Coordinated Action Needed To Help The Severely Mentally Ill Homeless

Silicon Valley Ethics Roundtable (5/20/20)

As the State of California, County health agencies, and hospitals courageously battle the COVID 19 pandemic, the Silicon Valley Ethics Roundtable highlights a subgroup of our community that also requires a strong commitment to action. A recent County-wide survey shows an ever increasing homeless population now at well over 9,000 with 42% having mental health issues. The severely mentally ill within this subgroup number in the many hundreds (26% by official estimates) and are those most visible, unfortunate souls on the streets every day. The Silicon Valley Ethics Roundtable believes the State of California should assume a leadership role and actively engage with County and local government agencies and non-profit service providers to meet the housing and treatment facility needs of these severely mentally ill homeless, not only in Silicon Valley but in other urban areas.

Some might question the need for such a facility. Indeed, San Jose, the County, and numerous non-profits are working together with significant resources such as voter approved housing bonds and private donations. Many affordable housing projects are underway with more planned. In addition, the County and non-profit providers already offer services to the mentally ill homeless, with more services on the way.

The ongoing commitment of these service providers is an immense contribution in addressing homelessness in this County. But the seriously mentally ill homeless rarely voluntarily seek these service options and those who do usually do not continue the treatments. Professionals in the field note that these severely afflicted persons simply cannot thrive in an independent living environment. They cannot be left to defend themselves from predators, are often in legal conflicts, and jailed with inmates who can make conditions even worse. The alternative voluntary “half-way house” system, set up in the 1970s after the State closed the “Agnews-type” mental facilities state-wide, can be a viable living and treatment choice for many with addictions or more manageable mental conditions. But the volunteer living setting has not often proven effective for the severely mentally ill.

That continuous cycle of cost and suffering of the seriously mentally ill…dangerously living on the streets, involved in legal infractions, incarceration, judicial review, reincarceration or hospitalization, then released to repeat the cycle…is ineffective, inhumane, and expensive. And those horrendous, repeated costs are born by the local city and county services designed to protect the citizenry and not as specialists in supporting the seriously mentally ill.

The State of California can offer both capital and operating funding (e.g. State 2018 Proposition 2 funds and the $1 billion program recently announced by the Governor) and possible site(s) for a permanent housing and especially trained, on-site, efficient treatment services. State laws regarding conservatorships can be utilized by the courts for the sensitive handling of multiple recidivist patients with full respect for their rights as individuals. Mental health service funding must be substantially increased; and insurance coverage issues, such as Mental Health Parity legislation as championed by Senator Jim Beall and Federal Medicaid eligibility, need to be actively supported. A portion of the old Agnews campus is still undeveloped and could be utilized for those hundreds of multiple-repeating offending seriously mentally ill. Financial needs beyond insurance, federal and the State of California can be addressed locally through existing funds (such as the voter approved housing bonds) and possibly with County-wide revenue measures so that everyone makes a commitment to this societal endeavor.

This is doable, humane, and cost effective, and the financing and sites are available! A working group of City and County agencies, Silicon Valley non-profits, citizens, and industry should be formed to partner with the State of California in an implementation strategy for the development and operation of an appropriate facility. State sponsored pilot programs (under the recently approved SB40) are underway in other regions of California. Silicon Valley’s must start now. There is no reason for delay. The severely mentally ill homeless and those who they impact need and deserve a maximum effort. After years of study and trials, this is the ethically correct course.

Provided by the Silicon Valley Ethics Roundtable members Bob Leininger and former Vice Mayor Frank Fiscalini, and Chair form County Supervisor Rod Diridon, Sr.

SVER NOTE: The opinions in this article are solely those of the author and do not reflect those of the Silicon Valley Ethics Roundtable. Articles are posted for comment and discussion.

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