Law for who can receive involuntary treatment leaves families without options
By Jocelyn Wiener / CalMatters
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| Mark Rippee's sisters Catherine "CJ" Hanson and Linda Privatte |
Rippee has schizophrenia from a motorcycle accident, which left him blind and with severe brain damage.
Some families recognize that conservatorship – in which a
court-appointed conservator manages another person’s living situation,
medical decisions and mental health treatment — is no panacea, and
should be a last resort.
In the half-century since it
was passed, much of the debate about helping people like Rippee has
centered on the Lanterman-Petris-Short law, which set strict guidelines
for involuntary treatment of people who are determined to be a danger to
themselves or others, or gravely disabled.
While
several recent bills have sought to modify the law, focusing on the term
“gravely disabled,” a shortage of placements and a lack of funding for
county programs means there would be nowhere to send many of those who
would qualify to be conserved. Earlier this year, a state budget
proposal to increase the amount of funding for public guardians by 35
percent, or $68 million, failed.
More than 5,000 people
in the state were in permanent conservatorships, and close to 2,000
were in temporary conservatorships, as of 2016-17, according to data
collected by the Department of Health Care Services. State
administrators say the data is extremely incomplete.
Most
state hospital beds are now reserved for people in the criminal justice
system. Inmates with mental illness can wait in limbo for months or
even years in county jails before a bed opens up.
Five years ago, an average of 343 inmates with mental illness were awaiting placement. Last year, the average was 819.
“The
easiest legislative fix is to expand conservatorship,” said Chris
Koper, a legislative analyst for the California State Association of
Public Administrators, Public Guardians and Public Conservators. “It
then will appear that the Legislature is trying to do something. But as
is often the case with social problems, the wound is so much deeper than
that. And the wound will require a lot of money.”
Last
year lawmakers agreed to create a narrow five-year pilot program that
makes it easier for three counties (San Francisco, Los Angeles and San
Diego) to conserve homeless individuals with serious mental illnesses or
substance abuse disorders. The program allows courts to conserve
individuals who have been placed under a 72-hour psychiatric hold at
least eight times in a year.
Disability rights advocates insist that maintaining the
standards outlined by Lanterman-Petris-Short is essential to protect
people’s civil rights. Most people with serious mental illnesses aren’t
refusing help, they say. Appropriate help just isn’t available.
As
San Francisco has assumed new authority to place people under
conservatorships, The San Francisco Chronicle found a backlog. In a
locked ward at San Francisco General Hospital, individuals who were
conserved were waiting four months for placement in Napa State Hospital,
and even longer for a residential facility.
Even
without the pilot program, depending on where you live, public
defenders, judges, public guardians and others have different
interpretations of the law.
On April 24, 2018, Rippee’s
sister, Linda Privatte, told the Solano County Board of Supervisors
that her brother had attempted suicide more than 20 times, showing up
repeatedly to beg the board for help. This spring, she received an email
from Supervisor Skip Thomson’s office on behalf of the county,
explaining that her brother could not be conserved in part because each
time he was placed on an involuntary hold, he stabilized to the point
that he legally had to be released.
“This is not a
situation that we have ignored nor that we condone,” the letter said.
“Simply the law requires stringent standards to impose conservatorships –
standards that so far we cannot meet.”
Last fall,
dozens of mental health leaders from around the state gathered in
Sacramento to talk about the future of Lanterman-Petris-Short. They
discussed how counties lack the resources to build out a continuum of
care.
Sacramento Mayor Darrell Steinberg asked his
colleagues if the debate around involuntary treatment might be reframed
to insist that people have both a right —and an obligation —to come
indoors. That would mean that, before the state could compel people to
come indoors, they would have to have safe, appropriate placements to
offer them.
“Our North Star needs to be to end this horrific situation,” he said.
For
Rippee’s sisters, Privatte and Catherine Hanson, they worry their own
health problems might someday leave no one to fight for him.
Full Article & Source:
What should be done? Mental health conservatorship in California
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