Editorial from the Sacramento Bee - Published Feb. 22, 1999

The Lanterman-Petris-Short Act, California's landmark mental health reformlegislation of a generation ago, urgently needs reform of its own. Families ofthe mentally ill, mental health providers, law enforcement officials andsocial service workers have known this for some time. Legislators heard itlast week when they received a report from a state task force of doctors,police and social workers who have been looking for three years at the state'sbroken mental health system and the law upon which it is built.

When first enacted 32 years ago, California's law facilitated the release oftens of thousand of mentally ill people from state hospitals, where many had been involuntarily confined. In those days, it was easy to commit people --too easy. The task force estimates that some 70 percent of those who werelocked up in dreary, sometimes inhumane state hospitals were there for no other reason than that they were alcoholics, senile, behaved oddly or, if children, disruptively.

The Lanterman-Petris-Short Act secured for the mentally ill, and those falsely labeled as such, long-overdue due-process safeguards. It provided that people cannot be involuntarily confined unless they pose a "danger to themselves and others." Enactment of the reform led to the release from state hospitals of thousands of perfectly sane people. It also permitted the release of schizophrenics, manic depressives and others with serious mental illnesses who were supposed to receive less restrictive care in community-based programs.

That's where the reform broke down. Promised support for the truly mentally ill never materialized. Without it, many of them stopped taking their medications or walked away from treatment. Some lapsed into irrationality, were picked up by police and taken either to jail or held briefly in local mental health facilities, where they were stabilized and released into the community until they lapsed again, in an expensive, never-ending cycle.

No longer confined in hospitals, too many ended up either homeless or in jail or prison. While only 4,000 patients still reside in state hospitals, an estimated 20,000 to 30,000 mentally ill are in our state prisons and local jails. At least an equal number are homeless.

The task force has offered 12 recommendations for change. The most controversial would allow, under certain limited circumstances, involuntary treatment of people with a history of psychotic episodes. Critics of that notion, among them former mental patients who fear a return of the forced hospitalizations of the past, have raised strong objections.

But Assemblywoman Helen Thomson says equal pressure is coming from families of seriously disturbed people such as the mother who wrote Thomson about the plight of her adult schizophrenic daughter who refused to take her medication and disappeared for weeks. The desperate mother found her daughter in a homeless shelter in Oakland only after she'd been raped repeatedly. Lawmakers will have to be careful that reform does not damage the due-process rights that protect all citizens against arbitrary confinement and abuse. But on one thing all sides in the mental health debate agree: No reform will work if the state fails to make more funds available. The money California now spends to arrest, book, transport, adjudicate, house and treat the mentally ill in prisons and jails could be more usefully and humanely spent to build the comprehensive community-based mental health system that was promised by the earlier generation of reformers who passed the Lanterman-Petris-Short Act.

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