Public Education & Policy :: Archive

CNMHC News Alert, June 30, 2002

Amended AB 1421 (Thomson, Davis) Passes Out of Senate Health and Human Services Bill Still Proposes Expanding Forced Treatment.
Goes to the Senate Judiciary Committee

AB 1421 continues its way through the legislative process. The bill was greatly amended over the objections of the author, most importantly its vague and all inclusive criteria for commitment were deleted and replaced with current LPS criteria. However, AB 1421 still proposes an expansion of forced treatment, primarily through expanding the time periods of current law to 180 days, adding treatment non-compliance to emergency commitment criteria, and an overly broad list of people who can initiate the commitment process.

Wrong Policy Direction

AB 1421 moves California in the wrong - and unproven - mental health policy direction.

• Investing in voluntary enhanced services is the answer to the suffering that surrounds us, not more forced treatment.
  
  
• Coercive treatment is not an answer to "treatment noncompliance." Refusing treatment is often the result of forced treatment; more forced treatment is not a solution.
  
  
• Informed choice about and control over one's treatment is essential for recovery.
  
  
• Current commitment law already has the power to force treatment on people who are dangerous to themselves or others or are gravely disabled.
  
  
• Most importantly, AB 1421 ignores the experiential expertise of the clients of the state. The people for whom this direction intends to help, overwhelmingly oppose it.
  
  

The CNMHC believes mental health policy should build on California's successful voluntary programs and move in the direction of a totally voluntary community-based mental health system that safeguards human dignity and respects individual autonomy.

Driven by Discrimination

AB 1421 is being driven by false stereotypes of people with psychiatric disabilities.

The false stereotype of the violent mental patient underpins the need to increase forced treatment. On the contrary, the MacCarthur Violence Risk Assessment Study found that "the prevalence of violence among people who have been discharged from a hospital and who do not have symptoms of substance abuse is about the same as the prevalence of violence among other people living in their communities who do not have symptoms of substance abuse."

The false stereotype that people with psychiatric disabilities have no insight into their condition also fosters the need to increase forced treatment. On the contrary, the MacCarthur Treatment Competence Study found that, "Most patients hospitalized with serous mental illness have abilities similar to persons without mental illness for making treatment decisions. Taken by itself, mental illness does not invariably impair decision making capacities."

The foundation of AB 1421 is discrimination based on centuries old stereotypes that have been exploited to pass a law.

Some Specific Concerns about AB 1421

AB 1421 will create a new kind of involuntary commitment system in those counties that opt for it. It expands the criteria for emergency commitments, the time period for commitments, and proposes an overly broad list of people who can initiate a commitment process. Within the context of taking people's rights away and increasing forced treatment, the amendments attempt to build in some protections.

• AB 1421 proposes a commitment time of 180 days, which can be repeated. The amendments provide for a mandatory review at 60 day intervals of the need for commitment which the subject of the order can contest if he/she is in disagreement. Nevertheless, the commitment time frame expands current LPS periodic time frames with their protections of people's liberty and freedom of choice. The 60 day interval reviews do not mitigate the expansion of the commitment time frame.
  
  
• Allows an overly broad list of people who can initiate a petition for commitment. Permits family and many friends to file petitions for an order authorizing involuntary outpatient commitment: roommates, parents, spouse, siblings or children 18 years or older. The potential for abuse of the power to initiate a commitment, such as in a custody or divorce proceedings, or for fiduciary gain, is endless. Current commitment law was developed to eliminate this kind of abuse of power. The amendments set in place a pre-screening mechanism which lessons the power of these lay people to directly petition the court. Nevertheless, the list of persons who can petition is expansive and intimidating, encouraging friends and loved ones to become keepers.
  
  
• Adds a new emergency commitment criteria (5150) in the counties that opt for this system: noncompliance of the court order or the negotiated "voluntary" settlement as well as refusal to be examined can initiate a 72 hour hospitalization.
  
  
• In some cases, allows for a hearing without the person who is the subject of the hearing - which would especially affect homeless people who are hard to find and for whom transportation is a problem. In some cases, allows a hearing to proceed without an examination of the subject of the hearing (if the person has refused to be examined or can't be found.) This puts undue power in the hands of the named lay people who can initiate a petition.
  
  
• Has a "voluntary negotiated settlement". However, the "settlement" entails entering into the same program that court ordered people enter, and noncompliance can initiate a 772 hourhold in a hospital as well as a probable cause hearing that could lead to further incarceration. The "voluntary negotiated settlement" is not voluntary as the consequences are hospitalization. If it is leveraged by force, it is not voluntary.
  
  
• Raises constitutional issues of equal protection under the law as different counties will have different commitment laws, including time frames and emergency commitment criteria. If a person lives in a county that opts for this new involuntary commitment system, he/she will have less rights than a comparable person living in another county. A person's liberty can be curtailed in one county while it can not be in another.
  
  
• Based on New York State's experience with outpatient commitment, raises concerns that outpatient commitment may target people of color. In New York State, 42% of the client population placed under outpatient commitment are Black while Black people represent only 24% of the total client population served. Conversely, 29% of the client population placed under outpatient commitment are White while White people represent 51%of the total client population served. 60%of those placed under outpatient commitment are male, and 83%have been located in New York City. Involuntary outpatient commitment appears to be used for political not mental health reasons, and the basis for a court order seems to rely heavily on both a person's ethnicity, gender, and location.
  
