Picture of Ciara Harraher, MD

Ciara Harraher, MD

CANS President

President's Message

It took more than two weeks after the election, but Proposition 1 did pass in California by a razor-thin margin.  In case you missed it, this measure reconfigures a 20-year-old “Millionaire Tax” for mental health services and approves a 6.4-billion-dollar bond to provide more treatment beds and housing. Treatment- not tents! That is the tag line of this bill which is sadly the first upgrade to the state’s mental health system in 20 years.

For anyone who has walked around San Francisco or any of our larger cities, we can all probably agree that homelessness is at crisis levels. Even in Santa Cruz, a small county where I live, many of my friends will not go downtown with their families as the numbers of people living “rough”, as they say in Ireland, is too much to bear.

I know this expression as my mother was a social worker and is Irish. She worked to house the homeless in Toronto for more than 20 years and I grew up learning about her “people”. She called them “people” and gave them respect. She shared their stories with us children growing up, partly I think now as a cautionary tale. Many had grown up in “normal” families but when mental illness ravaged their minds it also usually ravaged their relationships. Many turned to drugs which my mother had no tolerance for. She would physically remove and verbally abuse any “dealers” who she would see preying on her people. To this day she still hears from some of those she helped who thank her for her kindness. When she had cancer, some even made her small gifts and cards.

As a neurosurgeon, I didn’t think that my childhood experiences with the homeless would be so relevant but that has not been the case. Many of the infections I treat related to IV drug use occur in our homeless population. I now see many of my former patients on street corners or behind dumpsters. I know that homelessness, drug use and mental illness are separate issues, but I have found that they often form a tragic triangle. Once they have had their surgery, we try to find them a bed somewhere, at least until they are finished their antibiotics but despite this, I know many return to the streets. There they treat their paranoia, depression, hallucinations, and anxiety with drugs.

This measure has its faults. It is expensive and counties will have to move money from other programs to meet the housing requirements. However, the one piece that really justifies it in my mind is the increased funding to train and educate more mental health professionals.  It isn’t hopeless. Maybe we just need more people like my mom.