Woman who is mentally ill assaulted at group home, complaint says

Man who identifies as female charged with sex crime at facility for women where he also lived

 

By BILL SCHANEN IV

A 33-year-old resident of a Town of Port Washington group home for women under protective guardianships is accused in Ozaukee County Circuit Court of sexually assaulting another resident of the facility earlier this year.

Madison E. Robison was charged on July 10 with second-degree sexual assault of a person with a mental illness and is being held in the county jail in lieu of $50,000 bail.

According to a criminal complaint, Robison identifies as a female but is a biological male who is listed as such on government records. The complaint refers to Robison as a man.

On July 4, Ozaukee County sheriff’s deputy Kendra Carter was called to 33 Fields, a group home for women on Highway 33 where Robison lived with women with mental disabilities, to investigate a report from a citizen that Robison posted a video online that referenced sexual activity and had taken advantage of a resident of the facility, the complaint states.

Carter interviewed a resident of the home who is under protective guardianship and diagnosed with cognitive developmental delay, autism spectrum disorder, attention deficit hyperactivity disorder and generalized anxiety disorder. Staff members said she has the mental capacity of a person who is 6 or 7 years old and produced documentation that shows the woman is classified as a vulnerable adult who “may not understand a potential threat from others,” according to the complaint.

When questioned by Carter, the woman repeatedly denied having sex with Robison, who she referred to as a woman, but said, “I don’t like Madison bullying me,” the complaint states.

When Carter asked the woman if she knows what sex is, she replied, “It’s like when you have sex with someone and they want to, like, hurt, kind of want to hurt you.” She also said, “Sex is they say I love you. They want to be like a friend,” according to the complaint.

The woman said that although Robison has long hair like a woman she knows he has male anatomy. When asked by Carter if Robison had intercourse with her, the woman began to cry and said, “I mean, like, it was only one time. I mean that’s it,” the complaint states.

Carter than asked the woman if she wanted to have sex with Robison and she said, “No, I mean I told Madison to stop doing that because ... she was doing it hard on me. I told Madison to stop, but Madison wouldn’t stop,” adding that the incident occurred in Robison’s room in the basement of the group home, according to the complaint.

The woman said she is scared of Robison and had been staying in her room to avoid him. A group home staff member confirmed this and said Robison arrived at the group home on March 11. The complaint alleges the sexual assault occurred between March and July.

Carter talked to another woman at the group home who is under a protective guardianship and diagnosed with schizoaffective disorder, has intellectual disabilities and suffers from selective mutism due to anxiety. She is at risk for self-harm and is not allowed to be in the group home without a staff member present.

This woman told the deputy that she and Robison had sexual intercourse in the basement of the group home but it was consensual, the complaint states.

She said, “We had sex. Then he said that it was both consensual. We both agreed to this. There’s nothing wrong,” according to the complaint.

The woman said Robison asked her if she fantasizes about him and told her he loved her. She said Robison also talked about wanting to have sex with the woman he is accused of assaulting, the complaint states.

Robison admitted to having sex with the woman who said it was consensual and told Carter, “Me and a housemate, we consented on it. I don’t know who would say it was assault, but it was basically consent,” according to the complaint. 

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Woman who is mentally ill assaulted at group home, complaint says 

‘Profoundly disappointing’: Modest gains in S.F. effort to force mentally ill people into treatment

By Tom Li

Supervisor Rafael Mandelman criticized the city’s implementation of a state law intending to increase the number of people placed in conservatorship for treatment of mental illness, saying it has “not been a success.”

Lea Suzuki/S.F. Chronicle

In 2024, San Francisco was one of two California counties that jumped at the opportunity to implement a new law allowing cities to place those struggling with mental illness into involuntary medical treatment.

But 18 months after San Francisco began rolling it out, Board of Supervisors President Rafael Mandelman criticized the city’s implementation, saying it has “not been a success.”

“It’s profoundly disappointing that we are where we are,” Mandelman said during a Thursday hearing, which he had called for, of the Public Safety and Neighborhood Services Committee. Centered on behavioral health issues since he was first elected in 2018, Mandelman has sponsored several actions in support of expanding conservatorship programs. Now, he’s turned critical of the little progress that’s been made.

Passed in 2023, California Senate Bill 43 expanded the population eligible for conservatorship — a legal arrangement where the government can place people deemed unable to care for themselves into involuntary treatment — to include people whose mental illness or drug addiction inhibits their ability to keep themselves safe.

The city saw 136 temporary conservatorships in the first year of the law’s implementation — an increase of 28, or 25%, from the previous year. So far this year, the city has seen 50 additional temporary conservatorships, according to a presentation from the city’s public health and homelessness officials.

But although more than 85% of the new conservatorship cases fell under the expanded criteria of SB43, none relied solely on the new eligibility guidelines, meaning these patients would have qualified for conservatorship without the new legislation.

Mandelman called these improvements “exceedingly modest,” adding that he and other city residents have observed a persistently high number of people in critical need of mental health treatment and placements in conservatorship.

The slow progress arises from a shortage of 100 to 140 locked subacute treatment beds for those struggling with mental illness, according to Daniel Tsai, director of the city’s public health department. He also noted a lack of mixed-treatment facilities that can provide adequate care for patients who require treatment for both mental illness and addiction.

Last month, the state awarded San Francisco $27 million for 73 new treatment beds, including 57 locked subacute treatment beds and 16 dual diagnosis beds for those with both addiction and behavioral health needs. Tsai said that San Francisco currently has about 100 locked subacute beds and has bought 48 out-of-county beds, sending conserved patients as far as Southern California.

