Defeat of Mental Health Bill Vowed

A day after the Assembly approved legislation to expand treatment of severely mentally ill people against their will, key state senators vowed Thursday to work to derail the measure.

The bill by Assemblywoman Helen Thomson (D-Davis) marks the first major attempt in a decade to revise a landmark law passed more than 30 years ago that granted broad civil rights to the mentally ill, and sped the emptying of California’s state hospitals.

Three decades ago, the Lanterman-Petris-Short Act was hailed as an advance in the humane care of mentally ill people. But in the years since, community-based mental health care programs have been underfunded, while a growing number of family members, police and psychiatrists say the law has prevented them from providing care for those most in need.

“The obstacle isn’t science,” Thomson said, referring to new antipsychotic medications that can alleviate many symptoms of schizophrenia, manic depression and other serious mental illnesses. “The obstacle is the law.”

The Assembly approved Thomson’s bill late Wednesday on a 53-16 vote. But on Thursday, Senate President Pro Tem John Burton (D-San Francisco), the Legislature’s most influential member, said that attempts to expand involuntary treatment of mentally ill people “ain’t going to happen.”

“Forced medication? I’m against it and it won’t happen,” Burton said. “It took many, many years to deal with that issue . . . and I’m sure we’ll put [any revision] in for a long, long study to see what exactly should or shouldn’t be done.”

Burton has commissioned a study of the issue.

“Maybe there needs to be some changes, maybe not,” he said. But he added that “involuntary treatment ain’t going to happen.”

Before California approved the Lanterman-Petris-Short Act in 1968, people deemed mentally ill could be held indefinitely in locked institutions. Now, people can be held only for a short period, and only after court hearings to determine their competency.

Thomson’s bill, AB 1800, would require that a hearing officer determine if a person is “gravely disabled.” The officer could order treatment if a person refuses. The measure provides that the patient could seek a court review.

Under the bill, a person would be deemed gravely disabled if he could not provide for food, clothing or shelter; is a danger to himself or others; faces an acute risk of physical or psychiatric harm unless he undergoes treatment, and has been deteriorating during a 30-day period.

The maximum period someone could be held would be a year, up from the current maximum of six months. The bill would allow an individual to be released more quickly if he agrees to continue treatment at home.

California is one of 12 states that has no provision to require treatment of mentally ill people living on their own outside locked institutions.

The measure is similar to legislation approved in New York last year after Kendra Webdale was shoved in front of a train by a man with a long history of mental illness.

Opponents warn that the bill would result in incarceration of people who don’t need or want treatment. Foes also say the state should expand funding for voluntary treatment programs.

Opponents include civil libertarians, psychologists and some county mental health directors. Former patients have mounted demonstrations against the measure. The Church of Scientology also is among the foes, the bill’s analysis says.

Thomson said she has no desire to return to a state mental health system that at its height in the 1950s held more than 30,000 people. State hospitals now house fewer than 900 mentally ill people who have not committed crimes. At the same time, more than 20,000 state prison inmates and tens of thousands of jail inmates are severely mentally ill.

Thomson’s bill has support from law enforcement agencies, judges and physicians, as well as the National Alliance for the Mentally Ill. Officials including the Los Angeles County Board of Supervisors and San Francisco Mayor Willie Brown have endorsed it.

Advocates contend that the law must be changed to more readily allow involuntary treatment because one symptom of schizophrenia and manic depression is that some ill people don’t realize that they are deteriorating.

The measure is among the most far-reaching of the two dozen bills pending this year that deal with the mental health system. It is the one that has stirred the most passions.

In the Assembly debate, Assemblywoman Dion Aroner (D-Berkeley) noted that the current law allows for involuntary treatment. She talked about how her husband, who has manic depression, was committed against his will.

He remains angry about the experience, Aroner said, adding that she questions whether patients who are forced into treatment “are going to be willing to participate again” in any voluntary program. She voted against the measure, even as she said the law needs some changes.

Assemblyman Bill Leonard (R-San Bernardino) told of a mentally ill woman who was held at Patton State Hospital, an institution for people who have committed crimes but are deemed not guilty by reason of insanity.

The woman’s crime, he said, was jaywalking. Social workers, attorneys and a judge “conspired” to incarcerate her because she was pregnant and mentally ill. It was the only way to ensure she would receive adequate care during her pregnancy.

Leonard called it a “travesty” that there was no other way to find treatment for the woman. The current law is “actually harming people,” he said.