$70-Million Boost for the Mentally Ill

In a ceremony in the heart of downtown’s skid row on Friday, about $70 million skimmed from the wealthiest Californians was transferred to help thousands of mentally ill and homeless people in Los Angeles County.

It was the first cash infusion to arrive from a novel initiative that imposed a 1% additional tax on those earning more than $1 million a year. Voters approved Proposition 63, or the Mental Health Services Act, in November 2004, the only such public fundraising plan specifically aimed at improving mental health care and services.

It is expected to deliver about $700 million more annually into community-based mental health care programs around the state.

In Los Angeles, the first county to receive an allocation, an estimated 18,000 adults and children are expected to benefit this year from creation or expansion of such programs as around-the-clock counseling and support, rental subsidies and help finding permanent affordable housing, treatment for alcohol and drug problems, and drop-in centers and counseling for teenagers leaving foster care.

Much of the funding will be aimed at coordinating services for about 5,000 people with chronic and persistent mental illnesses -- including not only psychiatric care but also housing, jobs, clothes and even friendship. That means essentially doing “what [Los Angeles Times columnist] Steve Lopez has done for Nathaniel,” said county mental health Director Marvin J. Southard, referring to the homeless virtuoso cellist whom Lopez has befriended and written about.

The state has allocated the $300 million available in the first year according to a formula that weighs poverty levels; the number of uninsured, homeless and mentally ill; and the cost of living in each county. Forty-two counties have submitted three-year plans detailing their proposals for additional services and prevention programs.

Los Angeles received the largest county allocation and is expected to get about $250 million over the next three years. This year’s $70 million includes $45 million for programs, with the remainder to cover one-time expenditures.

The county hasn’t decided which agencies and programs will get the funds. Reviews by county officials and a community board will begin Tuesday. More money will go to programs in downtown Los Angeles and other areas with high numbers of homeless, impoverished and mentally ill residents.

The St. George Hotel, which provides permanent housing in skid row, plans to apply for a share of the money to supplant its federal grant, which will soon expire, that allowed it to hire a full-time nurse and part-time psychiatrist to help those with long histories of mental illness.

“They’ve been magical in getting people connected with other services,” said Admas Kanyagia, a program manager at Skid Row Housing Trust, a private, nonprofit organization that runs the facility.

Though the extra funding from the initiative is the largest windfall for mental health programs in generations, it represents just 7% more than the county’s current mental health budget of $1.1 billion, which covers programs for about 250,000 county residents. For the state, it will pump an additional 10% to 15% into the current $3 billion spent on outpatient mental health programs.

“What’s so ambitious is that we’re really trying to leverage that 10%-15% into changing the whole system to implement those programs that are most efficient,” said Stephen W. Mayberg, director of the California Department of Mental Health. “It’s ambitious to be the tail that wags the dog, but we’re trying to do that.”

Programs that aim to provide for all of a person’s needs have been shown to substantially reduce time in jail, emergency rooms and psychiatric hospitals. Investing $15,000 in an individual could spare the state the $130,000 annual cost for each individual in a state psychiatric institution, Mayberg said.