Due to the shortage of locked beds, city officials are piloting a program placing conservatorship-eligible people in shelters, while providing them with intensive treatment. The program has enrolled about five patients in the month since its launch, he added.

The program seeks to help those who, with medication or other treatments, may see improvements without locked facilities, Kelly Dearman, executive director of Department of Disability and Aging Services, explained during the hearing.

Though he’s eager to see where the pilot program goes, Mandelman said he’s skeptical about addressing a need for locked treatment facilities by placing people in shelter beds. He fears that people staying in shelters will be more likely to leave their treatment placements and engage in the same activities that led to their initial condition.

Within two years, the city plans to open an additional 57 locked beds at the Behavioral Health Center at San Francisco General Hospital, but the move would displace 82 residents who currently live at the center and receive residential care. The city’s public health department notified residents of the plans in early May, Mission Local reported, stating that no residents will be asked to move until the fall.

On Thursday afternoon, roughly 40 caregivers, family members and residents gathered outside of the center on Potrero Avenue to protest the public health department’s plans to displace those in residential care facilities. Around 90% of the residents have signed a petition calling on the city’s public health commission to reconsider the project.

“I just do not agree with closing beds to open beds,” said Jennifer Esteen, a union representative and a registered nurse who works at the center. 

While she emphasized her support for expanding locked facilities, Esteen said the city must not “displace people who are stable in order to find room for other people.” She also noted that a locked treatment facility already located inside the center has more than a dozen vacant spaces and doubts the city will be able to adequately staff and fill the expanded space.

“No current (Behavioral Health Center) resident will move without a secure and appropriate next home,” said Dr. Hillary Kunins, director of behavioral health services, said at the hearing. She added that the city’s acquisition of two assisted living facilities in Hayes Valley will help accommodate any displaced residents. 

But Esteen is skeptical of the city’s messaging, sharing that she’s seen cases where residents have not received accommodations under similar promises. She also raised concerns with the plans to move residents to privately contracted facilities, explaining that many residents were previously evicted or mistreated by similar facilities.

Rufus, left, and Ronald, residents of the Behavioral Health Center at San Francisco General Hospital, attend a protest Thursday over the city’s plan to close two floors to convert them into a fully locked psychiatric treatment facility. The plan is expected to displace people with mental health disorders who currently receive around-the-clock treatment, union members said. The protest came as the city is struggling to supply enough beds to place mentally ill people who are a danger to themselves or others into conservatorship.

Santiago Mejia/S.F. Chronicle

Antoinette Conde, the sister of a resident of the center, said she fears that moving her brother to another facility will create unnecessary stress and confusion, worsening his mental state. 

A lack of state-level oversight has driven much of this uncertainty over implementation, said Jill Nielsen, deputy director of programs at the Department of Disability and Aging Services, who also serves as the city’s public conservator. 

“Counties are operating these programs to some degree in a vacuum,” she said during the hearing.

Last year, several deputy public conservators told the Chronicle that they frequently ran into difficulty finding placements for conservatees, with many ending up on the street. These concerns came amid a push from former Mayor London Breed to aggressively increase conservatorship numbers.

Nielsen noted that the state did not give local governments additional funding to implement the law, a departure from how it provided San Francisco $4 million to implement Gov. Gavin Newsom’s mental health program, CARE Court.

Mandelman similarly advocated for more state guidance and oversight, adding that conservatorship currently “is almost entirely a local activity with very little state regulation.” 

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‘Profoundly disappointing’: Modest gains in S.F. effort to force mentally ill people into treatment 

Public Defender's Office Has 'Strong Concern' Over Gov's Approval Of Conservatorship Legislation

By Bay City News

The San Francisco Public Defender's office recently expressed "strong concern" about Gov. Gavin Newsom's approval of Senate Bill 43 -- legislation critics say will make it easier for the government to detain individuals in locked facilities who are mentally ill against their will.

SB 43, introduced by Sen. Susan Talamantes Eggman, D-Stockton, changes state conservatorship law to expand the definition of when a person is "gravely disabled," and can be involuntarily detained and conserved by authorities.

Conservatorship is a court proceeding in which a judge appoints a third party to direct the psychiatric treatment and finances of someone who has been deemed "gravely disabled."

San Francisco Mayor London Breed announced an "executive directive" last week to put SB 43 into practice as soon as possible.

"Over the last two years, we've advocated for these changes to state law to help people who cannot help themselves get the care and services they need," said Mayor London Breed on Tuesday. "I am directing all of our departments to work closely with the City Attorney's Office to ensure that there are no barriers to us getting this program into place and that we pursue all cases as aggressively as possible. There are too many people who are unwilling or unable to accept the help they need, and we need to get them into care immediately."

Deputy Public Defender Roberto Evangelista manages the SF Public Defender's Mental Health Unit spoke out against the new law in a statement released Friday.

"It defies logic that Gov. Newsom has made potentially thousands more individuals with mental illness eligible to be held against their will when our mental health treatment system is already overburdened and unable to care for those who have already been detained or conserved," he said.

"Patients face extensive wait times to access meager and appropriate treatment as it is. Individuals with mental health disabilities need more and better treatment opportunities in the community that support their independence and autonomy, not more confinement," Evangelista added.

The SF Public Defender's Mental Health Unit represents clients with mental health disabilities in both civil and criminal proceedings, including conservatorship hearings.

