Wellness and Recovery or the Same Old Sickness?
California must choose either a humane or reactionary direction in mental health policy
by Michael Diehl
the passage of Proposition 63, the Mental Health Services Act, last
November by California voters, an intensive public hearing process has
begun, involving mental health clients, family members, members of the
professional mental health community, social services providers, the
criminal justice system and other community stakeholders.
have been held on the state, county and city level. The initiative
itself has called for a commitment to expand the AB 2034 program from
its use in model city programs, such as in Berkeley, to a statewide
implementation of "wrap around services" for those living on the
streets and suffering from severe mental affliction.
program is aimed at getting people who have been homeless, often for
many years, into housing first, with supportive services and more
extensive street outreach (often under the name of Assertive Community
Treatment). Alameda County's planning group on Housing and Homelessness
has proposed a program to specifically target the so-called hard-core
homeless, particularly in North County. The County plan will enroll 100
such individuals with serious mental health issues and often
"co-occurring disorders" that also involve self-medication with illegal
hard drugs and alcohol.
Alameda County has received
35 more Shelter Plus Care vouchers towards the goal of housing homeless
people with mental afflictions. Enrollees will be recruited from John
George Psychiatric Pavilion, Santa Rita county jail, and the planned
county detox center and sobering facility, where those publicly
intoxicated on the streets will be taken by police, rather than to
Santa Rita. Other homeless people will be contacted by local outreach
teams -- Health Care for the Homeless, Operation Dignity and Berkeley
Mental Health's Mobile Crisis Outreach team.
are the sorts of concrete outcomes I went to Sacramento to fight to
achieve; but my concern now is that this be done in a humane and
voluntary fashion, as much as possible. I am concerned that these
guidelines will be turned into involuntary coercive programs to clear
the streets of "undesirable" homeless people. Clearly, many merchants
and housed members of neighborhood associations would like this
coercive approach of forced treatment. The question now is whether they
would accept housing such people in their neighborhood.
all its vaunted liberal compassion, Berkeley often has been resistant
to accepting programs for homeless and disabled persons; but even East
Oakland communities, such as the one represented by Oakland City
Councilmember Desley Brooks, have resisted the location of programs in
their areas. Brooks does have a legitimate concern shared by many
clients that programs also should be sited in more well-to-do
This year I have become a voice for
the concerns of mental health clients who want to see changes in the
mental health system. In March 2005, I went to several state meetings
on the Mental Health Services Act sponsored by the California
Department of Mental Health at the invitation of Sally Zinman, director
of the California Network of Mental Health Clients. We voiced the
concerns of mental health clients such as myself who have experienced
On May 18, 2005, state officials released
a series of guidelines on the implementation of Prop. 63 that quite
pleased advocates with the California Network of Mental Health Clients.
On April 20, Carol Hood of the California Department of Mental Health
had raised our ire by saying that money from Prop. 63 would be spent on
maintaining and even expanding involuntary mental health services, such
as the ACT involuntary outpatient program sponsored by State Sen. Helen
Thompson that had not been implemented by any county due to lack of
funding. This raised a great outcry and lobbying effort from the
California Network of Mental Health Clients.
statements seemed a betrayal after all the warm and fuzzy public
process that had heralded a transformation of the mental health system
in California. More radical critics like MindFreedom, a national group
of psychiatic survivors, and Robert Norse, who is active on homeless
issues in Santa Cruz, had been predicting this sell-out all along.
the guidelines released on May 18 felt like a great victory. Darrell
Sternberg, a legislative father of the Prop. 63 state initiative that
passed last November, came out and publicly supported our contention
that the proposition was not about funding more involuntary services.
new state guidelines address the concrete outcomes I had particularly
articulated, such as lessening the number of mental health clients in
the criminal justice system, lowering the number of mental health
clients who are living without a home, and reducing the number of
involuntary commitments to mental health hospitals of these homeless
clients (who are then often released back onto the streets). I was able
to report these results to those I am representing on the streets who
keep asking if I am getting any concrete results from going to all
these meetings. I spoke of the need to rescue people from being forced
to sleep on the concrete.
While those concrete
outcomes remain to be implemented next year, the state guidelines to
the counties now specifically include the goals of expanding the AB
2034 program and serving homeless people who are underserved or
unserved. I was a strong voice in Sacramento demanding that these
concerns be specifically addressed in the guidelines.
clients were concerned about my talk about the need to reach out to
mental health clients stuck in the criminal justice system as
reinforcing those who wanted to spend the money on involuntary
services. I told them, as someone who speaks to the concerns of mental
health clients who are people of color and homeless, I needed to
articulate the need to get mental clients out of the involuntary
criminal justice system that has locked away more clients than the
mental health system.
