Los Angeles Times
Families flame ACLU in mental health care debate
Many say focus on rights hinders efforts to get loved ones off street
Bob Britton doesn’t look like the kind of guy to be cursing out the American Civil Liberties Union, but there he was outside the state Capitol this week, offering up some choice four-letter words for the civil rights organization.
The ACLU is a leading opponent of Gov. Gavin Newsom’s plan to establish civil courts to help treat people with severe mental illnesses. The group says it will lead to “forced treatment” of unhoused people, with police and others given far too much leeway to trample on the autonomy of those who refuse aid.
But as the uncle of someone with severe mental illness — schizophrenia — Britton says that people like his nephew sometimes can’t grasp that they need help, and ignoring that medical reality isn’t a protection of their civil rights. In fact, it shuts families like his out from the ability to care for their loved ones.
“So f— the ACLU,” Britton told me seconds after I met him, adding that he considers himself a liberal. He was sitting in a low camp chair in a short-sleeved
button-up with cute little fish swimming across it. His gray hair was covered by a Panama hat, and he looked like he was ready for a day at the beach, like maybe he was about to suggest we grab some beers because it was 5 o’clock somewhere.
“The alternative [to Newsom’s proposal] is jail and forced medication. So what’s your civil liberties about there?” he asked to no one in particular. The ACLU was not in attendance.
That’s the frustration that brought Britton and the other family caregivers out on an overcast August day in the last weeks of the legislative session, to wave their signs at lawmakers who have no political need to even acknowledge them.
These families feel that their lived experience is being ignored in the debate over Newsom’s plan for CARE Court, a civil pathway to mental health treatment. They are fed up with severe mental illness being a political issue, or even a civil rights one, rather than a medical condition.
Much of the controversy about Newsom’s proposal has focused on what it could mean for homeless people on the street, which is understandable, given the enormity of California’s homeless crisis. But there are also families trying to get mental health care for adult relatives before they end up on the streets or end up in the criminal justice system, where again these families usually have no say in treatment of their loved ones.
And these caregivers lack political muscle. They spend more time helping their person than organizing for collective action. Many have fought for decades, banging their heads against a system that talks a lot about compassion but would much rather put someone in handcuffs than a hospital.
“We’re not family members who are there to push or boss or dictate. We are the family members who’ve learned how to [handle mental illness] in a respectful manner, and we’re willing to learn,” Elizabeth Kaino Hopper told me. “We recognize we can’t fix it. We recognize we can’t cure it. But we can darn well be a partner. It’s family. We don’t give up.”
Kaino Hopper’s daughter began suffering from mental illness after an assault in college. Over a period of years, she deteriorated until she was living on the streets, sharing a box with other unsheltered people. One night, she pulled a knife on someone when she felt threatened, said Kaino Hopper. Now she’s in jail, has been found incompetent to stand trial and has been waiting months for a bed in a state hospital — where she will receive enough forced treatment to stabilize her to return to criminal proceedings.
It’s a story that’s common to the point of sickening. Mental health is already criminalized, and these family members know it too well.
Britton was just back from Los Angeles, where he attended the felony sentencing of his nephew, who is headed to a state prison on a two-year term. To hear Britton tell it, the nephew, whom he asked me not to name, began having episodes of psychosis in his 20s. Britton’s sister purchased her son a trailer to live in, but he kept the neighbors up with his screaming and ripped out all the wiring.
He ended up living at a freeway offramp in Long Beach, where his mom would bring him energy bars and clean socks, Britton said.
Sometime in between the trailer and the offramp, Britton said, his nephew did a county jail stint for lighting a dumpster on fire on a cold night. When he was released, he was put in a group home where he did OK. He was on a treatment plan that included regular injections of an antipsychotic medication. Britton says when his nephew, who is 44, is on medications, he’s “quite lucid.”
But then he graduated to a studio apartment, and the medication was switched from an injectable to pills. His nephew stopped taking them because “he doesn’t believe he has any illness,” Britton said. “He kind of likes his delusions. And so he became more psychotic and it led to this.”
This being an assault with a deadly weapon charge for allegedly throwing a rock at a person who may have been yelling at the nephew for panhandling at the offramp.
It’s strange for me to be on the opposite side of an issue from the ACLU, an organization that fights the good fight tirelessly. I agree with the group’s concern that removing a civil right from anyone, even someone unable to make their own decisions, should never be done lightly.
In a June blog post titled, “Why we vehemently oppose the governor’s Care Court proposal — and so should you,” ACLU advocates argued any “proposal that ties treatment to courts is retrograde. It harks back to a dark era when forced treatment of people with serious mental health conditions was the norm. It would unravel decades of hard-won progress by the disability rights movement to secure self-determination, equality, and dignity for people with disabilities.”
And in its official opposition letter to the Legislature, co-authored by more than three dozen civil rights and social advocacy organizations that I also respect, it argues, “The right framework allows people with disabilities to retain autonomy over their own lives by providing them with meaningful and reliable access to affordable, accessible, integrated housing combined with voluntary services.”
Critics also charge that CARE Court — which stands for Community Assistance, Recovery and Empowerment Court — could unfairly target Black and brown people, who are disproportionally diagnosed with mental illness. It’s a real concern about racism that permeates nearly every aspect of our unequal society.
But I’d point out that Black and brown people are already over-incarcerated, meaning they are already subjected to more forced treatment than those on the outside. CARE Court would actually keep more people out of the criminal justice pipeline.
I don’t condemn any of the ACLU arguments, really — we should be having real conversations on this issue. But the group discounts that there are many California families unable to get treatment or housing for loved ones. Those families are desperate for any chance to change the terrible outcomes that have become our new, postinstitutionalization norm — homelessness, incarceration and death.
There are a lot of reasons for that — including a lack of supportive housing, treatment providers and so much more. But we also lack accountability and at times common sense, which CARE Court could provide.
Because while we assume our most severely mentally ill are alone in the world, I’ve lost count of the number of families I’ve met like Britton’s and Kaino Hopper’s who have spent their lives in service of their mentally ill loved one, only to be told at every turn that they don’t have any right to intervene. Told that their opinions are irrelevant and their pleas for help regressive because they would require their loved one to take medication, at least until they are clearheaded enough to resume making their own decisions.
But if a mother or a sister or uncle doesn’t have the right to help, a right to have a say in how their loved one is treated, where they wind up and what happens to them in their most vulnerable moments, who does?
Our current answer is cops and criminal courts, and it’s a pathetic response.
‘We’re not family members who are there to push or boss or dictate .... We recognize we can’t cure it. But we can darn well be a partner.’
— Elizabeth Kaino Hopper, whose daughter suffers from mental illness
This column is part of The Times’ mental health initiative, For Your Mind, an effort to increase coverage around treatment, public policy, wellness and culture related to mental health in California’s communities.