RE: https://www.washingtonpost.com/opinions/2022/10/03/newsom-california-mental-health-care/
Newsom’s Care Courts, full of promise, miss the mark.
Governor Newsom’s care court legislation aims to address the thousands of people in California experiencing homelessness or confined to prisons and jails with untreated and under-treated serious mental illnesses. Newsom is to be commended for taking on this needy and, often, helpless population.
Yet the bill, targeted toward people living with no fault psychotic disorders who are unable to care for their own self and safety, like the now infamous precedent setting Lanterman-Petris- Short (LPS) Act passed by Ronald Reagan in 1967, is full of poison pills.
The well-intentioned “rights” and cost containment based LPS legislation meant to mitigate inhumane conditions in critically underfunded mental institutions, pushed mainly by a group of young, liberal activists on the Assembly Office of Research staff, unintentionally moved California into first position of states with the highest number of people living with mental illnesses on the streets and in jails and prisons. Like many good ideas that sweep into the collective consciousness like an opioid of the masses, LPS has largely died on its own sword.
“One mental health professional who helped draft and move the original legislation said, “In our zeal to move people out of very restrictive, very inhumane places, we forgot that there were a whole variety of supports that were being provided (by institutions) and we neglected to find adequate ways of replicating them . . . we had a simplistic notion that basically what you could do is take people out of the institutions, move them into the community and provide outpatient mental health care. But what we forgot is that institutions provide people shelter, food, health care and a whole variety of other basic human needs.” https://www.latimes.com/archives/la-xpm-1987-03-22-op-14759-story.html
While Governor Newsom seeks to undo LPS damage while preserving its finest points, perplexingly, he vetoes the companion bill that would make care courts work – Senator Stern’s Bill SB 1446. SB 1446 required the consideration of a full continuum of housing and treatment guarantees into a more coordinated strategy that prioritizes high risk populations for what advocates call, “Housing That Heals.”
Having worked to help implement the New Orleans Assisted Outpatient Treatment Court of New Orleans, a form of Care Court, I can say with profound certainty that there are 2 basic elements most people living with untreated serious mental illnesses need in order to be successful in the program, *appropriate housing support based on level of functioning, and mental stability.
Mental stability takes longer to reach for some people than others. Insurance and funding restrictions dictate that all people must reach stability within 2 weeks of a Medicaid reimbursable acute psych visit, or when a person under a judge’s order meets the high bar for civil commitment determined by a doctor. Madness.
In reality, the nuts and bolts of care courts fall apart for those of us working in the trenches.
Sheriff’s service notices
In our Assisted Outpatient Treatment program, I can attest to the fact that simply meeting due process legal requirements can be a barrier for someone who does not have an address.
Assuming a person met legal criteria, how are they served to come to court? On a 5150 would they get expedited service?
We have a helluva time getting people who are homeless into Assisted Outpatient Treatment because:
- We can’t serve them if we can’t locate them. When hospitalized, they are never kept long enough to be served.
- Assuming they are served, we can’t find them for their court dates. They may not come voluntarily & obviously sheriffs can’t bring them in without a pickup location.
- Assuming somehow we can get them in the court, we can’t provide them with services unless the service provider knows where to find them.
In other words unless they are in some kind of secured or unsecured setting, hopefully #HousingThatHeals and not incarcerated, without a concurrent housing placement (or at least placement in a shelter the person is willing to stay in until housing is available), I can’t see how care courts can work.