Los Angeles Times

Mental illness in California


Re “The CARE Courts false promise,” editorial, July 26

I bristled at your statement in favor of “supported decision-making ... in which a person who recognizes that his or her capacity for making key decisions about care is compromise­d and selects one or more trusted family members, friends or agents to discuss options and make recommenda­tions. The patient ultimately retains final decision-making power.”

Has anyone on your editorial board dealt with a family member suffering serious delusions along with depression and suicidal behaviors? I have, for many years. A patient cannot make decisions for their own well-being until the patient is stabilized.

Had we allowed my family member to make her own “decisions,” she would have been half-naked, delirious and in pain on the street. Thank God for my brother who willingly petitioned to be her legal guardian and the judge who declared her incompeten­t.

My sister was put into a safe living environmen­t where she got the treatment she needed. You have no idea how difficult it was to achieve this outcome.

She died of a seizuredis­order-related stroke, but she was able to have as best a quality of life as possible. This was a much better outcome than her driving drunk, attacking people who she thought insulted her and wandering the street.

Mary Pierson Manhattan Beach

You write, “Experience demonstrat­es that people battling mental illness do better, for longer, when they retain as much of their

personal autonomy as their situation allows.”

No, experience does not show that at all.

Experience shows that a significan­t percentage of people who suffer from the most severe forms of schizophre­nia-related illnesses do not do better unless they are treated for as long as it takes to enable them to gain the insight necessary to meaningful­ly exercise their personal autonomy in ways that promote their recovery.

We need more treatment options for those who “want” treatment. But the crisis in our system is that for people who are too sick to “want” treatment, there is nothing but the endless cycling between jail, short stays in acute (“crisis”) facilities and the streets.

The CARE Court proposal is not perfect, but please, let’s not let the perfect be the enemy of the good. CARE Courts would represent a first in California history: holding every county in the state accountabl­e for treating seriously mentally ill individual­s with the appropriat­e level of care that they need and deserve. Brian Bloom

Berkeley The writer is a former assistant public defender for Alameda County.

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