"SB 43's expansive and overbroad definition of 'gravely disabled' raises serious concerns that more people with mental health disabilities will lose their right to receive treatment in the community and will instead be warehoused in locked institutions in violation of the Americans with Disabilities Act (ADA)," said Deputy Public Defender Tal Klement in a statement Friday.

"The state's mental health treatment infrastructure needs drastic reform. However, bills like SB 43 that make it easier to contravene the ADA and people's civil rights are misguided. This is a step in the wrong direction," Klement added.

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Public Defender's Office Has 'Strong Concern' Over Gov's Approval Of Conservatorship Legislation

Why One Woman Has Spent 5 Years in a San Diego County Jail With No Trial

The drawn-out case against Maria Moore underscores the complexity of prosecuting someone who’s severely mentally ill, pitting criminal justice, psychiatry and conservatorships against one another. Moore’s situation also speaks to a shortage of psychiatric beds in California.

 

by Jesse Marx

Inside Las Colinas Detention and Re-entry Facility / Photo courtesy of the San Diego County Sheriff’s Department

Maria Moore has spent almost five years in a San Diego County jail without having been convicted of a crime.

More than a decade ago, the district attorney’s office charged the 81-year-old in the beating death of another elderly woman in South Bay. Moore is one of the longest-serving prisoners in San Diego County who’s yet to go on trial. And she might never.

Moore’s case attracted media attention at the time, with headlines describing her as the victim’s caretaker. That turned out to be untrue. A prosecutor later told the Superior Court that the victim, Charmian Antaramian, had met Moore a few months prior and allowed her to move in. Court records suggest that Moore had once scalded Antaramian with hot water, sold herself as the trustee of the victim’s estate and isolated her from friends.

After a concerned relative requested a welfare check, an SDPD officer crawled through a window in the house, located in the Palm City neighborhood, and found Antaramian’s body, the Star News reported. A prosecutor said police arrested Moore at a neighbor’s house while she was in the process of purchasing a Greyhound bus ticket. Moore later claimed to be a lay nun.

It was a sensational case. But its drawn-out history underscores the complexity of prosecuting someone who’s severely mentally ill, pitting criminal justice, psychiatry and conservatorships against one another. Moore’s situation also speaks to a shortage of psychiatric beds in California.

The criminal proceedings were immediately suspended so that the Superior Court could determine whether Moore was fit to stand trial. Judges waffled on this question for years, as attorneys dug up new information and medical professionals offered one opinion after another. Moore was removed from the courtroom for her outbursts on several occasions.

In 2011, a judge concluded that Moore was mentally incompetent, then changed his mind a few months later. By the following year, he was back to his original position. In 2014, a different judge came to a different conclusion and set a new arraignment date, allowing criminal proceedings to resume. Those efforts were short-lived, though.

The issue of mental competency was put to rest in 2015, when a third judge determined, at least for the time being, that Moore was unfit to participate in her criminal defense.

To keep the murder case alive, prosecutors had relied on the testimony of a psychiatrist who said Moore was “malingering with the objective of avoiding criminal prosecution.” The psychiatrist found it “extremely unlikely,” he said, that Moore has a delusional disorder because the onset is usually 40 years of age, but she had no recorded history of psychiatric problems until her arrest.

Public defenders, however, produced mental health and criminal records from New Mexico showing that Moore had been diagnosed much earlier in life as a paranoid schizophrenic. She’d also been evaluated in the late 1980s as a result of criminal proceedings at the time.

Following her arrest in 2010, Moore was mostly confined to a state psychiatric hospital in Patton, Calif., outside San Bernardino. But in 2016, after being declared unfit for trial once again, Moore was booked in jail.

For nearly the last five years, she’s lived at the Las Colinas Detention and Re-entry Facility in Santee, the primary point of intake for women prisoners in San Diego County, which is home to a psychiatric security unit.

The facility has a better reputation these days — the Washington Post Magazine called it “a gold standard for gender responsive-corrections” in 2019 — but it wasn’t always that way. The San Diego County Grand Jury visited Las Colinas in 2006 and expressed surprise at the appalling conditions — “the floor of at least one dorm was caving in,” the group wrote. A new version of the facility opened in 2014 under design principles intended to reduce “physical and psychological barriers and promote direct and constructive communication among staff and inmates,” according to one architectural firm.

Moore is not eligible for release. It’s still possible she could one day go on trial, but only under a limited set of circumstances.

After the murder case against her stalled, the county became legally responsible for Moore’s well-being. The court agreed to place her in the care of the public conservator under what’s known as an LPS conservatorship, a civil program for Californians who suffer from biological brain disorders. It’s meant to protect gravely disabled people from civil rights abuses while at the same time involuntarily committing them to treatment.

At the request of prosecutors, Moore was later placed into what’s known as a Murphy conservatorship, which is set aside for people facing an outstanding felony charge. It’s a different legal standard than, say, being found not guilty by reason of insanity and has the goal of restoring one’s mental competency.

The conservatorship undergoes regular reviews, which is why Moore appears in the sheriff’s inmate database for “mental comp” and not murder. If there is a change in her status, that could trigger a new round of criminal hearings. The idea, in other words, is to get her well enough so she can participate in her own defense.

“If the defendant becomes mentally competent after a Murphy conservatorship has been established, the conservator must certify that fact to the sheriff and the district attorney, the defendant’s attorney and the committing court,” wrote DA spokesperson Steve Walker in an email.