  
• AB 1421 is optional for counties to adopt and is not contingent on a grant. Those research studies on outpatient commitment that suggest favorable outcomes insist that the commitment must be combined with intensive mental health services. AB 1421 adds only expanded commitment without additional services. The amended AB 1421 adds non supplanting language stating that funding can not come from a reduction of current programs. New monies should follow proven voluntary programs that are chronically underfunded and in desperate need of resources, especially given the 24 billion dollar deficit faced in California. In the last few years, California has begun to build a client-friendly outreach and service system through "AB 34" programs. These programs have engaged 84%of the difficult to serve people that have been contacted, reducing incarceration, hospitalization and homelessness significantly. Any new funds for the involuntary AB 1421 model would clearly cut into the availability of increased funding for and thus growth of voluntary services.
  
  

WRITE LETTERS TO THE SENATE JUDICIARY COMMITTEE.
THE HEARING MAY BE ON AUGUST 6.
MAKE PLANS TO COME TO THE CAPITOL

WARNING: THE AUTHOR IS TRYING TO REINSTATE THE ALL INCLUSIVE AND VAGUE COMMITMENT CRITERIA THAT WAS GUTTED FROM THE BILL.

Contact information for all of the members of the Senate Judiciary Committee.
Contact the CNMHC for travel information.

OTHER NEWS

SB 1448 (Chesbro, Arcata) Vote on Assembly Floor in Early August
SB 1448 has easily passed through all the appropriate Committees and is at the full Assembly for a vote.

Senator Chesbro's office tells us, "It is never too early to write to the Governor in support of the bill."

The intent of SB 1448 supports persons with disabilities in their efforts to restore dignity to persons whose remains are buried in gravesites on state hospital and developmental center lands, and other places, through conducting inventories, developing restoration plans for gravesites and cemeteries, and creating protocols for the future internment of patients.

SB 1448 is a product of the California Memorial Project's efforts, a collaboration of the CNMHC, Peer and Self Advocacy Unit of PAI, and People First groups.

(See Governor's Address below)

Legislature Restores Funds for The Village and AB 34 Programs

The legislature has restored much of the monies that the Governor in his May budget cut from the AB 34 Programs and the Adult System of Care funding under AB 3777 pilot programs in Los Angeles, Stanislaus and Ventura Counties. (This includes the Village in Long Beach .)

"The Governor has the authority in signing the budget to line item veto any appropriation. Those appropriations for any program which exceeds those which had been in the Governor's May Budget are always especially vulnerable. These include the $10 million of funding for the AB 2034 integrated services for homeless adults program and $7 million in funding for the AB 3777 pilots known as adults system of care in Stanislaus, Los Angeles and Ventura Counties."

"Letters should be sent immediately to the Governor as the Governor will be deciding what to sign or veto in the budget long before the budget actually reaches him. Accordingly, even if there is a long delay in the enactment of the budget, (the budget is now stalled on the Assembly floor) which is entirely possible, it is imperative that letters be sent immediately." (From California Council of Community Mental Health Agencies- State Budget Update, July 3, 2002)

These programs are voluntary, holistic services that save lives and dollars.

They have paved the road that California must travel in developing a mental health system that is client friendly and based on recovery.

Write to:
The Honorable Grey Davis
Governor of California
State Capitol Building
Sacramento, CA 95814

Senate Judiciary Committee

Judiciary meets every Tuesday at 1:30 pm in Room 4203.

JURISDICTION: Bills amending the following: a. Civil Code, except measures related to retail credit interest rates. b. Code of Civil Procedure. c. Evidence Code, except matters relating to criminal procedure. d. Family Code. e. Probate Code.

Martha Escutia - Chair
State Capitol, Room 5080
Sacramento, CA 95814
(916) 327-8315
Fax (916) 327-8755

Ray Haynes - Vice Chair
Capitol Office
State Capitol, Room 2187
Sacramento, CA 95814
Phone: (916) 445-9781
Fax: (916) 447-9008

Riverside Office
6800 Indiana Avenue, Suite 130
Riverside, CA 92506
Phone: (909) 782-4111
Fax: (909) 276-4483
E-mail: Senator.Haynes@sen.ca.gov

Dick Ackerman
Capitol Office
State Capitol, Room 4066
Sacramento, CA 95814
Phone: (916) 445-4264
Fax: (916) 445-9754

District Office:
17821 East 17th Street, Ste 180
Tustin, California 92780
Phone: (714) 573-1853
Fax: (714) 573-1859

Sheila Kuehl
State Capitol, Room 4032
Sacramento, CA 95814
(916) 445-1353
Fax (916) 324-4823

10951 W Pico Blvd. #202
Los Angeles, CA 90064
(310) 441-9084
Fax (310) 441-0724

Jack O'Connell
State Capitol, Room 5035
Sacramento, CA 95814
(916) 445-5405
Fax (916) 322-3304

228 W. Carrillo, Suite F
Santa Barbara, CA 93101
(805) 966-2296
Fax (805) 966-3707

1260 Chorro St., Suite A
San Luis Obispo, CA 93401
(805) 547-1800
Fax (805) 547-1871

89 S. California St., Suite E
Ventura, CA 93001
(805) 641-1500
Fax (805) 641-3647

Steve Peace
State Capitol, Room 3060
Sacramento, CA 95814
(916) 445-6767
Fax (916) 327-3522

7877 Parkway Drive, #1B
La Mesa, CA 91942
(619) 463-0243
Fax (619) 463-0246

Byron D. Sher
State Capitol, Room 2082
Sacramento, CA 95814
(916) 445-6747
Fax (916) 323-4529

100 Paseo de San Antonio,
Ste. 206
San Jose, CA 95113
(408) 277-9460
Fax (408) 277-9464

664 Gilman St.
Palo Alto, CA 94301
(650) 688-6374
Fax (650) 688-6378