General Resources / Legal Resources / Medical Resources / Briefing Papers / State Activity    
Hospital Closures / Preventable Tragedies / Press Room / Search Our Site / Home

San Bernardino Sun

January 2, 2004

Reprinted with permission of the author. All rights reserved.

County needs to do more on behalf of its mentally ill

Saida Dugally, the mentally ill woman profiled in The Sun's "Lost Among Us" series [Dec. 14-19], did not have to die.

Assembly Bill 1424 was signed into effect nearly twoyears before her death. Under this part of California's commitment code, the historical course of a person's illness must be considered at every step of the involuntary-treatment process. It's the law. Saida had been recently hospitalized. Her history shows how dangerous to herself she was when her illness escalated. Her most recent history also clearly established that she was gravely disabled under the most stringent interpretation of the Lanterman, Petris and Short Act, in that she was unable to utilize shelter effectively, even when it was provided to her.

Rather than being properly detained and committed to treatment, Saida appears to have been rapidly released back to the streets, into her personal hell to burn.

The Sun's series explains why San Bernardino County does not have an assisted-outpatient treatment program to which Saida could have been committed. The Board of Supervisors first must show its political will, passing a resolution to implement AB 1424's sister bill, AB 1421. This would give the county Department of Behavioral Health the political push that caused Los Angeles County to develop such a program.

If one had existed when Saida lived, she could have been discharged from the hospital into the responsibility of an intensive treatment team, which would have supervised her medication, found her housing and monitored her condition until she was truly well.

But I cannot fathom why the historical course of Saida's illness was not considered during the hospitalizations just prior to her death. San Bernardino County does not have to take any official action to implement AB 1424. It's the law. It must be followed.

Families that would like to make sure the historical course of their loved one's illness is considered if they require a "5150" evaluation and hospitalization can download a guide to the bill by putting "Guide to AB 1424" into the search engine on the Treatment Advocacy Center's website, www.psychlaws.org I would advise that they also write a brief historical outline of their relative's illness, concentrating on how their symptoms recently have changed or are similar to those displayed prior to previous hospitalizations. Provide a copy of the bill, the guide and that history to any law enforcement officer or mental health professional involved with the evaluation or subsequent court hearings.

AB 1424 also mandates that the family's information must be considered during all evaluations and court hearings. This is a landmark change, since prior to this bill, the family was so frequently ignored during the process.

California counties also have an obligation to implement assisted-outpatient treatment programs, because the treatment will keep people from revolving through the hospital, jails and streets. All debate is over. Certain people with mental illness cannot get well and stay well, unless they receive intensive treatment and supervision when they are in the community.

Citizens of San Bernardino County who wish to help the Board of Supervisors develop the political will to instruct their Department of Behavioral Health to find a way to get the law implemented can download a guide to AB 1421, also at www.psychlaws.org Don't be put off by officials who say, "We would, but it's too expensive." Intensive community treatment costs much less than ineffective, multiple hospitalizations and arrests. The lives and families they will save are priceless.

Carla Jacobs, who lives in Tustin, was a founding board member of the Treatment Advocacy Center in Arlington, Va. She co-chairs California's LPS Reform Task Force and is the editor of the report "LPS Reform: A New Vision for Mental Health Treatment Laws."