In June, we in Berkeley got
heavily involved in holding a number of public hearings on the Mental
Health Services Act (MHSA); and I got active in the consumers workgroup
fighting successfully in May to get stipends for other mental health
consumers to do this work. On June 22, the consumers workgroup held a
consumer forum at the Multi-Agency Services Center in Berkeley at which
we got input from over 20 actively engaged mental health consumers. The
consumers raised issues around race/cultural competence and the cozy
relationship between Berkeley Mental Health and the Police Department
and the need for the police to get more sensitivity training around the
issues of homeless people suffering with mental health issues.
need for more cultural competence in the delivery of mental health
services was raised clearly at this consumer forum, at the Berkeley
Drop-In Center, at the Drop-In cafe at Berkeley Mental Health with the
leadership of commission member Artensia Berry, at a special forum
reaching out to the Hispanic community and in my discussions with
African American and Hispanic homeless clients.
state meeting on June 1, the forces of the status quo in the mental
health system regrouped and came back strongly. New guidelines were
coming out of the state with a focus on Assertive Community Outreach
and AB 1421 that obviously had been worked out in detail in meetings
where none of the mental health clients we know of were present. This
raised concerns about the forces of reaction that were supporting
reinstitutionalization and were using the impatience of many community
members with the problematic street behavior of the mentally ill
homeless to support a more repressive and more aggressive policing
approach to clear the streets.
approach fits too cozily within the fear-based agenda of national
security at the expense of civil rights. I and other advocates like
Delphine Brody aired our great concerns that we, in supporting the
MHSA, were being used to fulfill the more reactionary
police-psychiatric statist agenda that MindFreedom had been warning us
we were falling for.
Also fitting in with this
repressive approach are the efforts of Berkeley Mayor Tom Bates and the
new police chief to appease the more conservative members of the
Downtown Business Association and the Telegraph Area Association, in
their call for more police enforcement and mobile crisis intervention.
The word is that other cities are seeing similar sweeps.
Carol Hood is showing some backbone in supporting the May 18th
guidelines and in standing up against the pressures coming from the
California Psychiatric Association -- now backed by the California
Alliance of the Mentally Ill.
I had wanted to write on these issues earlier for the Street Spirit;
but, unfortunately, my own difficult struggle with asthma -- fueled,
I'm sure, by the state of my own mental stress and exhaustion from
fighting all these struggles -- didn't give me the strength to do this.
Also, I have been involved in opposing the efforts of
the FCC to shut down Berkeley Liberation Radio 104.1 FM and our
eviction from our site at the end of June; we pulled off a successful
local media blitz calling attention to our plight. This means the loss
of my weekly radio soapbox where I can speak out on these issues in my
"Street Reports." This radio work has been good for my own mental
health by giving me a creative outlet to sound off on my ideas, rant
and use music (like the blues) to more emotionally address the issues
It is clear that for all my
compassionate concern about the social injustice that is homelessness,
I need to put more focus on my own wellness and recovery -- physically,
emotionally and mentally. The shift in mental health services delivery
is to look more closely at the holistic link between mental, emotional
and physical health, with a growing concern about diet, exercise, and
the need to address physical ills facing the poor such as obesity,
diabetes, high blood pressure and asthma, often linked to issues of
It is hard on a personal level
because the MHSA is bringing a lot of my own issues more to the front.
However, for all my inadequacies and failings, I still feel a lot of
pride in the work I have indeed been able to accomplish so far this
year. My general experience is that I am a more effective organizer
when I am true to myself, rather than seeking to conform to mainstream
expectations of what mental health is and what a proper role model is.
For me, that has always been a recipe for failure; I will always be
differently abled. Like it or not, that probably won't change -- or
won't change quickly.
However, it increasingly seems
imperative to me that, despite the great difficulties of personal
transformation, I must strive mightily to move towards a place where my
actions to bring about social transformation to a mental health system
clearly very resistant to change are motivated from a personal place of
growing wellness and recovery, rather than the inner place of rage and
frustration that has often motivated my activism.
path of liberation must be both inner and outer to really succeed in
the long run. We need to think of seven generations rather than the
latest profit report to the stockholders. As a Hopi grandmother told us
once, we are the ones we have been waiting for. I worry that the
warmaking and earth-destroying madness of our leaders could have dire
outcomes in the long run, unless there is a major, systems-wide
transformation of everything we do as a human race here on mother
Our country is exporting our consumerist
alienation. We are no longer grounded in physical reality. Whether we
run out of oil or end up setting off a nuclear holocaust, it is scary
to contemplate what will happen if we don't transform the error of our
collective madness. To stop that collective madness, we must all try to
change our own personal madness. It is a pretty daunting task.
means going beyond the individualism so prized in our Western frontier
creed of capitalism to embrace a greater concern for community. We must
begin helping everyone -- most particularly, those who are most in
need. It also means getting beyond thinking in terms of "us" versus
"them," since we, as the people of one earth, are all in this together.
No hoarding supplies in underground bunkers or expectations of the
holier-than-thou being raptured out of this world of sorrow is a sane
or just answer.
E-mail Michael Diehl at
firstname.lastname@example.org. Contact: BOSS Community Organizing Team, 2065
Kittredge Street, Suite E Berkeley, CA 94704. Phone: (510) 649-1930.
1515 Webster St,#303
Oakland, CA 94612Phone: (510) 238-8080, ext. 303
© 2002-2005 STREET SPIRIT. All rights reserved.
Published by American Friends Service Committee