In the meantime, the Sheriff’s Department confirmed that Moore is waiting for an available bed at a state hospital but couldn’t immediately say for how long. “I’m sure COVID delayed the hospitals being able to receive new clients/inmates,” Lt. Amber Baggs, a department spokesperson, wrote in an email.

A state audit in 2020 took issue with how Californians with serious mental illnesses are cared for. It noted that people in conservatorships have limited treatment options because the wait time to get into a state hospital can take a year on average.

“California does have an extreme shortage of beds,” said Lisa Dailey, acting executive director of the Treatment Advocacy Center, a nonprofit based in Virginia, “and a lot of that is because something like 95 percent of beds are taken up with forensic patients, people who are facing charges or otherwise in the criminal justice system.”

Still, the amount of time Moore has spent in jail as opposed to a state hospital seems extreme, Dailey said. “I’ve never heard of a case lasting five years.”

There are a number of outstanding questions in Moore’s case, like whether her legal representatives have tried to get her into a state psychiatric hospital and for how long they’ve been pushing. It’s hard to tell from the outside, because the records from Moore’s mental health hearings are not publicly available. One of the San Diego County deputy public defenders who represented Moore and the Public Conservator’s Office did not respond to requests for comment.

Moore’s case may be an extreme one, but she’s not necessarily alone.

CalMatters recently found that 44,241 people languishing in a county jail across the state — three quarters of all inmates — haven’t been convicted of, or sentenced for, a crime. San Diego County was home to more than 2,300 such people, including, KPBS reported, 380 who’ve been in jail for more than a year and 20 who’ve been in jail for three years and counting.

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Why One Woman Has Spent 5 Years in a San Diego County Jail With No Trial

Audit: Don’t make it easier to force mentally ill Californians into treatment — just improve treatment

by Jocelyn Wiener

A homeless person in a wheelchair on Sunset Boulevard in Los Angeles. The has struggled with how to provide care for people with mental illness, but a new state audit says the solution isn't lowering the criteria for compelling mentally ill Californians to get treatment. Photo by Damian Dovarganes, AP Photo

California’s half-century-old involuntary mental health treatment law isn’t broken, but much of the system meant to serve those with serious mental illness is, state auditors concluded in a much-anticipated report released today.

Some critics have called for rewriting state law to make it easier to force people into involuntary treatment, particularly by expanding the state’s definition of “grave disability” — something many recent bills have attempted – and failed— to do.

But instead, state auditors pointed the finger at treatment systems.

The thrust of their findings, based on an audit of Los Angeles, San Francisco and Shasta counties’ mental health systems, is encapsulated in the report’s title: “California Has Not Ensured That Individuals With Serious Mental Illnesses Receive Adequate Ongoing Care.”

Among State Auditor Elaine Howle’s major findings:

• Individuals who are under conservatorship — in which a court-appointed conservator manages another person’s living situation, medical decisions and mental health treatment — have limited treatment options. Many wait an average of a year to get into state hospitals. 

• People coming off of involuntary holds do not consistently receive ongoing care — in two counties, no more than 9% of these individuals were connected to such care.

• Two-thirds of the state’s counties have not yet implemented an assisted outpatient treatment program, also known as Laura’s Law.

• A lack of transparency and communication — both about how money is spent and who is in the mental health system — gets in the way of providing needed services to individuals with serious mental illness, and keeps the public from knowing whether mental health funds are being well-spent.

Not everyone agreed with all of the audit’s major findings and recommendations. Los Angeles County’s top mental health official was especially concerned by the auditor’s unwillingness to consider changing the law to make it easier to conserve people with serious mental illness who resist treatment. He also criticized the audit for failing to show how counties like his might receive more support from the state, feeling that it instead places further restrictions on how counties can use certain mental health funds.

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Audit: Don’t make it easier to force mentally ill Californians into treatment — just improve treatment

Why are more mentally ill people wandering SF streets? Report gives answers

by Heather Knight

Supervisor Rafael Mandelman listens during a board

meeting in San Francisco.

Photo: Santiago Mejia / The Chronicle

We see them every day — the lost souls wandering into traffic, ranting into the air or sleeping in their own waste. And we wonder why there seems to be so much more untreated mental illness on the streets of San Francisco these days, and why City Hall doesn’t seem to be doing much about it.

A new report from the Board of Supervisors’ Budget and Legislative Analyst gives some alarming answers, and here’s hoping it spurs action from the politicians who could make a difference.

The report examines conservatorship — compelling mentally ill people into treatment even if they’re too sick to realize they need help.

Despite the growing crisis on our streets, the number of conservatorship referrals in San Francisco plunged by almost 50% percent between 2012-13 and 2018-19. Per capita, San Francisco has a smaller conservatorship caseload than nearby counties including San Mateo, Marin, Alameda and Contra Costa — and a smaller per capita caseload than California as a whole.

Progressives may say that’s a good thing since conservatorship arguably takes away civil liberties. But in doing so, they’re fighting, in some cases, for people’s freedom to deteriorate and die on our streets.

And we actually have more people per capita on short-term holds lasting up to 30 days than other counties, perhaps signaling San Francisco is OK with whisking troublesome people off our sidewalks but unwilling to ensure they get the long-term treatment they need. That may also explain why seeing clearly mentally ill people stumbling around our sidewalks in hospital gowns and ID bracelets is sadly not uncommon.

Supervisor Rafael Mandelman requested the report and plans to hold a hearing on the subject this fall. He knows the heartache of watching a loved one fall into a mental health crisis. He was raised by a single mother who was diagnosed with bipolar disorder, schizoaffective disorder and borderline personality disorder.

