I see a crisis in mental health care all over the streets of Santa Barbara. A short walk from Stearns Wharf up State Street to the Public Library on any day of the week reveals the severity of problem. In 11 blocks there are far more than 11 people who seem to be severely mentally ill and living on the streets. Likely there are more than a couple dozen.
Unfortunately, many of them are “service-resistant,” meaning that they tend to avoid institutions, refuse programs aimed at them, and generally shy away from those trying to help them. They often spend over a decade on the streets and have repeated bad experiences in shelters and programs. These experiences, as well as other grave life events, have left these people fearful and filled with trauma. Outreach to this population is a time-intensive process that leaves even seasoned outreach workers frustrated.
As someone who has become homeless three times in the past 17 years, I have become very familiar with those who live on the street and face mental health challenges. A formal count of the homeless population takes place every two years in our county, as required by the U.S. Housing and Urban Development (HUD) department. The most recent count — by the Central Coast Collaborative on Homelessness (C3H) in conjunction with Common Ground and over 300 volunteers — found about 1,400 people without permanent housing on the streets of our county. HUD recommends a “multiplier” of two or three, giving us a total of between 3,000 and 4,000 people experiencing homelessness each year. Analyzing the survey data, we know that about half the people self-report having mental health challenges. This means probably about 1,500 people in the county are without housing and deal with mental illness.
The county’s Mental Health Services Act Report states that 60 individuals who are experiencing homelessness were served by the Homeless Service Program; I was disappointed to read this but not very surprised. Years of underfunding by the Board of Supervisors has left the department understaffed and without the resources needed to deal with this crisis. While many other counties our size in the state spend about 6 percent of their general budget on mental health, Santa Barbara spends about 3 percent.
I have been a close observer of the Behavioral Wellness Department since 2007, when I began working with New Beginnings Counseling Center as a counselor and outreach worker focusing on the needs of people with mental health challenges living on the streets. After years of neglect and underfunding, the Behavioral Wellness Department is regaining competence, and I am hopeful about its future. As a peer consumer I have played a semi-active role in the “system change” efforts within the department. I have seen substantial improvements in the quality of services and with the morale of employees. Dr. Alice Gleghorn has brought vision and managerial finesse to her departmental responsibilities.
Currently, it is my understanding that Behavioral Wellness has only one full-time outreach worker to address these needs and that this person holds regular office hours at all the shelters. In 2007 there were four full-time outreach workers (from CARES) with an increased ability to canvas the streets, waterfront, library, and parks.
It is my suggestion that Behavioral Wellness massively scale up the Homeless Services Program over the next three to five years. Also, I think we need to restore the outreach teams to their former size by hiring three additional employees. Moreover, there is a need to have outreach workers do more than have office hours at the shelters. We need trauma-informed outreach workers who canvas the waterfront, the parks, State Street, the library, and many other areas. The problem is not one of people being denied mental health services; it is one of people needing mental health services.
While the department already has some healthy collaborations with C3H and other service providers, this could be enhanced by having staff members work closely with all outreach teams in our community, especially those of C3H, Common Ground, and Doctors without Walls. Recently, the Housing and Recovery Action Team confronted these same issues and recommended a plan to address the housing needs and bed capacities for those without homes in our county
Clearly, to implement the changes I am suggesting would require the Board of Supervisors to substantially increase funding to the department. According to California code, each county’s board of supervisors is responsible for the health care needs of those who are indigent. We need to insist that our board fulfills its mandate.
Wayne Mellinger serves on the County Mental Health Commission and is a “peer consumer” of services from the Behavioral Wellness Department. He also sits on the Board of Clergy and Laity United for Economic Justice (CLUE) and has worked for Casa Esperanza (now PATH), Transition House, and WillBridge of Santa Barbara.