Newsom embraces controversial mental health policies to reform care

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Newsom embraces controversial mental health policies to reform care

“There was a justification in the ’60s, with Democrats and Republicans saying, ‘We’ve got to get away from these locked-down institutions,'” Newsom said this year before he signed the a couple of mental health bills. “We need to replicate that with community-based care and there’s no accountability, no obligation in any way.”

The governor stressed that most of the new services would be voluntary – and would provide shelter to thousands of people sick on the streets. His bond proposal, combined with three other programs he launched recently, is expected to fund nearly 46,000 outpatient treatment slots.

Right now, California has only a vague idea of ​​how many people it can treat in outpatient settings — which isn’t enough. That number may include group therapy slots, detox, counseling or many other procedures that do not require a license and are difficult to quantify. That’s part of the need for changes, officials said, to finally get a census of where the state is in treatment.

It requires a large workforce to provide all the treatment promised by the state. Newsom’s proposal includes nearly $7 billion to increase the workforce, which will rely on new medical education slots to provide practitioners, as well as people trained as counselors after receiving treatment. -substance abuse themselves.

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“I know the critics will say you don’t have the workers so you can’t change the laws,” said Sen. Susan Talamantes Eggman (D-Stockton), who authored one of the laws that will appear on the March ballot. “For mental health care, we seem to think that everything needs to be in its perfect environment before we can make any changes.”

The fact that California is building new treatment facilities and training additional staff on this scale is a feat unlike any other state, California Health and Human Services Secretary Mark Ghaly said in a interview. The idea is to strengthen the entire spectrum of care, including prevention and early interventions.

“But it doesn’t prevent the need for some people whose conditions can be so severe, so violent, so difficult to manage, that they need some level of involuntary care,” Ghaly said. “California’s vision for this, is that (involuntary treatment) is only used when absolutely necessary.”

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However, the bond measure allows some money for residential treatment to be used to build secure psychiatric facilities. California also made it easier to place people in conservatorships, an arrangement that allows judges to appoint someone to make legal and health decisions for people they deem “severely disabled.” ” and cannot take care of their health and safety. Compulsory care, for some, means involuntary detention in a psychiatric facility from 24 hours to evaluate a person to 180 days in severe cases to treat them. Court-ordered treatment plans may include medication, therapy or home placement.

Some mental health advocates fear that Newsom is overcorrecting.

“We’ve looked at all of this, and it’s going in the wrong direction,” said Clare Cortright, policy director for Cal Voices, a coalition of groups representing community mental health organizations. These groups and others are organizing Californians Against Proposition 1, to oppose the changes on the March ballot. Without a professional organization or high-dollar backer, the opposition’s main asset is anger from people in the mental health system who fear they will be forced into involuntary treatment.

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The idea of ​​forcing people into treatment has long been politically untenable for progressive Democrats, who see it as a violation of civil rights. Until recently, few state lawmakers were willing to call for more conservatorships or court-ordered services outside of the justice system — and recent California laws reflect an elaborate which attempts to balance such measures with civil rights concerns.

But Democratic mayors in cities with housing and addiction problems have begun to remove or change laws around civil commitments, where people living on the streets who can’t take care of themselves given court-ordered treatment plans. Others argue that governments need a way to reach people who can’t or won’t seek help themselves.