High rates of homelessness and incarceration tied to limited mental health care

Health professionals in Tulare County have been handed a tall order in training local patients to be smarter consumers of health care. But smarter health care consumers do not have the power to multiply doctors.

Read about the projects of other 2014 California Health Journalism Fellows.

Our county is lacking – as many are – in many essential medical services. Physicians in this area say the current mental health care infrastructure cannot keep pace with demand for mental health care. Such an imbalance cannot exist without repercussions, of which there are several.

Visalia and Tulare each have ever-growing homeless populations. Domestic violence continues to climb and a large pool of drug addicts supports an alarmingly large underground narcotics business that daily threatens the safety and stability of our families.

As a resident of more than two decades, I can attest that Visalia and Tulare were not always this way. It is my hypothesis that each of these issues is at least in some way tied to inadequate mental health care for key groups of people.

How is mental health care defined?

Mental health care can be split into a several categories – a variety of disorders, depression, addiction, etc. Is there certain health challenges that are better cared for than others?

How severe is the imbalance?

In order to determine how great an imbalance exists between the supply and demand for mental health services, I will research a variety of data, including:

How many physicians/counselors practice mental health care in Visalia/Tulare?

How impacted are those practices? How many mental health care patients do those doctors treat in a typical week or month?

How many beds are available at area mental health hospitals?

Historically, what’s the trend for these numbers?

Once one has been identified, what cause is there for the trend? Is it financial? Political?

Is there a link to crime?

Is there a definitive link between mental health and crime and homelessness? I plan to consult with members of law enforcement, adult protective services and the health care community to determine what chain of events leads individuals to a life of crime and/or homelessness.

 Accessibility

I would like to find out what groups of people are the most underserved when it comes to mental health care. How difficult is it for a homeless person, a veteran, a child or a drug addict of any age to receive mental health care and/or counseling?

What is it that would inhibit a person in one of the above groups from receiving treatment? Is it an issue of insurance? Bureaucracy?

How affordable is the care that is offered?

What effect will the Affordable Care Act have on mental health care services and how they are covered by insurance (private insurance, Covered California and Medi-Cal/Medicare)?

The money trail

Taxpayers and philanthropists alike have contributed a lot of money toward curbing homelessness and addiction, especially in Visalia. Police and city officials have tightened ordinances and demolished public restrooms in an effort to cut down on loitering and the criminal activity that they say results from it. But it seems that our community’s collective efforts are not getting at the root cause of homelessness.

So where is the money going? What are non-profits doing with their resources? What sort of services are people actually receiving from public health centers? How are dollars earmarked for mental health care services spent in this area?

What benchmarks do public and private agencies use to gauge the success of a particular program?