State needs humane path for mentally ill
Despite decades of effort, California is still far from creating an effective approach to treating severely mentally ill citizens, many of whom are homeless and desperately subsisting on our streets.
In the 1960s, then-Gov. Ronald Reagan won praise for dismantling the state mental hospital system and for recognizing the harm done by institutionalizing people while depriving them of liberty.
Many documented abuses were done in the name of protecting society.
But succeeding leaders did not provide resources for suitable local alternatives to institutionalization, leading in part to the homelessness crisis of today. An argument can be made that California traded inhumane lockups of mentally ill for the streets.
The hotly debated CARE Court program championed by Gov. Gavin Newsom, now under development, deserves a chance to determine if it can work. CARE Court works this way: By December of 2024, all 58 California counties must create new court systems to serve people suffering from severe mental illness. Family members, mental health specialists, first responders and others can petition these new courts to compel treatment for people suffering from schizophrenia or other psychotic disorders.
The courts would evaluate each case and prescribe 12 to 24 months of treatment. People who refuse treatment could be considered for conservatorship.
Compelling treatment is controversial. For some, conservatorships are too reminiscent of the old state hospital system that was discredited and abolished in Reagan's day. This is a primary reason some civil rights groups and disability advocates have filed lawsuits against CARE Court.
Their concerns are understandable. But too often, the alternatives to conservatorship are incarceration and homelessness.
One solution is reforming conservatorships to make treatment more widely available without overly impinging on people's rights. That is the primary goal of Senate Bills 43 and 363, both by Sen. Susan Eggman, whose similar legislation last year received bipartisan support but failed to win a committee hearing in Sacramento.
Despite ongoing opposition, enthusiasm for conservatorship reform may be building at the Capitol, in part because of turnover in lawmakers at the election last fall. That momentum is a good sign.
SB 43 would expand the “gravely disabled” standard for compelling treatment. Currently, too many of our most vulnerable do not receive treatment if they demonstrate that they are capable of the most minimal self-care. Under SB 43, treatment would be expanded to those suffering mental incapacity because of substance abuse — making thousands more homeless eligible for help. The bill specifically asks courts to take into account whether someone understands their illness and is able to make sound decisions.
Its companion bill, SB 363, would create a real-time dashboard that providers could check for open beds in often overcrowded psychiatric and substance abuse facilities throughout California.
SB 43 received unanimous support in two votes of separate Senate committees in recent weeks, and no senator voted against SB 363 in three committee votes. Both have yet to reach the Senate floor, and would require approval in the Assembly and by the governor. But support so far bodes well for loved ones of the seriously mentally ill — and taxpayers watching them suffer, whether on the streets or behind bars.
California's current approach is not working. It's broken, and has been for decades — a fact even opponents of conservatorship acknowledge.
“We're still operating on laws that were a good idea at one point in our history and have now become obsolete and a barrier to care, versus a protection for people,” Eggman said upon unveiling the legislation earlier this year.
SB 43 and 363 represent another tool in the effort to fix the most troubling problems afflicting California: mental illness leading to homelessness or incarceration. It's high time legislators grasp that tool and run with it.