California needs urgently to reform how it deals with chronically mentally and substance use disordered individuals. Reform should start in Assembly District 15.

The only candidate emphatically addressing this issue is two-term Richmond City Councilwoman and Contra Costa County children’s mental health specialist Jovanka Beckles.

Dramatic statistics from the federal government portray an epidemic that is not being addressed in a sustained way by any level of government. Because California has embarked upon prison reform, it might be expected that the mental health crisis in its prisons is being ameliorated. However, the mental health situation in California’s prisons and county jails has only deteriorated.

A 2014 federal survey estimated that 43.6 million (18.1%) Americans ages 18 and up experienced some form of mental illness; 20.2 million adults (8.4%) had a substance use disorder; and of these, 7.9 million people had both a mental disorder and substance use disorder. An earlier report stated that 38% of homeless people were dependent on alcohol and 26% abused other drugs.

For individuals suffering from one of these afflictions, having a roof over one’s head and some sort of economic stability is essential to avoid further psychological deterioration. But the sad truth is that we have abandoned and marginalized these victims, and, worse, we have criminalized them.

As you read these sobering statistics, ask yourself whether one of your loved ones is among these many millions? And then ask yourself whether you think your loved one should be locked up in a county jail or state prison simply because they are suffering from either substance abuse or mental illness or both?

To our collective shame, local and state prisons are now where most people with mental and substance disorders are being housed. A 2014 study by the Treatment Advocacy Center and National Sheriff’s Association concluded there are ten times as many people with serious mental illness in our jails and prisons than in mental hospitals.

How did this happen?

The 1977 California Determinate Sentencing Law eliminated rehabilitation as a goal of sentencing in favor of punitive practices that emphasized incarceration. Incarceration rates soared, resulting in overcrowding and a deterioration of conditions in prisons and jails. This was made worse by the “war on drugs”, as well as the closure of the state mental hospitals, which led to the imprisonment of thousands upon thousands of mentally disordered people and those convicted of using drugs. The failure of the state government to provide the funds for community mental health that were promised with deinstitutionalization never materialized, and public mental health programs have suffered repeated budget cuts ever since.

Ultimately, the United States Supreme Court ordered California to reduce its prison population by more than 30,000 inmates due to unconstitutional prison conditions, many of whom were suffering from mental disorders.

In response, Assembly Bill 109 (implemented on Oct. 1, 2011) shifted responsibility for adult non-serious, non-violent, non-sex offenders to the county level. Unfortunately, the state did not provide funding adequate to treat this population, nor has it acted to prevent released prisoners from winding up back in county jails or state prisons.

According to a 2017 Stanford University report:

The long-running problem of mental illness in California’s justice system appears to be getting worse . . . .

Recent reforms to California’s criminal laws have greatly improved the state’s justice system. . . . [O]verall crime rates in California have remained on a long-term downward trend.

Despite these significant legislative and administrative reforms . . . , the prevalence and severity of mental illness among California state prisoners are dramatically on the rise. Over 30 percent of California prisoners currently receive treatment for a “serious mental disorder,” an increase of 150 percent since 2000.

But it is not just state prisons that have become repositories for our mentally disordered. Among the ten largest counties in California, 42% of defendants convicted and sentenced to prison in Alameda County have a mental illness, compared to 24% of defendants from Orange County.

24% of the city of Berkeley’s annual budget is allocated to the police and fire departments. Though data is lacking as to how much of the police department’s time is spent on this population, it is estimated that 25 to 30% of all ambulance runs in the city of Berkeley deal with people who are suffering from either mental illness or substance abuse disorders, including alcohol. In a mental health crisis, people are more likely to encounter police than get medical help. As a result, 2 million people with mental illness are booked into jails each year. Many of these people are chronically homeless, exacerbating the homelessness crisis.

It is high time to acknowledge that those who suffer from chronic mental illness or substance abuse are human beings just like us, deserving of dignity and respect and provided with the resources necessary to survive in our increasingly unequal society.

So what are the answers to this revolving door of homelessness, incarceration and frequent visits to emergency rooms and county jails?

To begin with, the decriminalization of the use and possession of drugs would be a start toward fixing this humanitarian disaster. Though there are public programs supporting various community treatment options in California, they are vastly underfunded. Research shows that community based psychiatric treatment is frequently more effective and significantly less expensive than in-prison treatment at preventing crime and reducing incarceration rates for people with mental disorders. Our state can and should provide adequate funding for a community-based continuum of care to help those who are victims of these disorders. This continuum must include permanent supportive housing, job training and subsidized employment, educational opportunities, highly skilled professional treatment specialists who will provide services in the natural environment of the consumers of such services, and integrated dual disorders treatment of mental illness and substance abuse simultaneously.

In the race for Assembly District 15, there is one candidate who demonstrates a deep understanding of these issues, as evidenced by both her platform and her actual work as a mental health specialist. Jovanka Beckles says:

One way to vastly reduce our prison population and the pressure on our court system would be to decriminalize possession of illegal drugs. I want to work with other legislators to study the feasibility and best practices to move in this direction . . . . Drug possession and use should be responded to as health problems, not criminal acts. Rehabilitation, counseling, expansion of life opportunities and a health maintenance approach will reduce costs, improve outcomes, and be much more humane.

In campaign speeches, she has called for dramatic reforms in the state prison system. She has made it clear that state prisons are inappropriate places to treat mentally disordered individuals, and incarceration worsens their mental illness. She has worked as a Richmond City Councilwoman to set up mechanisms to help individuals returning from incarceration productively to re-enter their communities.

I’m impressed with Jovanka Beckles’s concern for those who most need help in our district and that’s why I’m voting for her on June 5.

Editor’s note: This op-ed has been updated to say that 24% of Berkeley’s annual budget, not 54% is allocated to the police and fire departments. The budget, including all funds, is $424 million; police and fire make up $105 million, which is 24%.

Dr. Goldmacher is a former director of Mental Health, Alcohol and Substance Abuse services for Contra Costa County, and currently serves on the Berkeley Health Commission as well as the Alta Bates task force.
Dr. Goldmacher is a former director of Mental Health, Alcohol and Substance Abuse services for Contra Costa County, and currently serves on the Berkeley Health Commission as well as the Alta Bates task force.