She suffered psychotic episodes, spent days in bed, and was in and out of the hospital throughout his childhood. Mandelman had to find food for himself by age 9 and left her Laguna Beach home at age 11 to be raised in San Francisco by a string of extended family, foster parents, classmates’ parents and teachers. She died in 2017, and Mandelman, his half-brother and aunt plan to scatter her ashes next month in Big Sur.

Despite his progressive bona fides, Mandelman vehemently disagrees that it’s compassionate to prioritize a very sick person’s civil liberties over helping them get better.

“It’s completely inhumane,” he said. “If you have known a friend or a loved one and seen that person in psychosis and seen how far that psychotic individual is from their true self, you cannot believe keeping that person in that state is somehow honoring their autonomy.”

The report Mandelman commissioned looks at San Francisco’s response to the state’s Lanterman-Petris-Short conservatorship law. The law, which took effect 50 years ago, was intended to end the indefinite commitment of mentally ill people against their will, but some think the pendulum swung too far the other way because of the long, complicated legal process it created to obtain a conservatorship.

“From a civil rights perspective, it’s good, but in terms of what’s best for the patient, it’s not,” said Dr. Paul Linde, who used to work in the psychiatric emergency room at San Francisco General Hospital.

Under the law, people causing an immediate danger to themselves or others or who are gravely disabled and cannot secure their own food, clothing and shelter because of serious mental illness or chronic alcoholism can be compelled into treatment.

A homeless man sleeps on the sidewalk on Ellis and Jones in San Francisco,

an area known for its encampments of chronically homeless people.

Photo: Amy Osborne / Special to The Chronicle

Under a complicated process, an initial 72-hour hold can be extended for 14 days and 30 days and then become a temporary six-month conservatorship before becoming a renewable, one-year conservatorship.

There are many safeguards in the law. Conservatorship starts with a recommendation from a psychiatrist and involves an investigation by the city’s public conservator within its Human Services Agency and a hearing before a judge.

If the one-year conservatorship is approved, the Department of Public Health is tasked with coordinating the patient’s care including placing him or her in a facility, which can range from a locked hospital to an unlocked board and care home. The public conservator makes decisions on the patient’s behalf during the conservatorship.

It’s not clear if the law itself is the problem or rather San Francisco’s loose interpretation of it. The report describes how some counties have more tolerance than others when it comes to referring patients to conservatorship. Counties also have different takes on the term “gravely disabled” and just how dire someone’s mental health must be to meet that standard.

San Francisco has a low tolerance for conservatorship. Fewer than 1 person per 10,000 San Francisco residents is part of the county’s conservatorship caseload versus more than 5.5 people per 10,000 in San Mateo and more than 4 people per 10,000 in Marin.

San Francisco in 2017-18 referred 141 people for conservatorships, a big drop from 284 people in 2012-13. Its overall caseload has decreased by 13% in that time.

The report says that one reason conservatorship may be dropping is that there aren’t enough beds to treat those who are held. The number of acute inpatient psychiatric beds at San Francisco General Hospital dropped from 88 in 2008 to 44 in 2011 — and they haven’t been restored during the economic boom. The number of sub-acute mental health care beds fell by a third between 2012-13 and 2017-18 to 241 treatment spots.

Jeff Cretan, spokesman for Mayor London Breed, said the mayor has added funding for 212 additional beds throughout the city for patients with mental illness, drug addiction or both. All those additional beds will be open by next year.

“There are too many people suffering on our streets who cannot care for themselves, and we need to get them the care and services they need,” Cretan said.

Another problem the report found is that the public conservator’s staff has shrunk due to retirements and delays in hiring, meaning there are fewer people to handle ongoing cases. The under-staffed office isn’t coordinating well with the Department of Public Health. The two departments are only now starting to share data on patients and to set regular meetings to discuss patient progress. (I recently called City Hall “sloth-like.” Perhaps that was too generous.)

Jill Nielsen, a deputy director in the Human Services Agency who oversees the conservatorship program, said she appreciates the report’s recommendations — and that she’s working to increase the coordination among various departments and that last year the number of conservatorship referrals rose slightly.

Breed has added two new positions to the public conservator’s office to allow for an expanded caseload.

Part of those expanded services will help address those who are severely drug addicted and can now be conserved under a change in the state law initiated by State Sen. Scott Wiener.

Wiener said he is glad the politics around conservatorship are slowly shifting in San Francisco, as evidenced by the Board of Supervisors voting to opt into his expanded conservatorship law.

“For the large majority of people on our streets, conservatorship is not the right answer — there are other tools that will help them like voluntary services or a shorter psychiatric hold,” Wiener said. “But for a small percentage of people on our streets, they are in such severe crisis, they can benefit from a conservatorship.”

“Allowing someone to deteriorate and die on our streets, allowing someone to sleep in their feces, that’s not progressive, it’s not compassionate, it’s frankly the opposite,” Wiener continued. “We need to help these people.”

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Why are more mentally ill people wandering SF streets? Report gives answers

Woman finds mentally ill dad sleeping on sidewalk after hospital workers sent him home in wrong cab

Robert Hill was discovered on the side of the road after being discharged from Detroit Receiving Hospital. (Photo: Fox 2)

A woman in Detroit was expecting her mentally ill father to be driven from the hospital to their shared home on Friday, but instead her dad went missing after being discharged. To her horror, she later discovered him sleeping on the sidewalk as if he didn’t have a home.

