Editorials

Costly decision to cut mental health care

The Sacramento County Board of Supervisors made a fateful decision in 2009 to close a 50-bed crisis unit for people in the throes of a mental-illness crisis.
The Sacramento County Board of Supervisors made a fateful decision in 2009 to close a 50-bed crisis unit for people in the throes of a mental-illness crisis. ccostas@sacbee.com

A jury of our peers rendered a verdict that any one of us understands all too well: The Sacramento County Board of Supervisors has failed to provide care for people who desperately need it, the severely mentally ill.

The Sacramento County grand jury homed in on the ramifications of a dreadful decision made by the Board of Supervisors in 2009 to shut a 50-bed crisis unit for people in the throes of a mental illness crisis. The grand jury urges restoration of the crisis unit, among several other steps.

Sacramento County supervisors did increase funding in 2015, and mental health officials are gamely trying different approaches to improve care. But the failures remain brutally evident.

“Suicide rates are up, inmates at the jail with mental illness have doubled, hospital emergency rooms are overwhelmed and police officers are diverted off the streets to deal with mental health crises; all attributable to county decisions,” the report issued two weeks ago says.

Between 2008 and 2014, the civil grand jury noted, the county’s population grew by less than 10 percent. But law enforcement logged a 29 percent rise in the number of mental illness crisis calls.

Suicide rates are up, as is the number of Sacramento County jail inmates with mental illness in part because of a bad decision in 2009.

The county scored a $14 million savings by shutting the crisis unit. But the decision merely shifted costs. Hospitals hired more security to deal with the increased number of patients in crisis, and successfully sued the county to recover more of the cost of caring for the indigents who are mentally ill.

The incidence of mental illness among jail inmates increased from 18 percent before the cutbacks to 34 percent in 2014. In 2010, the year after the county shut the crisis unit, the Sacramento County suicide rate increased by 16 percent.

While supervisors failed to protect mentally ill people, the board did protect its own. The final 2009-10 budget pared the total approved jobs in the mental health department by 1.5 full-time equivalent positions out of about 352.

The grand jury report underscores what anyone knows who walks along city streets or drives past freeway underpasses in any of the 58 counties.

Some people will blame the crisis on decisions made last century to shut some state hospitals without providing sufficient funding for the individuals’ care in the community. But 21st-century policymakers make the same bad decisions. Then, as now, they find better ways to spend tax money than on people who have grave needs but no clout.

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