by Alyssa Jeong Perry
There's an acoustic guitar propped up
near the center of Audrey Woolfolk's living room. It seems out of place
against the floral and lace decor, but Woolfolk likes it there. It's
the one visible trace in her Orange County condo of her only child,
Julie, now 29.
Other memories of Julie are tucked
away in photo albums and a plastic storage bin filled with childhood
mementos like a handmade quilt, little dresses and dolls.
Woolfolk said Julie had her first
psychotic break in her early 20s, back in the summer of 2011. Since
then, she's been diagnosed as having schizoaffective disorder, which causes her to suffer from symptoms of both schizophrenia and a mood disorder similar to bipolar disorder.
"It wasn't safe for me to be around
Julie anymore," Woolfolk said softly. She said she moved to a new home
in Orange County when Julie's mental health began to severely decline
after her daughter refused treatment.
For the past eight years, Julie has
been cycling in and out of jail, in and out of treatment, and on and off
the streets. But there was a time between 2014 and 2017, said Woolfolk,
when Julie was doing better. Woolfolk had become her legal guardian, known under California laws as a conservatorship.
It's a legal process in which the county or a private individual, like
Woolfolk, is appointed by a judge to handle decisions for a person with
mental illness.
In 2017, Julie petitioned to be free.
She was able to make her own decisions again. Julie refused to take her
medications, said Woolfolk, and fell apart. She ended up back on the
streets and in and out of jail.
Since last summer, Woolfolk has desperately tried to get Julie conserved again.
The debate around conservatorship
raises not only a legal question, but also an ethical one. When, if
ever, should we take away someone's civil liberties if they refuse
treatment?
These days, Woolfolk feels relieved
when she sees Julie's name and birth date listed in the L.A. County
Sheriff's Department online database where you can look up inmates. It means her daughter is alive.
HOW WE GOT HERE
In 1959, there were 37,500 patients in California's mental hospitals — a high for the state.
That number fell over the next few decades as state resources were cut and the number of psychiatric hospitals shrank.
In 1967, the treatment of people with mental illness drastically shifted when the Lanterman-Petris-Short Act (LPS) was signed into law by then-California Gov. Ronald Reagan. LPS,
which was in full effect in L.A. County by 1972, ended the ability to
institutionalize people against their will or for an indefinite amount
of time.
The law limits the involuntary
detention of people who are mentally ill to no more than 72 hours before
going before a judge. It's known as a "5150 hold", after that section of the law.
At the end of a 5150 hold, if a judge
finds a person to be gravely disabled or a danger to themselves or
others, they can be placed on a temporary hold for up to 30 days. Then
the process of a permanent conservatorship can be begin.
Researchers say
shortly after LPS was implemented, there was a significant increase in
the number of individuals with mental illness who entered into the
criminal justice system. The act is still in effect in California today.
"We have to look at, how is the
mental health disorder preventing them from obtaining their basic needs
of food, clothing and shelter?" said Connie D. Draxler, Deputy Director
of L.A. County's Office of the Public Guardian.
"And one of the things that the court will look at is, does the person
have a viable plan for obtaining their food, clothing and shelter?"
In 2014, Julie ran away from Orange
County. Woolfolk said she found her in San Francisco in a hospital after
being on the streets.
"She hadn't taken care of herself in
months," Woolfolk remembered. "Her hair was this complete mess. All she
wanted to do in that hospital was just hoard trash in a room." That's
when the courts allowed Woolfolk to become Julie's conservator.
A "permanent" conservatorship lasts
for a year, or until a clinician or the court determines the conservatee
no longer meets the legal requirements for conservatorship. A petition
to renew can happen at the end of the year, if the conservatee still
meets the legal criteria and there are no other alternatives.
By 2017, a doctor said Julie was well enough to make her own decisions, according to Woolfolk.
But within four months, she stopped taking medication, wandered the streets and ended up in the L.A. County jail system.
The cycle for Julie started all over again.
THE CYCLE
Currently, a third of California jail and prison inmates are considered to be severely mentally ill.
Last year, Woolfolk pleaded with L.A.
County Supervisors, the head of L.A. County Department of Mental Health
and L.A. County Superior judges to get her daughter conserved by the
county. Woolfolk felt she could no longer be responsible. In 2018,
Woolfolk was diagnosed with Stage 2 breast cancer.
There was a court hearing in
September to see if Julie was sick enough to be conserved. She walked
into the courtroom in DTLA, her hands shackled, wearing a yellow
jumpsuit — the color reserved for inmates with mental illness. She had
red lipstick smeared across her mouth.
The judge said the doctor did not
find that Julie was gravely disabled. He provided her treatment options,
but she refused and asked to take the time served.
This November, she was released onto the streets again. No one called Woolfolk.
And Julie went missing.
Three months later, Woolfolk still
hadn't heard from her. So she went to a neighborhood near downtown LA to
look for her and pass out missing person fliers.
THE LAWS AROUND CONSERVATORSHIP
In the past few years, California
lawmakers have discussed amending the conservatorship laws to make it
easier to conserve if someone with a serious mental illness refuses
treatment. State Senator Scott Wiener (D-SF) authored a bill, SB 1045, which passed last summer.
Under Wiener's bill, a person who has
been in a hospital or psychiatric facility due to mental illness and/or
substance abuse eight times in one year can be conserved.
"These people are not just on our
streets, these are people who are dying," Wiener said. "They are unable
to care for themselves or make decisions."
Wiener said it will only apply to the smallest fraction (50 to 100) of severely mentally ill people that need the most help.
Right now, it's only a five-year pilot program that's active in San Francisco.
But civil rights advocates, including
the American Civil Liberties Union, believe that the government should
instead do more to build supportive housing and create options for
community mental health treatment.
"We
have to try less restrictive options of supporting and stabilizing
people before we take all of their civil liberties away by conserving
them," says Susan Mizner, ACLU's disability counsel.
Others are worried that if there are
more patients being conserved, it will put a strain on an already
fragile mental health system, according to David Meyer, professor of Law
and Psychiatry at the USC School of Medicine.
"We don't have enough doctors, we
don't have enough housing," Meyers says. "So immense investments in
these things need to be made in order to meet the demand."
MOVING FORWARD
This February, Woolfolk found Julie. She was back in L.A. County jail.
Julie had been arrested for
assaulting a police officer in Glendale. In April, there was a court
hearing in Department 95, the county's mental health court. It was to
see if Julie was competent to stand trial. The judge ordered an
evaluation.
Woolfolk seemed relieved, but also reluctant.
"I wish this would end," she said. "It's a horrible cycle."
This Mother's Day, Woolfolk visited
Julie in the Twin Towers Correctional Facility, where many of the most
severely mentally ill inmates are housed.
"I would sure love to be able to give
her a big hug," Woolfolk said. "I mean, you go visit her in the jails
and there are these glass walls."
Ultimately, Woolfolk dreams of a time when her daughter's day-to-day reality might improve.
"I'm hoping that she'll get to experience a better quality of life."
Full Article & Source:
Why Californians With Severe Mental Illness Are Caught Cycling From Prison To The Streets
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