Newsom mental health plan needs full airing

Beginning in the 19th century and continuing well into the 20th, California maintained an extensive network of state mental hospitals to which people deemed to be dangers to themselves or others were committed, often for decades.

In the mid-20th century, however, the concept of involuntary commitments came under fire with critics saying that the hospitals were more like prisons than treatment centers, with their patients denied basic civil rights.

The upshot was legislation, signed by Ronald Reagan shortly after he became governor in 1967, with a declared goal to “end the inappropriate, indefinite, and involuntary commitment of persons with mental health disorders.”

The Lanterman-Petris-Short Act, named for Republican Assemblyman Frank Lanterman and Democratic Senators Nick Petris and Alan Short, set forth an elaborate process that would have to be followed for involuntary commitments, limiting them to the profoundly disabled.

Companion legislation was aimed at replacing the hospitals with community-based mental health programs. The package drew support from those who wanted to reduce the hefty costs of the hospitals, such as Reagan, and advocates for the rights of the mentally ill.

It never worked out as planned because successor governors and legislators didn’t provide enough financial support for local mental health services and the process for commitment essentially allowed the mentally ill to refuse treatment.

One by one, the state hospitals were closed, some converted to other uses, such as California State University Channel Islands in Camarillo, and others razed.

In some measure – we’ll never know how much – what followed the Lanterman-Petris-Short Act contributed to California’s explosion of homelessness, because many of those living on the streets of the state’s cities are severely mentally ill.

The debate over the situation has raged for years, pitting those who believe that forcing the mentally ill into treatment is a regrettable necessity against those who contend that involuntary commitments violate civil rights.

Gov. Gavin Newsom is now proposing a Solomon-like approach called Community Assistance, Recovery and Empowerment (CARE) Court, which would make it easier to compel the mentally ill to get treatment, via a special judicial proceeding, but with a one-year limit that could be extended only by further proceedings.

The CARE Court would tailor an individualized plan for each person found to be in need of intervention, including not only psychological treatment but other services such as housing, managed by a team of medical and non-medical personnel. All 58 counties would have to participate.

“This is a completely new strategy,” Newsom said as he introduced the new plan last week. “And I hope that creates a space for a different conversation than we’ve had in the past.”

Newsom should get credit for trying to solve a long-running and very knotty issue, but so far his proposal is just an outline that needs to be fully fleshed out and civil rights advocates remain skeptical.

Kevin Baker, director of governmental relations for ACLU California Action, told CalMatters, “The problem of homelessness is caused by the cost of housing, and we won’t solve homelessness, mental health or substance abuse problems in our communities by locking people up and drugging them against their will. New funding for housing and services would be good, if we also keep in mind that people don’t lose their civil liberties just because the government wants to help them, no matter how sincerely.”

This proposal affects people’s lives, not just those of the mentally ill, but their long suffering families, and should be fully vetted before enactment, not just stuffed into a budget trailer bill in the dead of night.

Dan Walters has been a journalist for nearly 60 years, spending all but a few of those years working for California newspapers. He has written more than 9,000 columns about California and its politics and his column has appeared in many other California newspapers. He writes for CalMatters.org a non-profit, non-partisan media venture explaining California policies and politics.