SAN DIEGO COUNTY PERSPECTIVE : Creative Financing

The San Diego County Board of Supervisors will face one of its most difficult choices today when it decides how much money to cut from the county mental health budget in its effort to plug a $30-million shortfall.

Specifically, the board is considering closing all but 30 of the 109 beds at the San Diego Psychiatric Center and laying off mental health workers to save $4.7 million.

Even if mental health programs were funded at a reasonable level--and they are not--closing beds in the county psychiatric hospital, where only the most acutely ill and financially bereft receive care, would be questionable. People turned away from its doorway are considered a danger to themselves or others, and they have no reasonable alternatives.

Their options are jail, overburdened hospital emergency rooms, family members ill-equipped to care for them, or the street--already home to too many mentally disturbed people. Each of those options carries a real price tag in additional social and criminal justice system services or in economic damage to businesses.

San Diego County has won a couple of legal victories that could bring some relief down the road--additional beds at state mental hospitals and a larger share of state funds. But they are too little too late.

The supervisors must find a way to reduce the mental health cuts, even if it means reducing salaries or furloughing employees in less critical departments.

Psychiatric care for the most severely disturbed is at an irreducible minimum.