Rosalee Smith had admitted her dad, Robert Hill, to Detroit Receiving Hospital on Dec. 14 for assessment and medication management because he has bipolar schizophrenia and had been refusing treatment, according to Fox 2 Detroit. Smith, who is her dad’s legal guardian, was at work when he was due to be discharged, so she entrusted hospital workers with sending him home in a Detroit City Cab — just as she had done in the past.

Smith told Fox 2 that the hospital even gave her the taxi number — 606 — and assured her they’d help Hill inside her house. But by 2:30, he still hadn’t arrived — and Smith was shocked to receive a phone call from the hospital asking whether her father had made it home safe because he hadn’t. She called Detroit City Cab company and says they told her that her dad was a “no-show.” She added: “He was never placed in cab 606 through the Detroit City Cabs.”

So she filed a missing person’s report and went out to search spots her dad was likely to be when he was well. While driving, she spotted a man on the side of the road, sleeping under a blanket. It was her father.

“He didn’t know who I was,” Smith told Fox 2. “He barely spoke his name.” An unknown person had apparently even taken his shoes and stripped him naked. “Someone did place a blanket and food out there,” she said, “but he’s not homeless.” Disoriented and suffering from hypothermia, Hill was brought directly back to the hospital in critical condition. The police department then launched an investigation into how this could possibly happen.

The police report revealed that Hill was never actually placed in a Detroit City Cab, as the hospital had confirmed. Officers discovered via video surveillance that a staffer had placed him in a gray Chrysler Pacifica owned by a different taxi service. “Whoever brought him down … they waited for the cab,” Smith said the police told her. “The cab I guess never showed up in their time frame, and they flagged another service down that had no knowledge of his home.”

Police officers could not figure out, however, how Hill ended up on the side of the road.

Yahoo Lifestyle has reached out to Detroit Receiving Hospital and will update this story should they reply. In the meantime, a spokesperson for the facility told Fox 2 that Hill had been given “a safe discharge.”

“I just want to know what happened,” Smith told Fox 2. “Horrible. Disgusting. Is that what they do to mentally ill people or old people that have no say so in the matter?” Though Smith hadn’t heard from hospital officials as of Thursday afternoon, she said she wants to make sure they never do this to another individual.

Hill continues to recover, and Smith told Fox 2 his condition has been upgraded from serious to stable.

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Woman finds mentally ill dad sleeping on sidewalk after hospital workers sent him home in wrong cab

Assembly OKs expanded conservatorship bill for mentally ill SF homeless

SACRAMENTO — The state Assembly passed a bill Wednesday sought by San Francisco officials to expand conservatorship rules so they can have more control over who can be involuntarily held for mental-health treatment.

The bill now heads to the state Senate, which has already approved a similar version. If passed there, SB1045 by Sen. Scott Wiener, D-San Francisco, would head to Gov. Jerry Brown.

The bill would allow the Boards of Supervisors in San Francisco, San Diego and Los Angeles counties to create five-year pilot programs that expand conservatorship rules.

“This pilot will provide for the least restrictive and most clinically appropriate placement including supportive housing and wrap-around services,” said Assemblyman David Chiu, D-San Francisco, before the bill passed the Assembly by a vote of 61-0.

San Francisco Mayor London Breed and Supervisor Rafael Mandelman testified in support of the bill at the state Capitol earlier this year, saying the city needed more power to help chronically homeless people suffering from both mental illness and substance abuse.

County mental health professionals can now hospitalize people against their will for 72 hours, in what is known as a 5150 hold, if they pose a danger to themselves or others or are gravely disabled because of mental illness. A county can ask a judge for a 14-day extension to continue intensive treatment and repeat that process every 30 days.

Supporters of SB1045 say the guidelines for a hold are too strict, resulting in severely mentally ill people with drug and alcohol addiction returning to the streets. Wiener said that even the bill’s expanded criteria would apply to only 1 percent of San Francisco’s homeless population.

“It’s beyond inhumane to sit back and let these people die when we have the ability to help them,” Wiener said in June. “Our current conservatorship laws are inadequate.”

Opponents of bill, including Western Center on Law and Poverty and American Civil Liberties Union, said expanding involuntary holds is an affront to civil rights and ignores the factors that lead people to homelessness in the first place.

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Assembly OKs expanded conservatorship bill for mentally ill SF homeless

Man accused of attacking pregnant woman was deemed mentally ill months ago

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CINCINNATI — The case of a man deemed mentally ill in April after a series of violent crimes was back in court Monday charged with attacking a woman who is nine months pregnant.

Anthony Smith in accused of attacking the woman near the LeBlond pool on Riverside Drive.

“Some doctor at Summit made a decision that he was suitable to be released,” said Probate Judge Ralph Winkler.

Winker said the court has little power over what happens after a person is considered to be mentally ill.

“Once he’s mentally ill, it becomes a medical decision, not a court decision. The doctors treating him decide when or if he should be released,” Winkler said.

The victim who is nine-months pregnant said she was walking her dog when Smith attacked her. The victim said Smith attempted to rape her and when she fought back, Smith hit her over and over in the face.

The victim was beaten so severely she had to be hospitalized.

Smith was released from Summit Behavioral Center despite a series of violent attacks beginning in May of 2017.

“They do take history into account. At the end of the day with competency they look at the person’s current state of mind,” said Smith’s probate attorney, James Bogan.

Summit Behavioral Center is part of the Ohio Department of Mental Health. They did not return phone calls about the case.

