Co-authored by: Carolina Valle, California Pan-Ethnic Health Network, Daisy Chavez, Transforming Justice Orange County, National Health Law Program
In the past few weeks, the California Legislature showed support for community-based mental health services when it voted to stop a bill which would have siphoned Mental Health Services Act (MHSA) funds away from local mental health departments and into correctional facilities. The proposed legislation, SB 665 (Umberg), would have invested in prisons and jails at a time when communities around the state have called for funding for alternatives to incarceration like community health.
In July, community partners sent key legislative leaders a letter urging the rejection of the proposal to expand funding for behavioral health treatment in correctional facilities at the expense of community-based services. We thank our partners and champions in the Legislature for stopping the bill.
Consistent with the intent of California voters, MHSA funds should continue to be invested to support our community, rather than jails which have become places to which we condemn our struggling neighbors. Most importantly, we must focus our behavioral health investments into prevention, early intervention, and culturally appropriate care. Our continued failure to do so, subjects Black, Indigenous, and other People of Color (BIPOC), particularly Black communities, to over-incarceration as a result of systemic racism in both the mental health and the criminal justice systems.
Allowing funds to be diverted from community-based mental health services into correctional facilities would deepen these existing inequities and further entrenched a system that effectively requires BIPOC to land in jail before they can receive behavioral health support.
California’s Mental Health Services Act (MHSA) was passed by California voters in 2004. It established a one percent income tax on Californians’ personal income in excess of $1 million per year to fund California’s behavioral health system to better serve individuals with, and at risk of, serious mental health issues, and their families. MHSA was passed by Californians to fund community mental health care, not to supplement jail budgets.
As Daisy Chavez of Transforming Justice Orange County testified in the California legislature: “People cannot get well in a cell.” Instead of allowing funds to be moved away from community-based services into correctional facilities, California should look to better serve incarcerated and formerly incarcerated people by spending MHSA funds in their communities, to provide support that can prevent arrest and incarceration, increase access to diversion or facilitate reentry.
While we fully support ensuring that individuals currently incarcerated have access to appropriate behavioral health treatment, robust funding for community-based care must remain in place and better treatment must be accompanied by decriminalization efforts and reforms that shield people with mental health and substance use disorders from the criminal justice system in the first place. According to CPEHN’s analysis of data from the State Controller’s Office, cities and counties spent over $26 billion on Police and Sheriff’s Departments and Corrections during Fiscal Year 2017- 2018, versus just $7.5 billion for mental health and substance use disorder services.
The funds raised by the MHSA are already inadequate to support our community mental health system and to address the dramatic increase in behavioral health need because of the COVID-19 pandemic. Rather than turning over more money to law enforcement in an ill-advised attempt to improve access to behavioral health services in correctional facilities, California should push county Sheriffs to redirect funds away from law enforcement practices that criminalize BIPOC with behavioral health conditions and make it harder for people to receive community-based mental health and substance use services, and instead invest in appropriate behavioral health treatment for incarcerated individuals. To the extent possible, these efforts should include a requirement that incarcerated individuals be connected to community-based services outside of the facility.
According to the California Health Interview Survey, 36% of Californians who require mental health services are unable to access appropriate care. This gap is particularly stark for communities of color, with 48% of Asian Americans unable to access appropriate care compared to 39% of Latinos and African-Americans. Moreover, MHSA funds and the other revenue sources currently supporting community mental health are likely to decrease over the next few years because of the looming economic recession.
California made the right choice in not allowing MHSA funds to be used as a blank check for local Sheriff’s Departments that already reap a large portion of county budgets, including millions intended for mental healthcare in the jails. California must continue to avoid creating incentives for institutionalized and correctional-based care. In this time of crisis, California should instead support alternatives to incarceration at all costs. While we recognize the need to reform the mental health and substance use disorder services that are available to incarcerated individuals, these reforms should not come at the expense of funding destined for community-based services.
Instead, our state should affirm our commitment to community-based mental health and SUD services and must take concrete steps to deemphasize criminalization of individuals with behavioral health conditions and redirect funds from enforcement activities into appropriate treatment. California must also focus on connecting incarcerated individuals with MHSA-funded community-based providers so that upon release, they already have connections to the services they will need in the community.
