Ken Carlson

Author says mental health spending bypasses the most severely ill

DJ Jaffe, a leading critic on how mental health funds are spent, talked about his book Insane Consequences in Lathrop, Calif. last week.
DJ Jaffe, a leading critic on how mental health funds are spent, talked about his book Insane Consequences in Lathrop, Calif. last week.

DJ Jaffe is convinced the following numbers indicate something is wrong with our approach to treating mental illness:

Despite national spending of almost $150 billion a year on mental health, 140,000 people with serious mental illness are homeless and 365,000 are behind bars, while 2 million are not treated.

Jaffe talked about his scathing book “Insane Consequences”, published by Prometheus Books, at the River Islands Welcome Center in Lathrop last week. Members of the Stanislaus chapter of the National Alliance on Mental Illness took a jaunt to San Joaquin County to hear Jaffe’s talk.

In a book crowning 30-plus years of advocacy, Jaffe maintains that too much spending is directed to community programs for people who fall within a broad definition of mental illness but are not among the 4 percent with severe disorders.

The 4 percent include adults who sleep on park benches or wander the streets of cities like Modesto arguing with the voices in their heads.

Jaffe is appalled that 40 percent of the population with severe illness, primarily schizophrenia and bipolar disorder, receive no treatment in a country where health care is available for most medical conditions.

In California, about 480,000 who suffer from serious disorders are not treated to relieve their agonizing symptoms.

The state collects a millionaire’s tax to improve community-based mental health services, about $1.7 billion a year, but, in Jaffe’s view, those tax dollars are missing the mark. He disparages the Mental Health Services Act spending on wellness programs including art classes, tai-chi and equine therapy.

According to his book, the mental health profession has broadened definitions for post traumatic stress disorder and invented new illnesses including “bullying” and the psychological trauma caused by the loss of a loved one.

“We spend way too much on ‘mental health’ and not enough on mental illness,” Jaffe said. “The least symptomatic go to the head of the line for services.”

Jaffe, who lives in New York, began more than 30 years of advocacy after a sister-in-law exhibited signs of schizophrenia. In trying to get help for the family member, Jaffe discovered what he called a dysfunctional and disconnected mental health system.

As executive director of the nonpartisan Mental Illness Policy Org., Jaffe appears on television interviews and has written opinion pieces for the New York Times, Washington Post, Wall Street Journal and National Review.

His book includes a section on some who wreaked havoc after going untreated for mental illness. For example, mass murderer James Holmes was not in treatment before he opened fire in an Aurora, Colo., movie theater in July 2012, killing a dozen people and injuring 70.

Jaffe recognizes the challenge of getting care for individuals who don’t know they are mentally ill and have legal rights to decline medication. But he suspects the focus on wellness programs is an easier path for what he calls the “mental health” industry.

As for solutions, Jaffe writes that those with the most serious mental illness should have priority for treatment. Instead of closing hospitals for the mentally ill, hospitals should be adequately funded.

Jaffe supports court-ordered outpatient treatment under Laura’s Law in California and Kendra’s Law in his home state of New York.

Manuel Jimenez, a former behavioral health director for Alameda and Merced counties, attended the talk last week and disagreed with the author on some points.

During his time in Merced County, Jimenez took pride in removing the last county resident from an institution. Services were wrapped around the patient that enabled him to live in the community, Jimenez said.

The former director said counties need strategies to engage the severely ill in outpatient treatment. Often, those folks are treated at great expense in the emergency room, jail or behavioral health facilities. But after their release they don’t receive less costly outpatient services to keep them from recycling through those facilities.

“In Alameda County, we created in-home outpatient teams to engage the person to get involved with outpatient treatment and connect them with services,” Jimenez said.

Jaffe’s book can be purchased at

Ken Carlson: 209-578-2321, KenCarlson16