Are we effectively using our mental health dollars?

By Supervisor Andrew Do

For the past 12 years, I have seen my best friend from high school struggle with our county mental health care delivery system. Seeing my friend, like many Orange County residents, make every effort to get her son, who has been diagnosed with schizophrenia, the necessary services, and often having to go out of our county to get the appropriate treatment has lead me to ask, “why?” This pivotal moment came almost three years ago, when I felt a closer look at our county mental health care delivery system was necessary. As I toured one of the largest hospitals in Orange County, the medical director for that hospital told me that he would not know which county programs his patients would qualify for because of the labyrinth of rules and requirements that he would have to maneuver through, only to be referred back and forth between programs.

Because of these experiences, I have been working hard since I was elected to the Orange County Board of Supervisors in 2015 to better understand our mental health care system, help destigmatize mental health illnesses and work to ensure we have an effective, efficient, and compassionate way to provide mental health services to our residents. This task continues to grow each year as awareness of mental health illness increases, including the growing prevalence of mental health needs among adolescents and our homeless population.

Mental health is a growing problem in Orange County, as the Register accurately outlined in their article “A look at the prevalence of mental illness in California and the U.S.” published on November 12, 2017. The article reported that “mental illness cases have risen in California, while treatment and funding have not kept up.” While that may be true and more funding is needed to meet increasing needs, it is a mistake to think that more money will provide an instant solution to better mental health care in our county. Given that a significant portion of Orange County’s budget is already dedicated to mental health services, it is time to ask important questions, such as whether public agencies are using the current funding efficiently and whether private health organizations presently provide sufficient allocation to meet its responsibility and adequately treat patients. As the provider of last resort, the public will ultimately pay the costs of mental health if everyone does not pull their own weight.

The county of Orange, through our Health Care Agency, has budgeted for 2017-2018 over $390 million for behavioral health services, with $186 million of this allocated for over 210 mental health programs to adults afflicted with serious and persistent mental illness, and children with serious emotional disturbances. The $186 million allocation, which was funded through Proposition 63 Mental Health Services Act revenues, was increased by approximately $36 million since last year. Mental health constitutes a significant amount of the county’s annual budget. However, it remains true that many of our residents still struggle to find adequate mental health care, but it is not because services or funding are cut or reduced. In fact, the county has more funding for mental health services than before.

Now, more than ever, we need to ensure that our mental health dollars make the most impact through efficient spending and meaningful programs for patients.

For this reason, I submitted a comprehensive performance audit and evaluation of every mental health program and services offered by the county for my colleagues on the Board of Supervisors to consider in December. We will begin with all mental health programs funded through MHSA. By doing this, we can identify what programs are working, which programs are not producing the results we hoped for, and which programs could be run more efficiently through consolidation or increased coordination to achieve greater operational effectiveness.

I believe Orange County is at a critical juncture. Now more than ever, the expanding need for mental health services requires that we ensure our mental health dollars are meeting the needs in our communities.

Andrew Do is vice chair of the Orange County Board of Supervisors representing Central Orange County. He is a former deputy district attorney and Garden Grove city councilman.