Task force seeks to change California’s mental health commitment law Los Angeles Times
April 10, 2012
SAN FRANCISCO — A homeless man plagued by schizophrenia is beaten
to death by police in Fullerton. A man from Fort Bragg fixates on
aliens for years while denying he is ill, then kills two men
before dying in a gunfight with law enforcement. A Nevada County
mental health client who had refused additional care storms into
a clinic and kills three workers.
Those headline grabbers, according to a task force pressing to
change the California law that governs involuntary civil
commitment to psychiatric hospitals, were merely the most visible
signs of a broken system.
Tens of thousands of mentally ill people wind up each year in
California jails and prisons, cycle in and out of overburdened
hospital emergency rooms or die on the streets.
California’s pioneering Lanterman-Petris-Short Act, passed in
1967, gave legal rights to those who previously could have been
locked up indefinitely and treated against their will. But the
task force — made up of family members, mental health
professionals, judges and public defenders — contends that the
law has failed those unable or unwilling to seek help.
They are calling for sweeping changes that would allow the
involuntary commitment of those deemed incapable of making
treatment decisions, expand the use of conservatorships, lengthen
involuntary hospital stays and standardize the checkerboard way
the law has been applied from county to county.
“Nobody wants to round people up and tie them down and give them
shots,” said task force member Mark Gale, a mental health
activist whose son has a diagnosed schizoaffective disorder.
“What we want is for people who should be evaluated to get that
evaluation, and for people who need crisis care to get crisis
The self-appointed group recently released its report after 30
months of study. And some of its recommendations are likely to
receive broad consensus. Among them: consistent application of
the law statewide, interagency coordination to ensure that
patients are promptly placed in appropriate hospitals,
availability of crisis stabilization services in every county,
and standardized training for police and others who respond to
those in need.
But proposals that would broaden the terms of involuntary
commitment and conservatorship touch the third rail of mental
health policy — and are likely to provoke a familiar contentious
One camp, which includes client organizations and advocates,
asserts that only voluntary care can truly be effective. The
other, dominated by medical professionals and family members,
says illnesses such as schizophrenia and bipolar disorder often
make sufferers incapable of the insight needed to engage in care
Furthermore, they note, jails, prisons and repeated brief
hospital confinements end up delivering involuntary care
regardless — at great cost.
“I’d go so far as to say that involuntary treatment has increased
since implementation” of the act, said Randall Hagar, a task
force member and director of government affairs for the
California Psychiatric Assn.
Nearly 200,000 people in California get their outpatient services
every year in a jail setting,” he said. “Something is really
wrong with this picture.”
The report already has provoked outrage, most notably for its
push to redefine “gravely disabled” to include an individual’s
“capacity to make informed consent to treatment and assess their
ability to care for their health and safety.”
“If I could send a message to the LPS Reform Task Force … I would
like to tell them to please keep their mental health laws off my
body,” said Charmaine Asher of Yorba Linda, 25, who has been
diagnosed as suffering from major depression and treated against
The client voice is nonexistent in the report, she said, adding
that “there is no healing when force is involved.”
Dan Brzovic, an Oakland-based attorney with Disability Rights
California, said “there is room for reform of the mental health
system, and some of these proposals should be seriously
considered.” But, he said, any effort to extend stays or broaden
the definitions that allow for involuntary commitment should be
“You place someone in a facility if they’re dangerous to society
or themselves or unable to take care of themselves,” Brzovic
said. “As we get away from that standard, while you may help some
people, you have the potential of roping people in who don’t
Assemblyman Michael Allen (D-Santa Rosa) said he hoped to take on
a broad examination of the issues in the fall.
“Everyone agrees that voluntary care is preferable to anything
done on an involuntary basis,” he said. “But at what point … do
we change things so people don’t have to go back to court
multiple times to get a treatment plan for a loved one who
doesn’t believe they are mentally ill?”