Before the novel coronavirus hit California, we enjoyed a generous budget surplus, and state leaders hoped to use its financial stability to create affordable housing and reduce homelessness.
Instead, California immediately responded to COVID-19 by allocating resources to meet urgent needs. When legislators return to the Capitol, they will confront the aftermath: vast unemployment, a budget deficit and other pressing matters. Yet the need to combat homelessness has not changed, especially for many on the streets who also experience mental illness. Nationwide, the Treatment Advocacy Center estimates one-third of the homeless suffer from mental illness. In California, that’s about 43,000 people.
California’s record of serving our mentally ill in state facilities is notorious. The physician’s admonition to “do no harm,” was as ignored as the patients residing in those state warehouses. Overcrowding, child predators serving as administrators, abuse and violence against patients and staff, inadequate and dangerous facilities all described California state hospitals.
COVID-19 adds new urgency to the homeless crisis and demands we transform this sorry history.
One strategy is housing the homeless incapable of caring for themselves because of mental illness or substance abuse. They are the most vulnerable among those lacking shelter. UCLA’s California Policy Lab surveyed 64,000 mentally ill, homeless individuals in 15 states between 2015 and 2017. About half of the unsheltered said they suffered from a combination of physical and mental health issues and substance abuse.
In March, Gov. Gavin Newsom directed the state Department of General Services to assess state properties to identify surplus sites for temporary housing. I had already begun working to assess surplus properties in my Assembly district. In collaboration with county leaders, we identified Patton State Hospital as an underused psychiatric facility.
Converting Patton hospital for use during the crisis is in line with the call for innovative solutions to homelessness. It supplies treatment for forensically and civilly committed patients within a secure, locked treatment setting. Patton has a 1,527 bed capacity with a significant portion of land remaining unused even as San Bernardino County has seen a 23 percent increase in homelessness.
The state highlighted a five-acre parcel at Patton as available for emergency shelter. In the short-term, Patton should house homeless people as soon as possible so they are humanely sheltered and treated. Long-term, we can design a model that reimagines how California cares for its mentally ill.
Combining housing and mental health services can eliminate obstacles to realizing the long-desired but elusive promise of advancing community mental health. Patton hospital could serve as such a model for the state and region.
California has a continuing need for structured behavioral health treatment services and supportive housing for those ready to transition back into communities after placement in locked settings such as state hospitals. Also needed are places for those committed to acute psychiatric hospitals because they are unable to care for themselves following crisis episodes.
Patton’s reimagined future could tap nonprofit organizations or local governments to provide transitional housing in a structured, “home-like” setting. It could offer additional care and observation so patients remain stable upon release from more restrictive facilities. It could assist those in transition “graduate” to independent living after commitment in more restrictive settings or experiencing crisis incidents while homeless.
This new vision for Patton would foster safety and recovery. Effective therapies would emphasize gold standard treatment, including assisting patients learn new skills such as coping mechanisms to prepare for independence.
COVID-19 is happening now, and homeless housing must happen now too. Transforming Patton State Hospital would allow us to offer emergency shelter and write a new page for our state hospitals. Let us not squander this opportunity.
James C. Ramos represents the 40th Assembly District.
This op-ed appeared in the Daily Bulletin. The link is https://www.dailybulletin.com/2020/05/05/transforming-patton-state-hospital-to-offer-emergency-shelter-james-ramos/