Legislators propose changes to California’s conservatorship law
With support from a coalition of mayors, mental health advocates and California legislators, state Sen. Susan Talamantes Eggman (D-Stockton) unveiled two bills Wednesday that would bring changes to the state’s behavioral health system.
The laws, proponents said, are meant to address the cycle that many individuals with severe mental illness face between homelessness and treatment, filling emergency rooms and exhausting providers, while running the risk of incarceration, overdose or death.
Eggman and other speakers voiced frustration with the state’s inability to help its most vulnerable residents. An estimated 16% of adults in California live with a mental illness, but more than 60% of those individuals do not receive treatment, according to a statement from Eggman’s office.
“The system that we currently have in place is allowing people to deteriorate and fall apart and ultimately die on our streets,” said state Sen. Scott Wiener (D-San Francisco), who was co-author of one of the bills. “Despite what some advocates say, it is not progressive.”
Senate Bill 43 would make it easier to provide mental health treatment for individuals unable to care for themselves. The other bill, SB 363, would create “an internet-based dashboard,” displaying availability of psychiatric beds in facilities throughout the state.
“We’re still operating on laws that were a good idea at one point in our history and have now become obsolete and a barrier to care versus a protection for people,” said Eggman, in a reference of the state’s landmark legislation regulating the treatment of mentally ill individuals, the 1967 Lanterman-Petris-Short Act.
Similarly referring to the state’s “archaic laws,” Jessica Cruz, executive director of the National Alliance on Mental Illness California, expressed the frustration of families struggling without support to help their loved ones.
“This law is important,” Cruz said, “which is why NAMI supports it.”
By identifying a need for conservatorship reform, Eggman hopes to amend the 1967 law, which established basic criteria — being “gravely disabled,” or the inability to provide food, clothing or shelter — for intervention in the form of involuntary confinement or guardianship.
But mental health providers and families have long argued that those criteria are too narrow and leave them unable to help, leaving many with severe mental illness to languish on the streets without housing. For years, advocates have lobbied for expanding the definition of gravely disabled to include the inability to seek medical treatment.
Eggman’s bill would allow a petition of conservatorship if an individual’s mental or physical health is at “a substantial risk of serious harm” due to “a mental health disorder or substance abuse disorder.”
The life of a 31-year-old living with schizophrenia illustrates the toll of illness and the challenge of getting severely mentally ill people off the streets.
Her effort is, however, not without precedent. For years, lawmakers have introduced similar legislation that has failed to advance because of concerns that such efforts would impinge upon civil liberties. Eggman hopes that her efforts will capitalize not just on public frustration but also on the momentum established last fall with the passage of Gov. Gavin Newsom’s CARE Act, which mandates treatment for individuals with severe mental illness.
The CARE Act has met with opposition from a coalition of disability and civil rights advocates, who have filed a lawsuit seeking to block the law by arguing that the system violates due process and equal protection rights under the state Constitution. Eggman’s bill will probably face similar opposition.
“Disability Rights California opposes SB 43,” said Deb Roth, the group’s senior legislative advocate. “The bill expands the definition of ‘gravely disabled’ in a way that is highly speculative and will lead to locking more people up against their will and depriving them of fundamental rights, including privacy and liberty.”
The advocacy group calls instead for investment in “greater voluntary, culturally responsive mental health services and supports to help people get on a path to recovery while maintaining their dignity and civil rights.”
As a companion piece of legislation, SB 363 aims to provide critical information to mental health providers looking for beds in treatment facilities. The dashboard would provide real-time openings in inpatient psychiatric facilities, crisis stabilization units, residential community mental health facilities, and licensed residential alcoholism or drug abuse recovery or treatment facilities.
Such a database, according to Eggman’s office, would help “providers quickly find and secure treatment for clients in appropriate settings, reducing delays or extended stays in emergency rooms.”
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