concept: the need for change

Community mental health: it seems as though it is chronically underfunded, never able to meet demand, always on the verge of collapse. This year's global economic crisis has taken us beyond that verge. If the Sacramento Department of Health and Human Services Mental Health Division is to be believed, the current system of Regional Support Teams (RSTs) will completely run out of funding on 30 June 2009 -- leaving up to 9,000 of Sacramento's most vulnerable mentally ill citizens without access to care. (UPDATE: it appears as though they're not closing the RSTs entirely, just reducing the number of citizens served by five thousand, with no practical alternatives in place.) This is not the beginning of the crisis, it is the end. For years, the community mental health system in Sacramento County has offered its citizens timely mental health care only through emergency rooms, jails, and one overcrowded psychiatric hospital. Those seeking care in a humane outpatient setting faced waits often exceeding six months, with jails, ERs, and the Sacramento County Mental Health Treatment Center as their only options for more timely medical attention. I have found myself face-to-face with this inhumane system time and again over my thirteen years in Sacramento County community mental health, and looked on helplessly while our leaders failed to acknowledge the seriousness of the problem.

Now that badly broken system has failed completely. Already, Sacramento County will only accept patients into the outpatient mental health system if they already have Medicare, Medi-Cal, or other health insurance. Soon, even the insured will have no place to go.

This does not save money. Study after study, program after program has demonstrated that providing humane, timely outpatient care pays for itself not in years, but in months. Forcing our friends, neighbors, and family members with mental illness into jail wards, emergency rooms, and overburdened psychiatric hospitals is ugly -- and it is poor fiscal policy to boot.

Proceed to technology for providers