Among cuts to shrink California deficit: Mental health

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Patricia Nazario/KPCC

Clinical Psychologist Dr. Elizabeth Change and her assistant, Dustin Kunkel, dim the lights and play soft music to help participants relax before therapy starts. This group has six 6-year-olds. Most kids who receive mental health care at Pacific Clinics Monrovia Intensive Outpatient Clinic have a traumatic history with the L.A. County Dept. of Children and Families.

Governor Jerry Brown is scheduled to unveil his budget proposal this morning in Sacramento. Insiders expect his plan will propose eliminating voter-approved accounts like the one that covers mental health services for kids and adults. KPCC’s Patricia Nazario visited an after-school treatment center to see how cuts might affect families.

At Pacific Clinics Monrovia Intensive Outpatient Clinic, six 6-year-olds begin their group therapy session with lying down and listening to soft music.

“That’s too close." Clinical Psychologist Dr. Elizabeth Chang scoots over 6-year-old Aaron. He politely complies.

But when he first started this program, Chang says Aaron was very aggressive. "Kicking, yelling, screaming, biting, yelling a lot," says Chang.

Aaron’s also a little shy, so I give him the microphone to loosen him up, but he doesn't want to say anything at first. When asked what he likes to do, Aaron says, "Nothing."

Then he starts talking about his favorite Christmas present – the white and black bunny he named Roger-Roger. “Like he’s too fat," says Aaron.

Aaron’s sitting on his mom’s lap, 28-year-old Melina Hernandez. The Los Angeles County Department of Children and Families removed Aaron and his two brothers from her home two-and-a-half years ago. Melina Hernandez says her marriage became physically abusive and she would verbally abuse her sons.

She says it’s behavior absorbed growing up in the San Gabriel Valley from her own parents. “My dad used to always tell me like I’m not good enough. I’m not good enough to do anything.”

Hernandez began to cry. She says she started catching herself putting her sons down when they couldn’t do something, "like make up his bed. And like how my dad would talk to me, I start talking to my son like that. But, I caught myself because I seen him crying and it hurt me. I realized I was like my dad and that’s one person I never wanted to be like.”

Hernandez says parenting classes at Pacific Clinics have helped her become a better mom. The courts returned her boys after they had been in foster care for about two years.

“We try and put together an individual package for each kid," says Program Director Dr. Scott Fairhurst. He says in this case, treatment includes individual therapy for Melina Hernandez and her son, Aaron, as well after school sessions five days a week for the boy.

Because of their foster care background, Medi-Cal covers the family’s expenses. Fairhurst says nine out of 10 children who get treatment at the Monrovia Intensive Outpatient Clinic have some history with the Department of Children and Family Services.

“The kids who come here at risk maybe of losing a foster home," says Fairhurst. “We’ve got kids like 10 years old who are on their sixth or seventh foster home. ... We’ve got 6-year-olds who’ve been to more funerals than I have. We’ve got kids who have made meals at home.”

Fairhurst says aggression and anger impulses are challenging for these kids. If they don’t learn how to control their emotions, they’ll become adults with poor self-control.

Monrovia Intensive Outpatient Clinic gauges its outpatient roster at about 150 patients a year from 5 to 20 years old. Success rate: 75 percent.

Most funding for California’s mental health programs comes from the Millionaires’ Tax voters approved seven years ago. It’s a dedicated account that the state department of mental health estimates at about a billion dollars a year.

“We’re worried the governor will put that back on the ballot," and ask voters’ permission, says Dr. Susan Mandel, to use that money to help close California’s projected $26.5 billion dollar budget shortfall. Mandel oversees Pacific Clinics, including the Monrovia Intensive Outpatient Clinic. The chain has locations in Orange, Riverside, San Bernardino, Ventura and Los Angeles counties.

It’s the Southland’s largest group of outpatient behavioral health care facilities and counts annual patient visits at a half-million. “Sure, we’re trying to fund raise," but more importantly, Mandel says, her team is evaluating how many patients might lose access and how many staff might lose their jobs.

“What’s so frustrating is taxpayers need to see it’s much more cost-effective to treat people in the community," says Mandel. "We treat people, maybe $2,400 a year in the community."

Compared to about $30,000 a year at a minimum security prison, where she says many will end up once they go off medications or start missing therapy. Governor Brown’s budget plan extends cuts to several other state programs and services, including libraries, parks and universities. To succeed, Brown will have to win over Sacramento lawmakers and lobbyists and sell his ideas to voters.

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