California governor seeks to expand involuntary treatment

February 19, 2020 - 8:00 pm

SACRAMENTO, Calif. (AP) — Gov. Gavin Newsom wants to make it easier for the government to force psychiatric treatment for people with mental illness and expand statewide a still-developing test program that allows officials to more easily take control over those deemed unable to care for themselves.

In a State of the State address Wednesday devoted almost entirely to the issue of homelessness, the Democratic governor said the state should broaden those laws “within the bounds of deep respect for civil liberties and personal freedoms — but with an equal emphasis on helping people into the life-saving treatment that they need at the precise moment they need it.”

Newsom drew support from members of both political parties. But civil libertarians have concerns, while advocates for the mentally ill warned that proper services must be in place and voluntary options exhausted first.

”We often look too quickly to getting individuals off the street involuntarily without assuring that the resources are available, the treatment is available first. And I think the governor candidly acknowledged that in his address," said Curtis Child, legislative director at Disability Rights California.

San Francisco, with one of the nation's most visible homeless populations, is on the verge of trying a new conservatorship program to allow court-ordered mental health treatment for people deemed incapable of caring for their own health and well-being because of serious mental illness or drug addiction.

Temporary conservatorships could be triggered with an individual's eighth 72-hour involuntary mental health hold in a 12-month period. Such commitments are commonly called “5150s," after the legal code section for detaining someone considered to be a danger to themselves or others due to mental illness.

Under the program, a 28-day temporary conservatorships could be followed by six-month programs in which judges could order patients to receive treatment. If they can't be treated at home, they could be ordered into community-based residential care facilities.

San Francisco is “very close” to having the five-year test program running after creating new processes and safeguards in coordination with providers and the courts, said Jeff Cretan, a spokesman for Mayor London Breed.

"That's an important, thoughtful process we have to go through because these are people’s civil rights we’re talking about,” Cretan said.

Newsom said California should allow every county to establish similar so-called housing conservatorships. They are different than longstanding probate conservatorships, in which a judge appoints a guardian for an adult who is unable to care for himself or herself.

“I am thrilled that the governor understands that it is not compassionate, it’s not humane, it’s not progressive to let people unravel and die on our streets," said state Sen. Scott Wiener, a Democrat from San Francisco who wrote two related laws creating the test program. “There are people on our streets who are so severely debilitated with mental health and eviction challenges that they cannot accept voluntary services and we have to help them.”

Opponents to his legislation included the ACLU of California, Western Center on Law and Poverty, and Disability Rights California, which were concerned it didn't do enough to respect individual rights, and the California Public Defenders Association, which feared it could “sweep many more people into the civil commitment system.”

The governor also called for removing some of the conditions for counties to implement what's know as Laura's Law, which lets service providers and loved ones ask judges to force recalcitrant people into outpatient mental health treatment programs.

It is named after 19-year-old Laura Wilcox, who was fatally shot with two others at a Nevada County mental health clinic in 2001 by a man who had refused psychiatric treatment.

Newsom said the law currently is too hard to use, but his office could not provide more details on what he wants to see changed.

Republican Sen. John Moorlach of Costa Mesa, who also proposed an involuntary commitment bill that died last month, applauded Newsom's proposals.

“We as a state shut down our mental health institutions and the patients migrated to the streets and to the jails,” Moorlach said, calling current conditions inhumane.

Then-Gov. Ronald Reagan in 1967 outlawed lifetime commitments for those deemed mentally ill, while the U.S. Supreme Court in 1975 ruled that mental illness alone is not enough to justify involuntary commitments.

The governor said all his other proposals hinge “on an individual being capable of accepting help, to get off the streets and into treatment in the first place.”

“Some, tragically, are not,” he said while advocating “better legal tools" to “help people access the treatment they need.”

Senate President Pro Tem Toni Atkins, D-San Diego, said the Legislature would need to take a “cautious approach" to some proposals, including making it easier for local governments to force the mentally ill into treatment.

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Associated Press reporters Adam Beam and Cuneyt Dil contributed to this story.

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