Caring For the Severely Mentally Ill Homeless

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The Silicon Valley Ethics Roundtable (SVER) issued an op-ed a year ago urging strong public and private leadership to direct resources to the unique needs of the severely mentally ill homeless.

A two-year-old county survey estimates 42% of the homeless population of over 9,000 to have a significant degree of mental illness, with 25% of those determined to be severely mentally ill. The housing crisis and the pandemic have made clear that everyone’s health and safety is at risk by the homeless population’s limited access to health care.

A recent audit of County Health Services found that despite having millions of unspent state and federal mental health dollars, the county has a shortage of facilities to house the mentally ill. Hence the severely mentally ill roam aimlessly through our neighborhoods, a danger to themselves and others. The recent stabbing at Grace Baptist Church by a homeless man and the fatal shooting at an encampment are shouting loud and clear; it is time for action! After years of study, the SVER recommends:

Re-open the Agnews-East Campus for the housing and treatment of the severely mentally ill. California needs to work with local agencies to quickly reopen that campus in North San Jose. The “Agnews-East” site was used for this purpose for decades, is in public ownership, and reactivation and staffing costs are much more affordable and humane then leaving those unfortunate folks on the streets. That old Agnews-East property or a similarly located parcel must be protected and dedicated to that eventual use.

This Agnews model will not lead to indiscriminate incarceration as skeptics contend. New family rights protective laws would apply with judicial and third party oversight, case reviews and medical and security support provided. Currently, the severely mentally ill homeless are often left to fend for themselves in very hostile environments, preyed upon by criminal elements and mixed into the general jail population.

The current “half-way house” approach has also not proven effective with the seriously mentally ill homeless who clearly need more focused, longer-term treatment. For the seriously mentally ill the current “revolving door” of apprehension, incarceration, medical evaluation, judicial review and release back to the streets to repeat the cycle is dangerous for all and unnecessarily expensive.

Design the proposed county jail/medical facilities projects in the North Street Civic Center area to operate in a manner sensitive to the severely mentally ill. Until recently the county jail was occupied only by those awaiting trial/sentencing. Any judicial sentence was served in state or federal prisons. Counties throughout the state are now required to house some convicted persons at the county jail, effectively becoming a jail/prison hybrid. That makes the separation of the mentally ill from the jail/prison populations even more critical.

The Santa Clara County Board of Supervisors is commended for its direction to develop an adjacent facility that will separate the mentally ill detainees. This new facility will provide vital mental health services as a first step towards moving the less severely ill to half-way or other community based options. But the severely mentally ill need a longer term, Agnew-type campus to receive extended therapy while being evaluated and, if necessary, humanely restrained.

Current costs of the severely mentally ill fall most heavily on cities and counties. Added federal and state financing must be pursued. The terrible damage to some of those least capable of protecting themselves continues to grow, causing their pain and that of their families, danger to those in their proximity and is a societal cancer to our American self-respect. That system repeatedly diverts law enforcement and medical staffs from their primary civic duties.

Government, community and business leaders must step up and make an Agnews-East re-opening a top priority. Indeed, there will be some expense but less than the current revolving door and affordable and honorable for one of the most innovative and wealthy places on earth. It’s the right thing to do. The benefits to those unfortunate souls and their families will be a lasting and immeasurable blessing, is more humane and less expensive than the current revolving door system and a tribute to our “can do” Valley.

This opinion was provided by San Jose Redevelopment Agency retired deputy director Bob Leininger and retired San Jose vice mayor Frank Fiscalini for the SV Ethics Roundtable.

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