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Nestled between hills and oceans in Orange County, California, approximately midway between San Diego and Los Angeles, is the city of San Clemente. Known as the “Spanish Village by the Sea,” San Clemente is a community with a population of 65,082 people, celebrated for its year-round sunny weather and overall pleasant climate. On the surface, San Clemente may seem idyllic, but the community faces challenges similar to those in communities of comparable size throughout California and the United States.
San Clemente is a prosperous city with a median household income that far outstrips the United States, California, Orange County, and even the Los Angeles metro area at $97,210 per year. Of the four others, the median for Orange County comes closest to the median of San Clemente, but it is still significantly lower at $78,145. However, there is not an even distribution of wealth in San Clemente as evidenced by the per capita income of $54,115.
The San Clemente area is predominantly Caucasian at 71.1 percent, more than three times the number of the second most populous group of Hispanic/Latino residents at 18.7 percent. The median resident age of San Clemente is higher than the median for California, 44.9 years compared to 36.4 years.
Orange County offers the third most acute care beds for psychiatric patients in California at 482. However, there is a shortage of beds throughout California, with 25 counties going without altogether.
Furthermore, acute care is only part of the problem. Preventative mental health services are difficult to find. Mental illness cases in California have increased while treatment options and available funding have decreased. The most severe cases are put on psychiatric holds until hospital beds become available, but by the time they get to the hospital, they have been given medication and stabilized, so they are released from the hospital. Then two weeks later, when the medication runs out, the cycle begins all over again. One medical center in the area called it a crisis in its 2016 community health needs assessment and referred to the current solutions as “Band-Aids,” providing only temporary fixes to the overall problem.
Social stigma regarding mental illness, particularly within certain cultural groups, often gets in the way of people seeking the help they need. However, the same stigmas can actually prevent communities from funding, building, and staffing the treatment centers so desperately needed by playing into the prejudices of the community’s residents. For example, certain neighborhoods are resistant to having treatment centers for mental illness and addiction treatment centers being built nearby out of concern for increased property crimes. This despite the fact that studies show that the risk of increased criminal behavior from a well-managed recovery home is minimal, and rates of property crimes are actually higher near convenience stores and liquor stores than drug and alcohol treatment facilities.
Another concern among affluent homeowners in communities such as San Clemente is that mental health or drug treatment centers in the community will lower property values. Currently, the median residential property value in San Clemente is $899,100, nearly twice the median value of homes statewide at $477,500. One such facility alleges that some communities, possibly including San Clemente, have local governments that bow to pressure from residents and prevent the establishment of treatment facilities within the community through strict zoning laws and regulations despite the practice being in clear violation of state and federal laws in place to prevent discrimination against people with a disability.
Poverty can be a stressor that leads to mental illness. The poverty rate of San Clemente is relatively low at 7.06 percent, but a disproportionate amount of non-white residents live in poverty. For example, 16.7 percent of black residents live in poverty despite African Americans only making up 0.5 percent of the entire population. The largest demographic of residents living in poverty are males age 45 to 54.
Youth and the elderly are also populations at particular risk. Elderly patients may be in denial about their symptoms, which may also be misdiagnosed as normal aging processes. Approximately 33 percent of Orange County teens have an emotional or mental health issue for which they need counseling, but less than half of them receive it.
