Editorial: Building both beds and standards

Up in the Bay Area last week, Gov. Gavin Newsom was dishing out dollars and hope for transforming California’s grossly inadequate infrastructure for treating mental illness — an essential step if this state is ever going to make serious progress in addressing its epidemic of homelessness.

Meanwhile, in Ventura County, we were given a reminder of just how challenging the task will be. Treating the acutely mentally ill is hard work. It must be done safely and humanely, meeting high standards of care. As urgently as they are needed, just having available patient beds on hand is not nearly enough.

Newsom announced that the state — ahead of schedule — will make available beginning in July the first $3.3 billion in funding from Proposition 1. Local governments, nonprofits and for-profit providers will be eligible to apply for funds earmarked to build or refurbish treatment centers. Ultimately, the voter-approved measure is expected to fund about 10,000 inpatient beds and 45,000 outpatient treatment slots statewide.

During a news conference at a treatment center now being expanded in San Mateo County, Newsom noted that voters who narrowly approved Proposition 1 in March are expecting deliverables. “People are demanding accountability, and with real results,” he said. “That is what we are aiming to deliver, but the state cannot do it alone — it is time for local officials to step up.”

The situation with Ventura’s Vista del Mar hospital provides a cautionary example of why simply building beds will not be enough to address the treatment shortage. It had been a facility at which county mental health officials could send individuals to receive involuntary treatment, but the county suspended that arrangement last fall, citing repeated failure to meet standards — including two instances in which patients died within days of being discharged.

There had already been a shortage of beds, but with that facility no longer available, county officials have few remaining options for dealing with such patients.

Similar shortages are common across the state. In fact, all but two of California’s 58 counties decided last year to delay implementation of a new state law that expands the circumstances under which a mentally ill individual can be placed under conservatorship and required to undergo involuntary treatment.

The law had been envisioned to go into effect statewide this year, but that has happened only in San Francisco and San Luis Obispo County. All the others exercised their option to delay until 2026, many of them citing a shortage of treatment facilities.

Given the lack of other options, it took some courage for county officials to suspend Vista del Mar’s authorization to treat conservatorship patients. But that extreme action appears to have spurred reform.

Responding to a detailed set of standards presented by county officials, the hospital has made what its CEO described as “necessary improvements,” and now the county seems poised to reinstate its ability to care for patients. Supervisors are scheduled to consider the reinstatement in the week ahead.

There seems to be a clear connection between the rise in the number of individuals living on the streets and in outdoor encampments and the shortcomings in the state’s mental health systems. A recent statewide survey found that 4 in 5 of unhoused individuals reported having experienced severe mental health conditions at some point in their lives.

It essential that opportunities for treatment be expanded, but the treatment must be meaningful, compassionate and humane. The events of last week underscore the twin challenges ahead: Build more beds but insist on high quality care.

This article originally appeared on Ventura County Star: Editorial: Building both beds and standards