Last month, I used Spears' very public mental torment to illustrate how a 40-year-old California law created to give mental patients dignity and legal protection has backfired. The bar is now so high for mandatory treatment that it's almost impossible to order mental patients to get care unless they physically endanger themselves or others, or cross the line from irrational to illegal so that jail becomes their mental hospital. The 1969 law was "the Magna Carta of mental healthcare," but in later years, even its coauthor worried that the pendulum had swung too far.
My in-box was chockablock with e-mails from mental health nurses, patients, social workers -- but mostly desperate and fearful families.
A former colleague's relative went off the rails, but the family could do nothing because the man didn't believe there was anything wrong with him. Nancy, in Georgia, whose son is bipolar, told me, "There is no more frustrating situation than watching while one's child refuses all help and treatment because they do not have the insight to realize they have a mental illness."
Two stories moved me especially. Jennifer e-mailed from Florida, where she takes care of her four children and her ailing mother. Her homeless, depressed 31-year-old brother, Kevin, hanged himself in El Cajon a week before Christmas. He had already tried to commit suicide twice, with dozens of pills, in a single week. The first time, a friend found Kevin unconscious. After the second time, he checked himself into the hospital and was put on a 72-hour involuntary "hold." It was horrible, he told his sister; he didn't want to stay. Jennifer tried to learn more about his condition and was told that she wasn't legally entitled. He hanged himself two weeks and change after he left the hospital, on Dec. 18.
"I was so upset that they didn't keep him longer," Jennifer told me. "He needed help and, had he gotten it, he would be here today. He should have been evaluated longer."
Then there's the Central Valley man we'll call Charles. His wife developed psychotic depression. Medication made her "a responsible individual," he told me. But then she stopped taking her meds and stopped seeing her psychiatrist.
Charles' seven-page e-mail chronicled a decade of anguish. "I soon found out that the mentally ill have more rights ... than the average citizen." When Charles' wife was hospitalized last year in bad mental and physical shape, the emergency room doctor said "he understood my frustration, but his hands were tied." She seemed lucid enough; she wanted out.
Charles raised a lump in my throat with this: "Mental illness has stolen the vibrant spirit and personality of a daughter, wife and mother. ... Even though my wife is no longer the woman I married, I still love her [but] the stress is overwhelming." Why, he asked, haven't lawmakers fixed this?
One man who's made mental healthcare his concern is Democrat Darrell Steinberg, the next state Senate president pro tem. He led the charge for Proposition 63, which raised over a billion bucks for community mental health, taxing millionaires like Britney Spears to help people who may share her mental state but not her bank balance.
Forty years ago, when the state made it harder to commit people against their will, it pledged to create more local outpatient mental services. Because it didn't make good on its pledge, there's never been much available in the way of care between "crazy" and "commitment." It's the missing link in mental health, and Steinberg thinks Proposition 63 can fill it. But "it's going to take time," he told me. "You don't make up for 40 years of neglect in one or two or three years."
But even a year sounds like a lifetime for Charles and families like his, who love and suffer in equal measure.