Jails as mental health centers

Re “How society betrayed the mentally ill,” editorial, Feb. 28

The Los Angeles Times should be applauded for its thoughtful discussion about problems in treating mentally ill homeless people.

Those who call for a balance between civil liberties and involuntary treatment assume that the latter entails forced confinement. Many patients who lack the judgment to participate in treatment would benefit from mandatory outpatient medication and related support. Attempts have already been made to modify the Lanterman-Petris-Short Act of 1967, but current procedures remain cumbersome and are too rarely utilized.

As for the jailing of mentally ill people, there are broadly two distinct populations. Some are incarcerated because of dangerous behavior that is “crazy” and the direct result of mental illness. Such patients are unlikely to cause legal problems if they are stabilized by psychiatric treatment and receive outpatient care.

Others are people who committed crimes and happen to have a chronic mental illness. These people cannot be handled by mental healthcare providers alone. Ideally, the psychiatric treatment can be made robust enough to stabilize the inmate and permit him or her to have the same chance of rehabilitation as others. Cyril Barnert, MD Los Angeles The writer is a retired clinical professor of psychiatry at UCLA.

Los Angeles, like New York and other large cities, has tried to lure people off the street into shelter or treatment facilities. Perhaps we can all point to instances where that effort has met with some occasional success. Though, more often than not, the choice is usually to remain on the street.

No, it’s not a lifestyle preference; it’s because the alternative is believed to be much worse.

By now, it’s hard to imagine why we haven’t understood that the lure is housing. Research studies have shown that people come off the street when they’re given the opportunity to move right into a home. And this “housing first” approach, combined with strong support services, works even for those who are struggling with significant mental health or substance issues.

It’s less expensive in the long term, yielding benefits in both direct and indirect costs, such as a reduction in hospitalizations and the use of other social support service systems. More importantly, it’s a much more humane approach than to simply warehouse people in shelters or allow them to fend for themselves on the street. Arnold S. Cohen New York The writer is president and chief executive of the Partnership for the Homeless.

I am a 56-year-old Angeleno who suffered (along with my siblings) trying to care for my mentally ill mother. Your editorial brought back painful childhood memories of our mother, who never was able to get the care she really needed.

The 1960s and ’70s were a terrible time for mental health treatment. After helping to care for my mother during my youth, I later witnessed firsthand as a college student living in Santa Monica in the early 1980s how low untreated mental illness can take someone. California’s closure of mental institutions without funding community-based centers to treat people should be noted as the worst paradigm shift in our collective compassion for the mentally ill.

Your editorial explaining how this happened is the reason I continue to subscribe. Thank you for giving all of us who have had to deal with mentally ill loved ones hope that a framework for treatment exists. Keith M. Jones Los Angeles