to advocate for those who can’t – for the uneducated, the severely sick, for those in crisis, for those left homeless. At the April 22nd Board of Supervisors meeting, over 80 individuals protested the draconian budget cuts and were supported by hundreds who chose to listen. After absorbing voices trembling with trepidation, filled with disgust, or boiling from anger, First District Supervisor Salud Carbajal remarked, “I’m losing sleep at night because of these issues.” If he’s losing sleep, imagine the nightmares we must endure. With our treatment and housing at risk and our mental stability in peril, we can’t – we won’t – sleep until realistic solutions are suggested; until humane proposals are ultimately adopted.

The fact that I’m compelled to emerge from the benign silence of consumers and, at risk of lasting societal stigma and tacit scorn, beseech society not impose what is planned means that many options have been exhausted and several attempts at compromise have failed. Annmarie Cameron, executive director of the mental health Association, described the process of working with county officials as “flawed from the beginning.” Mike Foley, executive director of the Casa Esperanza Homeless Shelter, characterized attempts to work with ADMHS officials as “a deeply dishonest experience.”

However, many of us felt relief after the last Board of Supervisors meeting. Detrick’s proposed cuts weren’t, according to the Supervisors, “creative enough.” The Supervisors, with the exception of Supervisor Firestone, seemed unsatisfied. They drafted a motion to explore more options. But left alone, the motion means very little. Supervisor Carbajal himself admitted that “…unless the board is able to do something in June, this will be the plan.” Given that the cooperation of county officials is described as dishonest and flawed, there’s legitimate concern that Detrick will not seek creative inspiration. There’s a real possibility that hundreds of severely ill members of our community will be left homeless. Should this happen, it is almost certain people will die. We can’t let cautious optimism render us complacent. There is still much more advocacy to be done.

It doesn’t require much creative inspiration to entertain different options. We could tap into the county’s strategic reserve. We could increase certain fees for county services. Rusty Selix, co-author of state Proposition 63, or California’s Mental Health Services Act, suggested that funds exist that would allow counties to finance existing programs. Or, ideally, we could increase the percentage of the county general fund that goes to mental health. Currently, the mental health budget constitutes only 2 percent of the general fund. But throughout California, the average figure for how much the county’s budgets go to mental health is 6 percent. Our Supervisors claim they’re committed to mental health and yet we’re one of the worst funded counties in California for such services. But I realize that some cuts must be made. Programs like Sanctuary Psychiatric Centers, the one I depend on, could sustain a cut of 15 to 20 percent and still continue, albeit with great struggle, to operate and function. Those are the types of compromises that I see reasonable.

Another problem is where the cuts are focused. The ADMHS budget is being decreased from $34.8 to $26.4 million – such a decrease balances the budget. But half the cuts come from county contracts with a host of Community Based Organizations that provide services for the homeless and mentally ill. But cuts to CBOs make little fiscal sense. “CBOs definitely provide a bigger bang for our dollar,” Supervisor Carbajal conceded. Then why would a cost-effective solution get cut only to pass far greater costs to individual taxpayers of the affected cities? CBO contracts are to be cut 60 percent from $10 to $4.2 million. And the cuts target only the adult services division – let’s consider cutting the alcohol or drug portions.

Like a lobotomy, the current proposal is a “quick-fix solution.” This is a lobotomy of our budget which will render our services obsolete or functionally inert; it is a lobotomy of the true compassion and empathy and service that represents the members of Santa Barbara County. Dr. Martin Luther King, Jr., was quoted with what is a very relevant proposition to the taxpayers of Santa Barbara County, “We are prone to judge the success by the index of our salaries or the size of our automobiles, rather than by the quality of our service relationship to humanity.” Today, we’re asking for your help so we can all succeed.

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