This blog posting and video are part of a series being produced by CSAC to highlight county best practices through our annual Challenge Awards. These awards recognize the innovative and creative spirit of California county governments as they find new and effective ways of providing programs and services to their citizens. The Challenge Awards provide California’s 58 counties an opportunity to share their best practices with counties around the state and nation. The programs being highlighted are recipients of the 2012 awards.

To review a video about how San Joaquin County is meeting the challenge, click here.

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Mental illness! For some reason, we are perfectly happy discussing other chronic problems, from diabetes to the heartbreak of psoriasis, but mental illness? Let’s not talk about that right now. And because we don’t want to talk about it many people who suffer from it suffer alone. Mental illness can manifest itself in behavior that is unpleasant at best so many people who have it are estranged from their families and friends. They often rely on county mental health services for help.

In San Joaquin County, they have developed a new model for providing that help, a new way of treating some people with mental illness and supporting them as they get treatment. In the past, the County operated a large locked-down mental health facility. It typically housed people who had been picked up by law enforcement for illegal or potentially dangerous behavior. They stayed in that facility for three days or more—and it was often full. That costs a lot of money, and, it really doesn’t provide any long term help for the mentally ill person either.

This model was not sustainable in the long run, but help came from Proposition 63, the Mental Health Services Act, which provides more money for outpatient services. “Proposition 63 allowed us to expand the outpatient continuum so folks stayed better maintained and more stable in or system,” said Vic Singh, San Joaquin County Director of Mental Health. “When they become isolated, that’s often when they become more acutely ill, and need more intensive and more expensive inpatient services.”

Proposition 63 funding allows them to stay closer to more patients, so they don’t reach that acutely ill stage. By spending money up front, they actually save money down the line—and they make a lasting difference for more of their patients. They’ve been able to close the larger locked facility and the smaller one they use has open beds. The savings are plowed back into more out-patient services. So this is a financial benefit for the county—but the dramatic improvement among some clients is the real benefit. People who had been outcasts are getting the treatment and services they need to function on their own and contribute to society.