County adopts new tool for providing emergency services

Services will go to those gravely disabled by mental illness

REGION — San Diego County has adopted new means of providing services for those gravely disabled by mental illness by allowing extended psychiatric treatment for people who are committed involuntarily. The new tool may save the county thousands of dollars.

An individual suffering from mental illness can be involuntarily detained for treatment in a hospital or mental health clinic. To be committed involuntarily, a law enforcement officer, mental health clinician, or doctor must determine that the person is unable to care for themselves or may be a danger to themselves or others.

Currently in San Diego County, doctors have the ability to keep a person for treatment for up to 17 days. If a doctor believes that a patient will need psychiatric treatment beyond those two-and-a-half weeks, the doctor must petition for temporary conservatorship.

A temporary conservatorship appoints a person to make medical and legal decisions on behalf of another person who is deemed unable to do so on their own. In cases involving the gravely mentally ill, a temporary conservatorship gives the appointed conservator and doctor the legal authority to continue involuntary psychiatric treatment beyond 17 days.

The catch is that doctors do not have the full 17 days to decide whether or not to petition for temporary conservatorship on behalf of a patient, according to Dr. Michael Krelstein. Krelstein is the clinical director for the county Health and Human Services Agency’s Behavioral Health Services.

Doctors need to decide about the petition by the twelfth or thirteenth day of a patient’s treatment to allow the county conservator’s office enough time to investigate the case before the petition is decided in court.

According to Krelstein, less than two weeks is not enough time for a doctor to make a determination about petitioning for a temporary conservatorship. He explained that most of the time, psychiatric medications take about two weeks to fully take effect.

Because of this, doctors often end up filing temporary conservatorships that later turn out to be unnecessary when a patient responds to treatment and is ready to be discharged by the sixteenth or seventeenth day of involuntary treatment.

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County adopts new tool for providing emergency services