Editorial: Forcing homeless people into mental health treatment isn’t the way to solve homelessness

A pedestrian walks past a homeless woman
A pedestrian walks past a homeless woman, left, who rests with her belongings.
(Los Angeles Times)

The tension between Los Angeles residents and the homeless people among them has only escalated as the population living on the streets has increased. Encampments sprawl across sidewalks, a nagging reminder of a humanitarian debacle that touches everyone in the city.

Hoping to solve what some observers consider a root cause of the problem, former California Assemblyman Mike Gatto has proposed a ballot measure that aims to push more homeless people with mental illnesses and addictions into treatment. His proposal would direct law enforcement to strictly enforce so-called public nuisance laws, then sentence offenders not to jail but to time in treatment programs or residential facilities. The idea is to help people who cannot help themselves “because of personal issues or a lack of awareness of available resources,” according to the official initiative.

Gatto said his measure would target crimes that are particularly offensive or intimidating, such as wandering the streets screaming at people, using illegal drugs in public, panhandling too aggressively, behaving disruptively on public transportation or squatting in a government building. People charged with these crimes will be assessed to see whether they are suffering from a substance abuse issue or mental health problems. If they are — and they are also homeless — they will be directed into a treatment program instead of being given a jail sentence.


An attorney who lives in Hollywood and rides his bike everywhere, Gatto says for years he has watched unsheltered homeless people intimidate others on the street and on public transportation. He believes their behavior constitutes “cries for help.” His measure, dubbed the California Compassionate Intervention Act, would answer those cries and also keep the streets clean and safe, he says. “It is not humane to leave people who need help alone on the streets,” his initiative states.

Frankly, it’s not humane to have anyone living on the streets. Their presence amounts to an ongoing crisis that cities and counties have yet to resolve successfully. However, while we agree that mental health and substance abuse treatment are important, we fear Gatto’s measure isn’t the solution.

His ballot measure may be a well-intentioned push to get help to people who he believes are refusing to help themselves. But sending them into the criminal justice system and forcing them into treatment — sometimes in secured facilities if they are deemed unlikely to complete the program otherwise — is not a productive approach.

Many mental health practitioners who have spent lifetimes studying these issues say forced treatment for substance abuse or mental illness is not effective. “We know that delivering those services in a forced, institutional setting — which this seems aimed at doing — actually has a very low success rate. It doesn’t result in people stabilizing over the long term,” said Anya Lawler, a policy advocate at the Western Center on Law and Poverty, in a California public radio station article on the Gatto measure.

Gatto lays out in an accompanying document the types of crimes he expects the measure to target. These would be quality-of-life crimes that are particularly egregious. But the specific penal codes the measure cites are broad, and people could be dragged in for committing much less serious crimes, such as urinating in public.

And where would people who were found to need treatment be placed? There are far too few spots available in mental health treatment facilities right now, certainly in L.A. County. Even people who desperately want one can’t get one, say county officials. Gatto’s measure would draw on the resources created by Proposition 63, the Mental Health Services Act, a surtax on millionaires that voters approved in 2004 to provide more mental health treatment in the state. But there are already too many demands on that money. It’s also being used to fund the No Place Like Home program, which offers housing along with treatment services to mentally ill homeless people. So if a person gets arrested and there are no available treatment options, where would they go?


And if they do get treatment, where would they go when it is complete? Even if they are connected with service providers, there’s no guarantee they will get shelter or housing.

Both the Western Center on Law and Poverty and the activist group Disability Rights California strongly oppose this measure. Disability Rights says the state has “criminalized mental illness and filled our jails with disproportionate numbers of people with mental disabilities” for decades. It adds, “The proposed measure would do the very same thing — shift responsibility for solving homelessness to the criminal justice system.”

While Gatto’s measure doesn’t aim to put people in jail — just the opposite, he wants to put them in treatment programs — it would indeed put people into the criminal justice system. The ballot measure says records of convictions would be expunged upon successful completion of a program.

According to the Los Angeles Homeless Services Authority, about 31,500 people have been evaluated and are currently in the county’s Coordinated Entry System. They have been assessed by case managers and have said they want housing. Let’s concentrate on getting housing and mental health services to those homeless people who are asking for them. Gatto’s measure to force homeless people into treatment should not make it to the ballot.