Our failure to treat people with psychosis is killing them
Compassionate involuntary intervention for people suffering from untreated psychosis is getting an undeserved bad rap these days.
Opponents, including disabilities rights groups, push a fear-mongering narrative that frames any kind of lifesaving medical treatment for people unable to consent due to the effects of their brain disease as “forced,” “coercive,” “brutal” or “tortuous.” They push an agenda that no treatment is better than any kind of lifesaving involuntary care.
In effect, they are promoting the status quo. Do we, as a society, want to continue to leave very sick, treatable people deteriorating, suffering and dying on our streets and in our jail cells, and ultimately winding up in the morgue? I certainly do not.
We should be striving toward a common goal of saving the lives of people sick with severe treatable neurological brain diseases, like schizophrenia and other psychosis spectrum disorders. Today we know what we didn't know in the 1960s when California legislation, known as the Lanterman-Petris-Short Act, was passed defining the requirements needed to get someone the necessary medical treatment to live their best life.
Every day a person is in untreated psychosis more brain damage occurs with a resultant increase in disability. Psychosis is like a slow-moving stroke. This limits a person's chance of a robust recovery. Because most people with schizophrenia suffer from the cruel symptom of anosognosia, which is lack of awareness they are ill, they will never seek care voluntarily. This is not denial — they “know” they are not sick.
We as a humane society have a duty to help those who cannot help themselves. People in psychosis lose their decision-making capacity and cannot direct their own health care. When they receive lifesaving treatment and regain self-awareness, they can take back control of their lives.
Do we leave Alzheimer's patients on the streets to fend for themselves? No, of course we don't — that would be cruel. Voluntary care is always preferable, but in this population of our sickest that we see suffering on our streets every day that is not happening and will not happen.
Senate Bill 43, by state Sen. Susan Talamantes Eggman, DStockton, focuses on updating the 60-year-old definition of grave disability found in the Lanterman-Petris-Short Act. The current definition is not based on medical necessity. The new definition is based on lifethreatening psychiatric and physical deterioration coupled with the lack of awareness to recognize decline that is crucial to saving lives.
Why is this important? To ensure people get the urgent medical treatment they need before they degenerate to the point of homelessness, jail or death. Gov. Gavin Newsom's CARE (Community Assistance, Recovery and Empowerment) Court is based on the same premise. These initiatives are designed to save and improve lives, not to use mental health laws as tools for social control as some opponents maintain.
This is a medical policy issue, not a civil rights argument. We have the power and have had it all along to stop needless deaths and give treatable people their lives back. Let's exercise our voices and support initiatives that eradicate the status quo. Families across California are sick and tired of watching their loved ones “die with their rights on.”