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Man accused of attacking pregnant woman was deemed mentally ill months ago

City Adds Dozens Of Conservatorship Beds To Help Mentally Ill

Dozens of conservatorship beds will be added starting this month to the dozens already available in San Francisco to help the seriously mentally ill, the mayor and the city's health director announced Monday.

Starting March 12, 54 new locked psychiatric beds will be available at what's being called the San Francisco Healing Center at St. Mary's Medical Center, in addition to the 47 already available at Zuckerberg San Francisco General Hospital.

The beds will be used to help the seriously mentally ill who are placed in conservatorship and are too ill to live on their own but do not require acute hospital care.

The patients who would be helped are gravely disabled because of a mental illness or they are incompetent to stand trial.

"The mental health problems on our streets are one of the biggest issues facing San Francisco," Mayor Mark Farrell said in a statement.

Farrell said by more than doubling the number of beds, city officials will provide "real results" for the people who are ill, as well as local residents and businesses.

Currently, patients have to wait for placement in out-of-county facilities, acute care hospitals or jails.

City officials said placing patients in out-of-county facilities puts a burden on their families.

Crestwood Behavioral Health will run the program. The city is funding the program and is responsible for the placements and care of the patients.

The San Francisco Healing Center will cost $5 million a year to operate 40 beds. Fourteen beds are available for other providers to purchase for their clients, according to city officials.

The non-profit hospital system Dignity Health contributed money toward the cost of space and renovations at St. Mary's.

The University of California at San Francisco contributed $1 million to the cost of renovations and programming.

Conservatorship is a form of civil commitment by a judge after finding that the person is gravely disabled due to a serious mental illness and cannot take care of his or her basic needs.

City officials said serious mental illnesses are treatable and people who receive treatment and manage their illness can recover. Jail is not conducive to a person's recovery and when patients remain in the hospital, psychiatric emergency services back up.

Board of Supervisors president London Breed said in a statement about today's announcement, "These additional beds are critical to providing a pathway to help us get individuals who are conserved healthy, stabilized and housed for the long-term."

Breed said she has introduced legislation to decriminalize mental health conservatorship by making the city attorney and not the district attorney responsible for the cases.

Breed will be introducing legislation establishing a pilot program focused on identifying and coordinating services for the highest-risk individuals suffering from severe mental illness, substance abuse and chronic homelessness.

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City Adds Dozens Of Conservatorship Beds To Help Mentally Ill

Mentally ill people trapped in nursing homes because Louisiana lacks support programs, DOJ investigation finds

Thousands of Louisiana residents with mental illnesses are being unnecessarily housed in nursing homes, deprived of independent living and cut off from their friends and families, because the state has failed to provide them with more humane options, according to an investigation by the U.S. Department of Justice.

The Justice Department's investigation, which spanned more than two years and was detailed in a letter to Gov. John Bel Edwards this month, found that some 4,000 people with serious mental illnesses are cooped up in costly nursing homes in Louisiana. These people are often much younger and physically healthier than the typical elderly nursing home resident and have no clear path to regaining independence. They also receive minimal mental health services at the nursing facility, the report said.

The report concluded that Louisiana is in violation of state and federal laws, such as the Americans with Disabilities Act, that require states to provide options other than institutionalization to people with disabilities. Chiefly, the state should be improving access to "community-based services," which allow people to be treated in their own homes, often at a lower cost than nursing homes. The Justice Department estimated that the state is spending as much as $7,000 more per person, per year, to treat a mentally ill person in a nursing home instead of in his or her community.

"Louisiana's unnecessary reliance on nursing facilities violates the civil rights of people with serious mental illness," the report said. "By contrast, community integration will permit the State to support these individuals in settings appropriate to their needs and in a cost-effective manner."

The reason so many mentally ill people end up in nursing homes is because the state lacks an adequate supply of community-based services to treat people in their own homes. Louisiana also does not identify people with mental illnesses, once they're in the facilities, to inform them of their options and plan for a transition back to their homes, the report stated.

The Justice Department reported that 14.5 percent of people in Louisiana nursing homes have a serious mental illness, which is among the highest percentages in the nation. At least eight unnamed nursing homes in Louisiana had such high populations of mentally ill patients that people in the community identified them as psychiatric facilities instead of nursing homes, the report said.

Many of the patients interviewed over the course of the investigation told the Justice Department they hoped to be able to leave, and at least two people said they felt like "prisoners."

Remarkably, the report found that some of the people staying at the nursing homes were fairly healthy mentally and physically.

"One woman with serious mental illness experienced a crisis after the death of a family member, leading to her nursing facility admission. Four years later and still in her fifties, she remained in the nursing facility, despite needing minimal physical and psychiatric care," the report said. "She longed to go home saying, 'I would like to be normal, complete, whole again -- like I used to be.'"

In a emailed statement, Louisiana Nursing Home Association executive director Mark Berger said he had not yet fully reviewed the data to support the Justice Department's findings, which made responding to the allegations difficult. But he said the association would be working with the state to improve mental health outcomes.

"The report mentions hundreds of instances where Louisiana's nursing facilities successfully discharged residents into the community," he said. "It is important to note that nursing facility residents are voluntarily admitted and are free to leave the facility except in the rare case of a court order."

Louisiana currently offers a variety of community-based programs for the mentally ill, such as housing assistance, crisis intervention services and at-home primary health care services. But the report said there aren't enough of these resources available.

Many of the people with mental illnesses who end up at the nursing homes come from private psychiatric hospitals, where they are admitted for acute care after a crisis. State hospitals were another source, discharging 153 people with serious mental illnesses directly into nursing homes, between 2010 and 2014.

