Newsom Mental Health Plan Needs Full Airing

Beginning in the 19th century and continuing well into the 20th, California maintained an extensive network of state mental hospitals to which people deemed to be dangers to themselves or others were committed, often for decades.

In the mid-20th century, however, the concept of involuntary commitments came under fire with critics saying that the hospitals were more like prisons than treatment centers, with their patients denied basic civil rights.

The upshot was legislation, signed by Ronald Reagan shortly after he became governor in 1967, with a declared goal to “end the inappropriate, indefinite, and involuntary commitment of persons with mental health disorders.”

The Lanterman-Petris-Short Act, named for Republican Assemblyman Frank Lanterman and Democratic Senators Nick Petris and Alan Short, set forth an elaborate process that would have to be followed for involuntary commitments, limiting them to the profoundly disabled.

Companion legislation was aimed at replacing the hospitals with community-based mental health programs. The package drew support from those who wanted to reduce the hefty costs of the hospitals, such as Reagan, and advocates for the rights of the mentally ill.

It never worked out as planned because successor governors and legislators didn’t provide enough financial support for local mental health services and the process for commitment essentially allowed the mentally ill to refuse treatment.

One by one, the state hospitals were closed, some converted to other uses, such as California State University Channel Islands in Camarillo, and others razed.

In some measure — we’ll never know how much — what followed the Lanterman-Petris-Short Act contributed to California’s explosion of homelessness, because many of those living on the streets of the state’s cities are severely mentally ill.

The debate over the situation has raged for years, pitting those who believe that forcing the mentally ill into treatment is a regrettable necessity against those who contend that involuntary commitments violate civil rights.

Click here to read the full article at CalMatters

Comments

  1. There must be some balance between necessary commitment and the kind of misery and permanent confinement that prevailed in the early 20th Century. Now that we have great advances in medication and other treatment for mental illness, why can’t those with documented significant mental illness be involuntarily committed for a period longer than 3 days — say, for 90 days – enough to do a full evaluation, begin a course of treatment and see whether the person can be released, or if not then extend the commitment another 90 days? This seems to be a benefit to both that individual and society, certainly an improvement over leaving them in the streets to wander and suffer.

  2. As a person training to be a school counselor I was able to spend time observing the processes in the state mental institution called, I think, the Napa State Hospital. While it had a fairly elaborate evaluation procedure it also tended to retain people for longer that required times. It also included housing for people who were significantly mentally disabled and others who were dangerous to self and others. It had a juvenile section where the young were allowed to co-mingle. This led to individual youth taking control of the other youth placed there. Not a healthy situation. With today’s medications many of the same people are freed to return to the streets for various good and bad situations. That is leading to the situation today of thousands of nearly helpless people being on their own without the skills to function. Drugs, alcohol, etc become an escape because they do not know what else to do. When that happens they become far less capable of functioning and if re-evaluated would most likely not qualify for release except when the law forces their release. As with much of government today the buck is being passed to the public. How, at this time to deal with the situation, is close to unsolvable. History placed them with the families – not so today.

  3. Really??? says

    Wonder how many of the State Legislator including the Gov. office would be committed based drug use and/or volatile personal conduct?

    There is a fine line and that is the issue with commitment.

    Then there are the issues of family not wanting to take on family members that prior to WWII often was the case.

    Not an easy debate.

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