They are a social tragedy, many illegally camping in the Parkway, and, often, a public safety issue; so, this article from California Globe is well-timed.
An excerpt.
“Governor Newsom just signed three bills promoting needed reforms to California’s dysfunctional mental health system. It’s a good beginning, but what next?
“The state auditor had many insightful and helpful recommendations concerning the care and treatment of the severely mentally ill in her July 2020 report. However, the report did not attempt to analyze the defects in California’s outmoded Lanterman-Petris-Short Act (LPS), which governs care and treatment of those who are dangerous due to severe mental illness, or so “gravely disabled” that they cannot care for themselves. Rather, the auditor’s described methodology was to evaluate whether LPS was functioning as written in three counties, using 40 cases in each county as examples. The report found that LPS does function as written.
“For treatment advocates, that wasn’t the question.
“Anyone who spends times in California cities knows our laws aren’t working to help the sickest people we see on our streets, eating out of garbage cans and screaming at no one in particular. LPS moved them out of the old state hospitals—rightly, because most did not belong there—but in so doing, criminalized severe mental illness. The severely mentally ill have ended up in our morgues, on our streets, and in our jails, usually for very minor crimes. There they are treated expensively and abominably. Both the human and dollar costs of this movement from hospital to jail are enormous and insufficiently calculated, according to the auditor.
“LPS—revolutionary and respected fifty years ago, but now the Model T Ford of state commitment laws—is responsible. It got an “F” among state commitment laws recently given grades by the Treatment Advocacy Center, for excellent reasons. LPS went to extremes to eliminate the problem of unjustifiable detention, which is now far behind us. California now has the opposite problem. Treatment is efficacious and constantly improving, but people who need treatment aren’t getting it unless they are willing to volunteer for it—which severely mentally ill people too sick to know they are sick rarely do. Even if they are dangerous.
“LPS created this tragedy by premising treatment entirely on dangerousness, while adopting anti-treatment standards at a time when treatment was primitive and sometimes tantamount to torture. Treatment aside, how do you prove someone is dangerous by “clear and convincing evidence” – the constitutional standard – when they assure you they won’t do anything bad in the future? The answer: proving something that hasn’t happened yet by “clear and convincing” evidence is virtually impossible, until someone has shown such a severe pattern of dangerousness that they are probably already dead or in jail.
“Compounding the problem, LPS immunizes police and treatment personnel from civil and criminal liability for loosing even the most dangerous mentally ill on the public. The most disturbed among us can usually hold it together long enough to fool the police—remember Elliott Rodger, who did so before shooting six people in Isla Vista, despite desperate pleas from his parents that he was severely mentally ill, dangerous and needed help? Who suffers then? Sometimes innocent bystanders, but usually the family members who dialed 911 and are stuck with a very angry psychotic when the police walk away. Do you wonder why many family members hesitate to make a 911 call, no matter how terrifying the situation?
“What’s worse, and as acknowledged by the auditor, the dangerous mentally ill in California are rarely kept longer than 72 hours. This is because California’s same “dangerousness” standard continues to apply to those whose dangerousness has already been shown for purposes of the “5150” hold, no matter how badly those dangerous individuals need continued treatment. The state auditor’s report seems to assume this is inevitable. Constitutionally, it isn’t—premature release is one of many defects built into LPS.
“Tragically, dangerousness is even harder to prove when a severely mentally ill patient has had time in a quiet stable environment with a patient advocate whispering in his ear, telling him exactly what to say to get discharged. Nobody likes being in a hospital, but most hospitalized adults are too physically ill and too sensible to check themselves out against medical advice. Not so those patients whose brains are broken.
“72 hours is not enough time stabilize many and perhaps most patients, much less evaluate their needs for purposes of community placement. So, as acknowledged in the auditor’s report, the most dangerous patients cycle in and out of repeated short-term hospitalizations at enormous public and human cost, without every achieving the stability that would release them from their suffering. Only jail or death stops this tragic cycle.
“The supreme irony of our system is that by making civil commitment too difficult, we have consigned desperately ill people to our jails and prisons, where they are infinitely worse off.”
Retrieved September 28, 2020 from https://californiaglobe.com/section-2/state-auditors-report-shows-lanterman-act-reform-is-badly-needed/
Be well everyone>
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