Many parents of mentally ill adults are
supporting AB 1421, hoping it can help their children get the
services they need to put them back on the path to a normal life.
But some advocacy groups oppose it, saying it might scare people
away from the few voluntary services that do exist.
Local mental health officials said that even if the bill passes, it
is unlikely the money to administer it will be available. No funding
is attached to the bill.
"At this point, unless there's a money tree somewhere -- and I
sure don't see one in Sacramento -- I don't see how counties are
going to do this, without doing harm to something else," said
Donna Wigand, Contra Costa County's mental health director.
Proponents have countered that the bill will save money because
fewer people will cycle through expensive hospitalizations and jail.
Authored by Assemblywoman Helen Thomson, D-Davis, the bill would
allow city or county mentalhealth workers to ask courts for
permission to force mentally ill people who refuse treatment to
accept outpatient help, which could include medication, therapy and
a host of other services.
Current law allows courts to commit people who are an immediate
danger to themselves or others, or who are so gravely disabled they
cannot provide food and shelter for themselves.
But those commitments often last only long enough to stabilize
someone temporarily, parents said. They said a lot of people who do
not meet the criteria simply slip through the cracks.
Modeled on a similar law in New York state, the bill would allow
judges to require services for adults whose mental condition is fast
deteriorating or in danger of deteriorating. The person must have
already faced multiple hospitalizations or have been violent. And
they must have the chance to accept voluntary treatment first.
Some observers fear the bill will target the homeless, many of whom
are victims of mental illness. "What we end up saying is that
all of behavioral health care is harm removal, not a harm reduction
strategy. It's about how to remove people from the community who
others find harmful. I think that's not a direction we want to move
into," said Dave Kears, Alameda County's health care director.
Local homeless advocates gave the bill mixed reviews.
"If mean-spirited bureaucrats got a judge's ear, I could see
the possibility of (bad things) happening. But in the best of
worlds, if people have the person at heart, it could work,"
said Calvin Johnson, services coordinator for BOSS' mentally ill
homeless services in Hayward. Johnson supports the bill.Families
hopeful
Family members of mentally ill adults are hopeful the bill can help
their loved ones.
Marsha Ryle thinks the bill could help her 39-year-old son, who
recently stopped taking his medication and disappeared.
He was studying classical music in Manhattan when his illness first
struck, 13 years ago. Ever since, Ryle said it has been a constant
battle to keep her son stable, who she said suffers from paranoid
delusions,.
"My son has no concept that he's ill," Ryle said. But she
said the medication has allowed him to live in a studio apartment in
her Emeryville condominium complex and to attend a local university,
where he has an A average.
But when he went off his medication for the first time in eight
years, everything changed.
"He's been set back, because he's been ill," Ryle said.
"You can't study, because you're so paranoid. You're running.
All your life goals get put out."
Ryle heaved a sigh of relief last week when she got the call that
her son was in a hospital in Anchorage, Alaska. But after two days,
she said, he was released. She thinks he is somewhere in Anchorage
still but does not know where. She is not sure if she will be able
to get him back into treatment.
The lack of information and help available can translate into an
agonizing experience for parents and siblings. Mentally ill people
are at high risk of suicide and a higher risk of becoming crime
victims than most other people.
"It's not just frustrating. It's terrifying," Ryle said.
"And it just requires tremendous endurance."
But opponents of the bill said forcing people into care might not be
the most effective treatment option. They said proponents are simply
looking for ways to compensate for the myriad flaws in the current
mental health care system, which both sides said only treats people
when they reach a critical point.
"Most of the forced treatment is a failure to provide
meaningful services on demand," said Nancy Thomas, executive
director of the Alameda County Network of Mental Health Clients.
"It's very difficult to really get services without creating a
crisis or being deemed dangerous."Heightened stigma
The stigma of mental illness may also be heightened by forcing
someone into treatment, opponents said. That could keep people from
seeking help.
Jerry Thomas of Oakland said she does not want to take medication
for her manic depression, because she is afraid she could get caught
up in the mental health system and lose her daughter.
"When I get depressed, I listen to music, something to get me
out of that. You don't have to take medication," said Thomas, a
service advocate at the Berkeley drop-in center for the mentally
ill.
A recent set of laws authorizes some money for county mental health
departments to set up intensive, voluntary services for the mentally
ill -- an approach that has had an 84 percent success rate with
people who were often considered untreatable in the past, according
to a state report.Up to counties to decide
Bill opponents and some mental health directors said they would like
to extend that approach and fully use existing law, before forcing
people into treatment. County supervisors would decide whether to
use the bill locally, and they could do so only if voluntary
programs set up through two earlier bills are in place.
San Joaquin County, Contra Costa County and Berkeley have such
services; Alameda County does not. But officials in these places
said the money treats few of the people who really need help.
"With a properly funded system and new approaches, in terms of
how we engage people as well as new medications that are better than
the old ones -- let's try and support that before we enact laws
where the basis of the relationship is a coercive and adversarial
one," said Harvey Tureck, director of Berkeley's mental health
program.