Once Upon a Time in the California Mental Health System:
A history lesson with Barbara Wilson LCSW
Season 2 | Episode 1 | April 30, 2021
Barbara Wilson, LCSW, has had a distinguished career in social service and helping people for over 50 years. She is well-known in Los Angeles County as a tireless advocate for improved services to people coping with serious mental illness and the families who care for them. She also is credited for being one of the first in the state to sound the alarm approximately seven years ago that a precious housing resource for people with mental illness was slipping away due to the fiscal realities facing board and care operators whose rent revenues were not keeping pace with escalating costs.
In this interview, Barbara walks us through an important chapter in California’s history. Any young student in social work would do well to sit at the feet to learn from this wise woman. Policy makers interested in reform should take heed. Barbara describes the role of a psychiatric social worker during a time where they had the responsibility–and the authority–to partner with people and take into consideration their whole life needs. This is exactly what they do in Trieste, and still do in Trieste. This is why people don’t slip through the cracks in Trieste.
In the 1970’s, there was a statewide system in place to serve people with mental illness, with very few bureaucratic layers. She was assigned to the 90044 area code. As she describes this, it reminds me of the “micro-areas” in Trieste where one social worker has a broad command of the human needs in his or her assigned catchment area. So, in fact, it appears that once upon a time, in California, we did provide a social safety net that involved social workers looking out for the interests of people.
Barbara was responsible for the re-entry of people coming out of the state hospital system back into the community. She describes the origin of the board and care system, where well-meaning people would open their homes to guests.
The unravelling of these safety nets occurred in the 1980’s. We hear about the increasing bureaucratization–social workers moving into desk jobs–and the dismantling of a system that bestowed a sense of trust upon social workers to do the right thing for their clients.
Feeling overwhelmed by the needs of the people she was trying to serve and the constraints of a system that was taking away her freedom to serve them, she took an early retirement as the 1980’s came to a close. After raising her family, she re-entered this space, urged on by desperate families looking for help and advice on how to navigate an increasingly broken system in behalf of their loved ones. We’ll hear how Barbara’s life seemed to go full circle; the whole person safety net care she provided as a public psychiatric social worker in the 1970’s now became a skill she could rely on as she started her own business (now a non-profit) Mental Health Hookup.
The message: we can do better, because we used to. Tomorrow’s leaders are encouraged to listen and learn from the past.
Resources for this episode: