L.A. Mental Health Centers Face Cuts and Stigma
Weekly meetings of community members and staffers at a Long Beach mental health facility have several rules. The first is to “be brief.” Another rule, though, gives a clear understanding of what has been on the minds of the people who run this center, called the Village, which delivers mental health treatment and social services to the underserved populations in Long Beach.
“Don’t ask for money,” the moderator tells the group. “The state is $28 billion in the hole. We don’t have it.”
Mental Health America of Los Angeles, which runs the Village, offers many of the same services as a clinic, but there’s little clinical about it. Staffers pride themselves on the center’s socially interactive model of care, meaning they try to foster the development of a community among the patients – to whom they refer as “members” – and the 80-or-so people who work there.
One staffer at the Village site has hung on his wall a poster from the film “One Flew Over the Cuckoo’s Nest.” But Nurse Ratched is nowhere to be found. The rooms are welcoming and the people are friendly. The members can get medicine and hang out in the garden area outside.
At the Full Service Program upstairs, members receive job skill and literacy training. They can also learn personal finance, an important skill for people subsisting on $845 a month from the government in Supplemental Security Income.
But the center has its difficulties, which will only be magnified when and if Jerry Brown’s proposed budget goes into effect. Cuts to Medi-Cal, the primary funding source for the Los Angeles Department of Mental Health, will have consequences, as will the proposal to cut monthly SSI payments to $830. The lone psychiatrist who works in the in-take room on the first floor works with about 80 patients on a on-going basis.
Dave Pilon, CEO of Mental Health America of Los Angeles and one of the original writers of the program, spoke to Neon Tommy about the services offered and the struggles his organization faces.
Neon Tommy: How has the program changed since you started?
Dave Pilon: It’s changed remarkably. We had the basic idea of creating someplace where people with psychiatric illness could feel welcomed and have their needs met. Over the years, it’s become much more of a place where we actually are pushing people out back into the community where they can recover. When we first wrote the proposal we thought, “People will be here for a lifetime,” but what we discovered is, people can recover and actually live very full and productive lives out in the community.
So our job has changed in that respect, where we’re not just protecting them but giving them the skills where they can go out and live a whole life.
NT: What are the main difficulties you face in serving this population?
DP: Funding is always a challenge. There aren’t enough funds to provide all the services that people with severe mental illnesses need. We actually do a lot better since the passage of Prop 63 back in 2004. That was the tax on people earning more than a million dollars, and that money goes to mental health. But the Governor’s proposed budget would take some of those funds to fund other services, so it’s sort of up in the air as far as how the Governor’s budget will play out. We’re right there with all the other human services. And it’s especially hard for our members, when they get only $845 per month on which to pay their rent and all their meals.
So besides the funding issue, the stigma is a big issue for a lot of folks. A lot of people don’t understand mental illness or they have some concerns about people who are mentally ill so you run into a lot of the “not in my back yard” issue. For example, we’re trying to site a program in the center of Long Beach right now, and the neighbors are up in arms against us because they feel like people with mental illnesses are dangerous. And the recent events in Tucson don’t help that situation.
People overemphasize the danger that’s involved. It’s certainly not to play down what a tragedy it was, but to paint all mentally ill people with the same broad brush is a huge mistake.
NT: Where, exactly?
DP: It’s near Burnett St. It’s in the middle of an industrial park, and the nearest residence is 900 ft. away and there’s still community resistance to it. The city of Long Beach has voted us in there so we do have the right to move there, but there’s still a lot of resistance on the part of the community. But we’re still planning on moving in there.
NT: What kind of outreach have you done in that area?
DP: We’ve had lots of conversations with the community members, but so far we have been unable to convince them that it’s a good idea. Was there any sort of similar problem when this site started? No. You asked how things had changed? When the Village was created back in 1990 it was actually on the consent calendar for the city of Long Beach City Council. So we actually had a lot of support form the city council to move in, but as the neighborhood has gentrified around us – it wasn’t as commercially vibrant an area as there is now – and so there’s more resistance now than there was 20 years ago.
NT: It’s interesting to see the contrast between here and just two blocks away.
DP: When we moved in, those condos across the street didn’t exist, and there was an elementary school right where the parking lot of Albertsons is. So here we were, running a program to serve people with mental illnesses right next to an elementary school. That would be unlikely to happen today. It seems like the stigma has gotten worse in that respect over the years.
NT: What is your relationship like with the Department of Mental Health Services?
DP: The Department of Mental Health is our primary funding source. So we are a contract agency. Mental health America of Los Angeles is a private non-profit, what is know as a 501(c)3 organization. And our full-service partnership upstairs and all these services are funded one way or another through the Mental Health Services Act. The Department of Mental health administers all those dollars. And there is a network of programs like this one across L.A. County that serve this population.
NT: I see you talking with the members on a personal level. Can you explain how that works and how that’s a benefit?
DP: The whole model here is basically that a sense of belonging is important to everyone. So what the Village does more than anything else is create a feeling that ‘I belong in a community,’ that no matter what else is going on, whatever problems you’re having, there’s a community that supports and embraces you. It’s not that homeless people are resistant to treatment. They’re resistant to clinics.
NT: How do the members relate to each other?
DP: It’s a good place to create friendships. That sense of social isolation that many people experience, we try to break that down to some extent… If you walk into your standard, traditional clinic, you probably wouldn’t see a lot of this going on. For one thing, most of it’s done on the idea of individual therapy. There’s a lot of talking between the counselor and the member. We’re much more group-oriented and much more focused on finding meaningful roles for folks. Most clinics don’t have a place were you can learn to work or get educational needs met. They have a therapeutic model as opposed to a social interaction model.
NT: Where do you see room for improvement?
DP: I would love to have more employment opportunities, but in this is economy it is very difficult for people to find jobs, let alone people coming with psychiatric disabilities. So it’s become tougher to find jobs out in the community, but I would hope that we could find some employer looking for an entry level workforce, where they could provide our members with some employment opportunities. That would be extremely helpful.