"One man's journey into the nursing facility began when he had a mental health crisis a few years ago and repeatedly called 911 about his blood pressure. Instead of connecting him to community treatment services, he was charged with abusing 911, sent to jail, and then admitted to a State hospital," the report said, adding that the man was eventually discharged to a nursing home.

"Six years later, the man, who is in his sixties, remains in the same nursing facility, even though he wants to return to the community and could do so with proper physical and psychiatric supports. This man's story is not unique."

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Mentally ill people trapped in nursing homes because Louisiana lacks support programs, DOJ investigation finds

Financial predators stalk the mentally ill

The “leech,” as he is known to Gloria and Maurice Bowersox, knew just how long he could bleed their daughter dry.

He knew that the kind 33-year-old woman had schizophrenia.

He knew how lonely she was, trying to shape an independent life in the Olathe duplex her parents provided for her.

He could get her to do just about anything he wanted: pawning anything of value, opening store charge accounts in her name that he abused, pilfering the title to her car from her parents’ house so she could borrow money on it for him.

That one got her car repossessed.

For months, against their daughter’s will, they had tried to run him off. Then they finally realized they had the legal leverage to have him evicted.

Ha!, the con man laughed at Maurice Bowersox when the father confronted him. I won’t have to leave for 90 days.

“He knew the drill,” Bowersox said. “He’d been down this road before.”

Nearly three months later, in November, he was gone, finally. But the experience left the Bowersoxes freshly shaken by a pestilence that strikes people with mental illness and their families.

The mentally ill are vulnerable. They are often repeatedly exploited by predators, by strangers, by friends and sometimes even by their guardians or family members.

“A larger problem exists than we know,” said Kiersten Adkins, the executive director of Pathway to Hope in Olathe. “So much of it is hidden.”

She hears hard tales seemingly every week, she said, and not just of mistakes in bad relationships, but of bad decisions with payday loans, casino gambling and lottery tickets.

Such incidents expose the gaps in community support that leave so many people poorly protected and often lead to homelessness.

“Imagine if we weren’t here to help her,” Gloria Bowersox said of her daughter. “She’d be on the street.”

Lack of support

Predators are hard to catch and even harder to prosecute when the victim is a willing — and often collaborating — adult.

Social service agencies and case managers struggle to manage heavy loads while confronted with too few housing and treatment options to keep their clients protected. Guardianships help, as well as payee services that give a third-party agency control of getting bills paid, but they’re imperfect.

“Folks are trying to live in the community, but there are not enough supports to keep them from being taken advantage of,” said Wyandotte County District Judge Kate Lynch, who runs a special court docket for people with mental illness.

“Some will go into (a nursing home for mental illness), but when they come out they will go into an apartment, and we don’t know where they are,” she said. “We don’t know if they’re alive.”

By the time abuse complaints reach the Kansas Department for Children and Families, said Leslie Hale, the director of adult protective services, “things have gotten pretty bad.”

Many abuses go unreported because victims feel shame or they do not see themselves as abused. They may even aid in their exploitation.

“People strive toward independence,” Hale said. “You want the most minimal intervention as possible.”

Case managers can counsel a client and ask courts to help weigh their mental capacity to make decisions, “but if they are just making bad decisions, there’s not a whole lot we can do.”

It also can be difficult to pursue criminal or even civil cases against someone who is exploiting an adult with mental illness.

“It can be hard to sort out,” said Guyla Stidmon, the executive director of the National Alliance on Mental Illness of Greater Kansas City.

“Family members and guardians take advantage of them on occasion,” she said. “Many (of the victims) suffer from paranoia, and there are not many pro bono attorneys around to help them.”

“Imagine being an arresting officer,” said Adkins of Pathway to Hope. “It’s a he-said, she-said thing, and one of them has mental illness. One is not making a lick of sense, and the other is telling a good story.”

Frustration

The police usually tried hard to help, often sharing the Bowersoxes’ frustration.

Gloria Bowersox remembers the Olathe officer who was left sorting out the scene after one of their daughter’s previous roommates was arrested for crimes unrelated to their daughter.

It became clear why the arrested man had been living there. The officer obviously had seen it before.
“He said, ‘I hate it when people take advantage of people like this.’ ”

As someone with schizophrenia, their daughter can become confused by intrusive voices or hallucinations. She can grow incoherent.

Medication will control it at times, but then fail and need adjustments.

She started showing symptoms at 17, was diagnosed at 18 and was at one point a freshman at Kansas State University studying early childhood education when they had to bring her home.

The torment for the parents is that they never know how long her better, more lucid times will last or when the illness will overcome her once more.

There have been times when she participated in a panel of people speaking to students in schools, when she was reflective and able to discuss her symptoms.

She’d been in a good stretch, Gloria Bowersox said, before the latest predator crept in.

“He got her believing that he was her protector and that we were her enemies,” she said.

The daughter willingly gave in to his control. She was constantly without a phone, believing his warnings that electronics were dangerous.

The parents cut off funds to their daughter, regretful for the hardship it might bring her but seeing it as a way to root him out.

“Stop the money,” Maurice Bowersox said, quoting their daughter’s case manager, “and the leech will let go.”

But the leech hung on hard. Their daughter began hocking most anything of value for him. She took out store charge cards in her name.

One day the Bowersoxes came home and found their house had been searched. They would learn that the title to their daughter’s car was gone.

Their daughter took out a loan on her car, and it was soon repossessed.  (Continue Reading)

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Financial predators stalk the mentally ill