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EDITORIAL: Will we abandon the mentally ill to death on the streets?

Modesto Bee - 2/10/2018

Feb. 10--Nick Petris had the best of intentions a half century ago when he applied his talent and clout to the law that to this day governs how California cares for -- and too often fails -- its mentally ill.

Petris represented Oakland and Berkeley for 40 years, ending in 1996. He set out to end the "tyrannical and oppressive system of incarcerating people so easily" in the state hospital system, which, at its height, warehoused 36,853 people.

But as he recounted in a 1989 oral history, the law "went overboard," and Petris became tormented by unintended consequences of the California Mental Health Act of 1967, better known as the Lanterman-Petris-Short Act, as they played out in the streets, jails, prisons and morgues.

The Lanterman-Petris-Short Act remains more or less as it was 51 years ago when Gov. Ronald Reagan signed it into law. With virtually every city in California -- including our Valley -- seeing the effects of homelessness and mental illness that goes untreated, this law must be revised and brought into the 21st century.

Gov. Jerry Brown and those running to replace him must focus on the issue. Whoever becomes governor should make improving the care of severely mentally ill people central to their agenda. They must not look away.

Petris was a Stanford education lawyer who died in 2013. In his oral history, Petris explained that the Lanterman-Petris-Short Act gave mentally ill people their freedom, but too often that meant they are free to wander the streets untreated.

" 'Don't I have a right to treatment?' " Petris said to the oral historian, as if channeling a mentally ill person. " 'If I had broken a leg or had a heart attack, you would be swarming all over the place with doctors and nurses and this and that. Why the hell didn't you get me treatment?' 'Well, because you resisted.' 'Well, baloney I resisted! Of course I resisted, because I didn't know what the hell I was doing.' "

Under the act, individuals must be deemed a danger to themselves or others before a 72-hour psychiatric hold can be applied; it's a bar too high and too subjective.

The Los Angeles County Board of Supervisors approved a bipartisan resolution last week calling on the Legislature to revise the act so that the severely mentally ill can be treated more effectively.

"If someone is bleeding on the corner, I wouldn't walk by," LA County Supervisor Kathryn Barger said. "We have a moral obligation."

Los Angeles Democratic Assembly members Miguel Santiago and Laura Friedman want to amend the law so that mentally ill people could be held and treated if not getting that treatment would harm or kill them. This conversation cannot end with one tweak to the 1967 law.

Why, for example, do we jail so many mentally ill people? Clearly, jails and prisons are horrible places to keep the mentally ill. Yet 36,153 men diagnosed with significant mental illness are housed in state prisons, 30 percent of the entire population. Another 2,545 women have psychiatric diagnoses, 49 percent of all prisoners. County jails house thousands more mentally ill. Many die while behind bars.

California accounts for a fourth of the nation's homeless population, 134,000, says the federal government. Up to a third are mentally ill.

Forty homeless people died in Stanislaus County last year. The causes vary -- walking in front of trains, murder, being struck by a car. But the underlying cause is often mental illness. Or hopelessness.

Voters approved Proposition 63, the Mental Health Services Act of 2004 that imposed an income surcharge on people earning $1 million or more to help pay for mental health care. It generates $2 billion-plus annually, money we will need if the law is changed.

Changing a 1967 law won't end homelessness among the mentally ill. But it could avert needless deaths, get some of the most vulnerable into treatment, and honor the good intentions this state has spent half a century trying to implement.


(c)2018 The Modesto Bee (Modesto, Calif.)

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