Only Half the Answer
Caring for the homeless mentally ill often means immediate treatment for people who don’t want treatment and then providing outpatient treatment within the community over long periods. It takes both kinds. So when government starts pushing harder for increased hospitalization without pushing equally hard for the community programs, you have to ask why. That’s at the heart of reservations about legislation that is now pending in Sacramento to increase the time during which people can be held against their will by county mental hospitals.
The bill, sponsored by Assemblywoman Doris Allen (R-Cypress), has the backing of a number of mental-health organizations as well as of Los Angeles County government. It would provide that county mental-health hospitals could hold people for treatment against their will for as long as 47 days without a court hearing. The current limit, under some circumstances, is 17 days. The bill’s backers say, rightly, that many patients are hospitalized for treatment time and again because they cannot legally be held long enough for their conditions to be stabilized.
They’re right about the problem, but hospitalization is only part of the solution. Unfortunately, it seems to be the part about which the county government cares most. Los Angeles County was slow to develop solid community-based programs despite the enormous need, and it still isn’t among the leaders in innovation. Therefore the county’s vigorous support of the Allen measure is suspect among those who think that its main interest is to clear the streets of people whose behavior attracts attention.
The governor’s proposed budget contains a modest 3.9% increase in money for mental-health programs. This is not enough to meet the enormous need for community programs that, when sensitively handled, increase the odds that the mentally ill will seek help, take medication and perhaps start to feel some stake in their own survival. People who view these programs as essential would feel far more comfortable if they thought that the county supervisors were as passionate in backing increases for community care as they were in supporting the Allen bill. Assemblyman Bruce Bronzan (D-Fresno) told county officials as much during hearings on the measure.
The bill passed an Assembly committee last week. There now needs to be serious analysis of how much increased hospitalization would cost and whether the money would come at the expense of community programs. This cannot be allowed to happen. County officials could lessen the distrust if they raised their voices on that subject as well.