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There are 1.5 million Californians who need mental health services, but aren’t getting treatment, mainly because the state lacks “a clear commitment to provide mental health services to people who need assistance,” according to a report released Monday by a state commission. 

The Little Hoover Commission report examined how the state handles services to the mentally ill and concluded that the state needs to invest more money in helping communities provide housing, employment, counseling and other services to the mentally ill. 

Currently, the state “rations care to only the most severely disabled. And even then we often turn people away because adequate resources have not been budgeted,” said Richard Terzian, chairman of the commission. 

The commission, an independent oversight board made up of elected officials and private citizens, recommended that lawmakers immediately take steps to ensure anyone who needs mental health services gets treated. 

“The question is, are we going to continue to muster the political will to build the system that was promised a generation ago?” said Assemblyman Darrell Steinberg, D-Sacramento, the author of several bills on community-based mental health systems. 

“The history is clear. About 30 years ago when the decision was made to close the state hospitals, there was a promise to pay for the community programs where people could live with dignity. It hasn’t been done,” he said. 

Counties are responsible for providing services, but only to the extent that they have the money to pay for it. 

Until the state makes more money available, the public will “continue to be frustrated with a fragmented, crisis-driven system where cost-inefficiencies mount and fewer people recover,” said Assemblywoman Helen Thomson, D-Davis, a former nurse. 

The state should invest more funds in community-based programs that use integrated service programs, the report recommends. Those programs, such as Project HOPE in Sacramento, provide a gateway to every service that the client needs – medical, counseling, drug rehabilitation, housing, food and clothing. 

“The goal is to have these integrated services in every county in California,” Steinberg said. “And not just the homeless. The same model of integrated services and outreach can apply to people who are living with their families.” 

Steinberg says in its first year of operation, Project HOPE and the other pilot programs in Stanislaus and Los Angeles counties cost the state $10 million, but saved $20 million by not taking the mentally ill to jail or to emergency rooms. The state is paying $55 million to expand those programs this year. 

The report also recommends that the governor establish a temporary commission that would conduct a public education campaign to overcome the stigma of mental illness, study what programs work and what is needed, and assess the costs of failing to provide appropriate care. 

Commissioners also suggest that the governor establish the California Council on Offenders with Special Needs, which would investigate approaches to treating the long-term needs of mentally ill prison inmates.