Although you wouldn’t know with all the fanfare about how great San Francisco is doing on homeless issues, a major travesty was committed within San Francisco Mental Health System.
A major policy change resulted in 1,700 clients losing their treatment at the end of January. This was proposed by Department of Public Health with little input from community members as to its effect. The cuts passed swiftly through the Board and Mayor as part of the mid-year budget cuts.
This new policy states that people who have no insurance, and particular diagnosis no longer qualify for treatment. Only “Thought Disorders” and “Affective Disorders” are covered. Anxiety disorders, Post Traumatic Stress, and so forth are no longer covered.
This new policy particularly affects veterans, immigrants and homeless people. It doesn’t matter how severe the mental illness, how effective the treatment has been, or how needed the treatment is. With a fell swoop of the knife, potentially life saving treatment is gone. Eligibility based on diagnosis is generally considered bad public health policy for many reasons, including subjectivity of diagnosis, lack of adequate access to mental health treatment, and inability to take into account severity of illness.
The funding is lost for private providers, over 20 non-profits and city clinics. The policy brings us back about eight years to when it was harder to get mental health treatment in San Francisco then it was at San Quentin Prison. At that time, the state forced a change for MediCal recipients, broadening the eligibility criteria to a more common sense approach. At that time, the Coalition on Homelessness pushed for a “Single Standard of Care” where uninsured people would get the same access as those on MediCal. With this policy change, this is no longer the case. If you are suffering from mental illness, you either have to have insurance or the right diagnosis to get the basis treatment you need.