What does $10 billion mean in the context of a $3.8 trillion federal budget? We spend $10 billion and more on tax giveaways for huge multinational corporations with financial operations overseas, on fossil fuel subsidies for enormously profitable oil companies, and on unnecessary farm subsidies.
What would a $10 billion national commitment to effective mental health services mean to the American people? Millions of lives saved. Millions of healthier and more productive lives.
We ask the questions after each deadly rampage at schools, at theaters, at shopping malls, at temples and workplaces all over the country. Everybody talks about the need for mental health services, but what does that mean? What should we do? What will it cost?
California offers a proven model of preventative and comprehensive mental health care that can be replicated across the nation. And we can pay for it on a national scale for the cost of one corporate tax giveaway. It can be done.
We should all be sensitive to equating mental illness with violence, which increases the stigma upon those who are ill. The vast majority of people living with depression, bipolar disorders or schizophrenia have no propensity to pick up a gun and kill innocent victims.
Yet if a national tragedy can raise mental health treatment to the top tier of public health issues, we must take advantage of that opportunity. Bold action to curb accessibility to guns is critical. But that's simply not enough. Every year across the country, more than one of every four adults suffers from some form of mental illness or substance abuse.
If we're serious about giving more than lip service to truly helping people, we have to do what works and be prepared to fund it. According to the National Association of State Mental Health Program Directors, states have collectively cut more than $4 billion in public mental health spending since 2009. While the Affordable Care Act provides enormous potential, millions of Americans will still face barriers to full mental health treatment.
In meetings recently in Washington, D.C., with Congress, representatives of the Biden commission and mental health services advocates, I offered a framework for a $10 billion federal investment in mental health services and programs focusing on three key areas: prevention and early intervention ($1.2 billion), school-based health centers ($800 million) and comprehensive mental health treatment with a "whatever it takes" approach for the most severely ill ($8 billion).
After planting the seeds of this idea, we'll be following up in the weeks and months ahead.
My proposal is based on California's Mental Health Services Act, enacted by Proposition 63 in 2004. As the act has transformed California's mental health system, this federal investment would have an immediate impact in communities around the country; more prevention and early intervention for young people showing early warning signs, and a more comprehensive approach to fostering recovery for the most seriously mentally ill.
A person's initial episode of severe mental illness commonly called "first break" usually occurs in the late teens or early 20s. Intervention at the first sign of symptoms offers the most effective treatment before someone hits rock bottom.
There are 421 prevention and early intervention programs throughout California linking services to those at risk or in the early stages of mental illness.
In Sacramento County, a nationally recognized program identifies, screens and treats teens and young adults who are at high risk or already experiencing the initial onset of psychosis, especially schizophrenia.
At University of California campuses, faculty and staff receive training to recognize and respond to signs of student distress. UC also reaches out to students through online stress and depression questionnaires. Campus psychologists respond within 24 to 48 hours, offering counseling and services.
The American Foundation for Suicide Prevention says students engaged in such screening are three times more likely to enter treatment.
While mental health treatment is among the services provided at close to 2,000 school-based health centers nationwide, most lack the resources to help students needing more intensified care. A federal investment can expand such centers, to help children and youths overcome mental and behavioral disorders in the early stages.
California's Full Service Partnerships have provided a "whatever it takes" approach for 60,000 people needing the most intensive care. This not only provides treatment but also can include safe housing, a job, help in school and physical health care. For these clients, a recent UCLA study shows dramatic reduction in psychiatric hospitalization, emergency room visits, incarceration and chronic homelessness.
We know what works. We must be prepared to fund it. We don't need another tax giveaway. We need a $10 billion federal investment that can save untold numbers of lives and help untold numbers of people in every neighborhood, in every state across the nation. The time is now.