The fact that the driver of the 1967 Cadillac had a history of mental illness should not be a surprise. Vehicular violence and general violence toward children by individuals with untreated mental illnesses occur regularly in communities around the country. Sadly, Californians have read about several other similar preventable incidents involving fellow citizens with untreated severe mental illnesses over the years. In 1998, for example, Eric Ayran Umali was sentenced to 21 years in prison for repeatedly slashing Bertha Valencia, a nine-year-old girl who had stuck her tongue out at him earlier in the day. Umali left Valencia with more than 30 cuts and stab wounds that exposed her intestines and cut her bones. Patrick Edward Purdy killed five Indochinese children in a Stockton schoolyard in 1989 and wounded thirty other people at that time with an assault rifle before committing suicide. After allegedly driving up and down the street trying to hit people, David Hasson drove his car recklessly into another car killing three children. Darlin June Cromer kidnapped Reginald Williams, five, from his home and strangled him. Cromer’s delusions led her to believe that African Americans like Williams should be eaten for health reasons.

These incidents occur because nearly half of those who have schizophrenia or manic-depressive illness lack insight into their illness. They do not realize they are sick and in need of treatment because their brain disease has affected their ability for complete self-awareness. They do not recognize that the symptoms of their illness – hallucinations, delusions, paranoia, and withdrawal – are, in fact, symptoms. Since they do not believe they are sick, they refuse to take their medication, and this is perfectly acceptable in the eyes of the current law.

When individuals refuse treatment, California’s assisted treatment law prevents them from receiving treatment until it is too late. The law prohibits treating individuals over objection, until they pose a danger to self or others. In other words, an individual must be careening through a fence of a preschool playground before any medical intervention will be prescribed.

Many states have abandoned the dangerousness standard for treatment, which California still maintains. These states consider factors such as deteriorating to dangerousness, being unaware of a need for treatment, having a history of medication non-compliance or violence. Abrams had a history of aggressive and violent behavior. In 1994, he was arrested on charges of stalking a pregnant, married neighbor. He spent two months in jail during which time he received medication for his illness. Because his mental state had improved, he was offered probation for time served before a psychiatrist could evaluate him for follow-up treatment. Abrams was not required to continue taking his medication after his release and he was never monitored to see how he was doing in the community. He also was convicted of misdemeanor child cruelty for whipping his teen-age daughter with a belt.

The Lanterman-Petris Short (LPS) Act, which governs the treatment of California’s mentally ill, is based on outdated, nonscientific ideas, not on current scientific studies. The consequences of the failure of the LPS Act have been, and continue to be, tragic for California's citizens.

The fact that under LPS individuals with severe mental illnesses can be treated involuntarily only under the most extreme circumstances has had, and continues to have, dire consequences for Californians:

• At least one-third of homeless individuals are severely mentally ill and not being treated. In California, their total number has been estimated to be 49,500, approximately the same as the total population of Davis or San Rafael. This is an urban disaster, especially in cities such as San Francisco and Santa Monica.
• Approximately 10 percent of inmates of California jails and prisons are severely mentally ill. Many of them were arrested for minor crimes that were the direct consequence of their untreated illness.
• A California study reported that police now spend more time responding to "mental health crises" than to robbery calls. When police confront severely mentally ill individuals who are out of control, the encounter sometimes turns deadly. This happened in 1998, for example, when the police killed Tom Neville in Fresno, Brian Burgos in Los Angeles, Han Huynh in Ventura, and Martin Arias and Doeon Lifton in San Francisco.
• Suicide and accidental deaths are increased 10 to 15 times in individuals with severe mental illnesses who are not being treated.
• Individuals with severe mental illnesses who were not being treated were 2.7 times more likely to be a victim of a violent crime in one study; in another study, severely mentally ill women were 2 to 3 times more likely to have been raped.
• Nationally, it has been reported that approximately 1,000 homicides each year are committed by individuals with severe mental illnesses, almost all of whom were not being treated. California has 12 percent of the nation's population, which suggests that there are approximately 120 homicides each year in California committed by individuals with severe mental illnesses who are not being treated.

In February, Assemblywoman Helen Thomson took a bold step in the right direction to begin reversing this deadly course by holding a hearing on the criminalization of the untreated mentally ill before the Assembly Select Committee on Mental Health and the Senate Select Committee on Developmental Disabilities and Mental Health. She, like many others around the country, rightly recognizes that mandatory treatment for those too ill to understand their need for treatment is a much more humane intervention than what we have now: mandatory non-treatment.

The legal standard for assisted treatment should be the need for medical care, not dangerousness. Society has an obligation to save people from degradation, not just death. This does not mean that we will have to reopen all the psychiatric hospitals that have closed as a result of deinstitutionalization. Most individuals with severe mental illnesses who have experienced severe deterioration in rational thought can live in the community with the proper medications. For some, living in the community must be conditioned on continued medication compliance.

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