Such Private Pain, So Little Public Care

I was shocked and saddened to read last week about the stabbing death of social worker Robbyn Panitch in Santa Monica. And then I saw the picture on Page 3: David Scott Smith was the man who had sat next to me in church the previous Sunday.

My boyfriend Tad had just gotten up to help out with the collection--this was the week the money would be used to help the homeless who live in the park across the street. A man I recognized as one of our “park people” slipped into the empty space beside me. His smell was unpleasant, but not overpowering. I mentioned that the seat was taken and that my boyfriend would return soon. The man didn’t move.

We use a lot of music in our 5:30 Mass and it’s not unusual to find people crying quietly during the service over some private pain. The man from the park sitting next to me began to sob, tears streaming down his face. He began calling: “Yahweh, heal me! I am in so much pain!” I had no tissues in my purse to offer, but I did reach out a hand of comfort to rest on his shoulder. He didn’t acknowledge me or my feeble gesture. Instead, he began to call out: “God I love you so much.” Then he shouted an obscenity. And that’s when I knew we had a problem.

When my boyfriend returned, the man I later recognized as David Scott Smith seemed to calm down. He appeared to be genuinely grateful when several people reached out a hand to him during the part of the Mass when everyone extends a sign of peace. He took Communion. Afterward, as my boyfriend bent his head down for a moment of quiet reflection, this man who’d been ranting just a few minutes earlier extended a hand of his own and placed it on Tad’s shoulder.

Two days later, he stabbed his social worker to death.

The incident affected me not only because I had had some personal interaction with the man, but also because my job takes me out on the streets where I talk to people like David Scott Smith every day. I talk to their social workers who complain about their ever-increasing caseloads. And I talk to the people who operate the clinics, who say that they find themselves treating the David Scott Smiths only in the latter stages of their diseases because there isn’t enough manpower to treat them any earlier. And I talk to the Los Angeles County supervisors, who tell me that the state isn’t living up to its agreement to pay 90% of the mental health bill, and that the county doesn’t have enough money to pick up an $18-million deficit. And I talk to the people who work with the homeless, who tell me that fully a thirdof the people who live on our streets are mentally ill.

Those who saw David Scott Smith more often than I knew that he was deteriorating mentally. His mother tried to have him committed after he tried to strangle her, but David was unwilling to enter a hospital. The only other way to have someone institutionalized is to prove that he poses a threat to himself or to others. But a woman who works with the homeless mentally ill told me a joke among mental health professionals: The only way to prove that the threat exists is if someone attacks a psychiatrist in the presence of another psychiatrist.

On Monday, the county began dismantling services at 13 clinics from the San Fernando Valley to San Pedro. Eventually, nearly 500 mental health workers will be laid off, demoted or transferred to other jobs. Robbyn Panitch was one of those scheduled for demotion.

Twenty thousand patients will lose their counselors. Another 10,000 could find themselves transferring buses as many as three times in order to get counseling and medication at one of the few remaining open clinics.

The closures have not come without protest. Psychiatrists and parents of the mentally ill staged loud and colorful rallies throughout Los Angeles County. Patients stood nervously at microphones, telling in painful detail what their lives were like before they found counseling. Groups marched on Sacramento. But unless the supervisors act quickly, the clinics will close.

Mental health has not been a top priority for county budget planners. That’s largely because most of the money to run the clinics is supposed to come from the state. But for more than a decade, that hasn’t happened.

Supervisors must take a more active stand in the fight for state funding. A united board should demand that the governor invoke the dreaded “T” word to pay for mental health care and half a dozen other health crises in the making. If a general increase in state income tax proves too distasteful for the politicians, alternative “user fees” could be found. Such tax increases are not unpopular with Californians. Voters approved an increase in cigarette taxes last November to offset some of the costs of treating poor patients. And recent polls indicate that drivers would pay an extra five cents a gallon in order to reduce traffic woes. Wouldn’t they agree to a tiny increase in the state’s sales tax in order to pay for adequate mental health care?

It’s time to realize that the system of caring for the mentally ill is falling apart. You don’t have to look very far to see for yourself. Walk the streets of downtown Los Angeles. Take a stroll beneath Santa Monica Pier. Or come to church with me next Sunday.