California’s governing law in this area, the Lanterman-Petris-Short Act ("LPS") was passed over 30 years ago. It takes no account of what has been learned about mental illnesses and the vastly improved medications that have been developed for them over the last three decades. As a result LPS now champions the "right" to be sick over the right to be well.

The California Treatment Advocacy Coalition (CTAC) is dedicated to helping change California’s laws so that they no longer prevent the provision of care to those who need it most: people so affected by mental illness that they can no longer get help for themselves. We ask you to join us in this effort.

Last year, California Assemblywoman Helen Thomson and Senator Don Perata introduced long-needed legislation to reform LPS, Assembly Bill 1800 ("AB 1800"). Assemblywoman Thomson and Senator Perata made the purpose of their legislation clear. They stated:

"It’s time to make the law work for anyone with severe mental illness, whether rich or poor, homeless or decompensating in the back bedroom of their parents’ house, who are unable to make healthy treatment choices because of their lack of insight into their illness."

CTAC’s members began supporting the proposed measure before it was even introduced. While our Coalition cannot, of course, take full credit for the entire progress of LPS reform up until now, we know our members’ efforts have paid off.

AB 1800 passed the Assembly, 53-16.

The Los Angeles Board of Supervisors unanimously resolved to support Assemblywoman Thomson and Senator Parata’s measure. The Board of Supervisors for San Francisco City and County and San Francisco Mayor Willie Brown also endorsed AB 1800.

AB 1800 gained the support of, among others, CAMI, American Association of Retired Persons, American Nurses Association California, California Judges Association, California Medical Association, California Psychiatric Association, and California State Sheriff's Association.

Perhaps most importantly, editorials calling for LPS reform and AB 1800’s passage were published by most of California's leading newspapers, including the San Francisco Chronicle and Los Angeles Times.

AB 1800 seemed destined to be law, but it was buried in a Senate Committee from which it never emerged.

This session CTAC is supporting a reform legislation package introduced by Assemblywoman Thomas and Senator Perata. At the heart of these new reforms is AB 1421, which would create an innovative and intensive supervised outpatient program for those with mental illness stuck in the "revolving door" of psychosis, incarceration, and multiple hospitalizations.

Yes, we are back this year…and we will be back next year...and the year after that...and the year after that--until our legislature hears the cries of people who suffer the countless tragedies associated with untreated mental illness.

The California Treatment Advocacy Coalition is dedicating to reforming the Lanterman-Petris-Short Act so that people too sick to access treatment voluntarily can be helped.

Please join our mission.

By reforming LPS we will save countless lives and give thousands a new chance at recovery!

Randall Hagar, Carla Jacobs & Chuck Sosebee
Coordinators
California Treatment Advocacy Coalition

Many street corners and other public spaces in California have come to resemble open-air insane asylums. Sometimes muttering obscenities and lashing out at invisible demons, the state's estimated 50,000 mentally ill homeless people often have just each other and the streets. Government pays attention only after they harm someone or otherwise break the law. Even then, the typical response--tossing them in jail, then releasing them without any required follow-up care--does nothing to redirect them into productive lives.

This week the Assembly Judiciary Committee will consider legislation by Assembly- woman Helen Thomson (D-Davis) that would solve a key part of the problem. AB 1421 would amend the Lanterman-Petris-Short Act, a well-intentioned but ultimately misguided law passed in the 1960s that bars doctors, judges and counselors from compelling seriously mentally ill people to be treated unless it can be proven they are at imminent risk of harming themselves or others.

The law was intended to protect what was seen as the civil right of mentally ill people to be free from the overzealous restraints that were common at the time--primarily medications like Thorazine and Haldol, with their harsh side effects like sedation, blurred vision, impaired memory and muscle stiffness. But today, highly effective medications with few adverse side effects greatly enhance patients' decision-making ability. The law, as outmoded as Thorazine, denies helpful medications to people who are too sick to recognize their need for care.

At a series of town hall meetings organized to support Thomson's bill in recent months, relatives of victims harmed by untreated mentally ill people have detailed how the act's original intention went awry. At a rally at UCLA earlier this month, Cindy Soto said she found little comfort in knowing that a paranoid schizophrenic who refused treatment is now in prison after plowing his Cadillac into 30 children at a Costa Mesa playground in 1999, killing Soto's daughter and another child. "Do you think he is better off in prison than he is in a treatment program?" Soto asked. "Am I better off without my daughter? There is nothing civil or right about that."

Last year, Senate President Pro Tem John Burton (D-San Francisco) successfully opposed a similar version of the bill out of fear that it would abrogate the civil rights of the mentally ill. Burton has not come out against AB 1421, however, in large part because this year's version includes due process rights and other safeguards to ensure that families and a range of mental health professionals are consulted before medication or other treatment is compelled. The state revenue drain caused by the power crisis makes it unlikely that the fiscal part of AB 1421 would be funded: a $ 50-million provision calling for "the delivery of community-based care by multidisciplinary teams of highly trained mental health professionals with staff-to-client ratios of not more than 1 to 10." Even so, changing the Lanterman-Petris-Short Act would allow public health workers to better serve the mentally ill using existing--if woefully insufficient--resources.

Adequately funding community services for the seriously mentally ill, using successful models like Long Beach's the Village and Wisconsin's PACT program, makes sense. Well-conceived continuing care--including group housing, therapy, daily supervision and job assistance--has been shown to reduce costly hospitalizations and incarcerations by more than half.

Although the fiscal crisis may have foreclosed legislative consideration of such long-term care, at the very least lawmakers should pass the cost-neutral portions of AB 1421. It is high time for Sacramento to recognize that the only civil entitlement the current law protects is the right to a future dashed by debilitating illness.

In 1995, the leadership of two organizations, the Los Angeles County Affiliates of the National Alliance for the Mentally Ill (NAMI) and the Southern California Psychiatric Society, joined together to develop a task force to explore the growing difficulty to convey needed treatment with any consistency to people so impaired by mental illness that they required involuntary help. The membership included NAMI members, psychiatrists, law enforcement officers, psychologists, attorneys, nurses, social workers, consumers, and others.

The final report of the task force, A New Vision for Mental Health Treatment Laws, can be seen in its entirety at www.psychlaws.org under state activities, California.

This report was introduced at a joint hearing of the California legislature on Feb. 16, 1999 and has since served as the basis for the need to reform.

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Treatment Advocacy Center