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TO: California Treatment Advocacy Coalition
FROM: Carla Jacobs
DATE: May 1, 2001
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MORE MUSCLE FROM THE TIMES--AND FROM US

After reading the Times' strong endorsement eight days ago of AB 1421, we asked, "What could be better than a Los Angeles Times editorial lauding the bill and calling for its passage?"

Yesterday that inestimable publication responded, "How about two?"

And California's largest paper did not stop at just reinforcing its backing of AB 1421. The Times also embraced two other components of Assemblywoman Helen Thomson's reform package, AB 1422 (various measures to improve the mental health system's ability to provide treatment) and AB 1424 (requiring the consideration of psychiatric history at treatment placement hearings).

The editorial is framed around the story of Chris Hagar. Randall Hagar, CTAC's Co-Coordinator, is Chris' Dad. In our battle to get help for those that we love, sometimes our stories are the best tool that we have. Thank you Randall. Sharing as you did took a lot of heart.

And Randall is not the only CTAC member influencing the press. After the editorial--which is the first item below--you will find a striking letter by Brenda Scott from the LA Times. And after that is another letter from the same paper by John King, a physician who works with the homeless and has come to what should be for all an obvious conclusion. Finally there is one from the Long Beach Press Telegram that we haven't had the chance to send you (things have been moving so fast).

As these letters prove, we can make (and are making) an impact.

Don't forget--the Judiciary Committee is scheduled to consider our most important reform bill (AB 1421) on May 8, one week from today.

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Los Angeles Times
April 30, 2001, Monday

Editorial

MAKE CHRIS TAKE HIS 'MEDS'

On any given day, about 50,000 severely mentally ill homeless people roam California's streets, rummaging through trash bins, doing battle with invisible demons and occasionally inflicting harm on very real citizens. They do so largely because laws crafted decades ago put their "civil right" to be free ahead of society's right to compel them to be treated.

These well-intentioned laws made some sense when they were passed, in the 1960s. Then, the awful side effects of some psychiatric medications turned patients into virtual zombies, blurring their vision, stiffening their muscles and dulling their memories. Better medications are available today; as a result, lawmakers will have a chance soon to make California safer and saner.

In and Out of Jail

Who are the new proposals aimed at? Meet 22-year-old Chris Hagar, who is now locked up in the Sacramento Mental Health Treatment Center. Since age 15 Hagar has cycled in and out of six jails and mental hospitals, tormented by paranoid schizophrenia. He'd steal food from mom-and-pop grocery stores and promptly get arrested. He'd assault his parents and others. He'd break into a car to escape shadowy stalkers.

Before the onset of his illness, Hagar was a smart kid with a keen sense of humor who excelled at life. When he was 12, he joined the San Francisco Boys Chorus and was quickly promoted to master singer because of his perfect pitch and musical memory. He toured Europe and won second place in an international competition against dozens of other nations; he ran a business airbrushing fine art on T-shirts.

At 15, his illness was diagnosed as schizophrenia with psychotic symptoms and agitated depression, but his dreams never died. Just last week he told his father how much he wants to work again.

The problem is that when he is not compelled to take his medicine, he doesn't. When he doesn't take his "meds," he gets wildly aggressive. Seventeen times Hagar has attacked his family. He once bashed his father with a chair at the suggestion that soldiers weren't really hunting him down. Two months ago, at a treatment center, he kicked a fellow patient in the face. He was expelled and spent a week in the Sacramento County jail.

Three Problems

Hagar and thousands like him are falling through California's increasingly tattered safety net because of critical flaws in the system. To start mending it, Assemblywoman Helen Thomson (D-Davis) has introduced three good bills, all of which will come up for crucial votes in the Assembly in the next two weeks. Each addresses a specific problem:

* Because Hagar is now on medication, he shows no imminent danger to himself or others and thus can't be monitored against his will or detained. Soon, a judge must release him. At best, the court will be able to supply him with the address of a good mental health clinic, which he's unlikely to use.

Thomson's first bill, AB 1421, would allow judges to compel Hagar to accept follow-up care and outpatient treatment and would provide for social workers and psychiatrists to administer it. Such treatment could be compelled only after judges, mental health professionals and family members decided that without it, a severely mentally ill person would be at "high risk" of injury to self or others.

* Often when Hagar gets out, he high-tails it to counties far from home. Judges and mental health workers there have no history on him. They don't know crucial details about the medication regimen that brings him back to reality: that one antipsychotic medication, risperidone, doesn't help him at all but another, olanzapine, does.

Thomson's AB 1424 would get at this problem by requiring courts to consider psychiatric histories when sentencing and would computerize and streamline an existing database of mentally ill people in the state who had been arrested for violent crimes. The database would replace the state's woefully ineffective, mostly paper-based mental health information system, rightly derided as the MISS system because it misses so much.

* Counties often fail to care for Hagar and others like him because their mental health, law enforcement and judicial systems are ineffective. Thomson's third bill, AB 1422, would bring business leaders together with doctors, law enforcement, psychiatrists, homeless advocates, and others in a new mental health commission. By reaching beyond the usual bureaucracies, this approach could better succeed in identifying the most cost-effective treatments for people like Chris Hagar.

Regaining a Balance

Economic considerations are important because Sacramento now spends $ 2 billion a year on mental health services without requiring counties to show they are using it prudently. AB 1422 would require state Mental Health Director Stephen Mayberg to come up with "best practices" and accountability measures. Taxpayers would have a much better idea whether the money is being used wisely.

It is a symptom of this nation's goodness that it protects the rights and liberties of the mentally ill. In this noble pursuit, we have granted some genuinely helpless individuals the liberty to harm themselves, and others, in never-ending cycles. Free people should always hesitate to diminish anyone's civil liberties, but in this instance there's good reason.

Chris' parents love him. That is why they take no joy in knowing that a Sacramento County judge is likely to release him any day now. They know it will be only months at best before Chris goes off medication and breaks the law again.

What will it be this time? Stealing beer and chips from a convenience store? Something more serious? As always, his parents pray no one is hurt.

There's not much more they can do--until our legislators approve these firm but ultimately compassionate measures.

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Los Angeles Times
April 27, 2001, Friday,

Letters Desk

In response to your editorial on AB 1421, which would amend the Lanterman-Petris-Short Act: I can see how it affects the families. It affected my own family when I was a young girl. My mother was in Patton State Hospital in the '60s and early '70s. She was schizophrenic and bipolar. My father would take her to the hospital when we were children. In 1972, after the laws changed, she could leave when she chose, and she committed suicide and died on Christmas Eve in 1972 when I was 14 years old. She left five children.

She should have been in the hospital. She might be alive today if the laws had not changed. I want people to be aware that in some cases our relatives are better off getting the treatment they don't understand they need.

I wonder if my mother would have ended up on the streets like so many others. When the state hospitals closed, where do you think they went? Home? Unfortunately our society stigmatizes these people, and they are treated as subhuman. We need to recognize that this could happen to anyone. You or me, your mother or mine.

BRENDA SCOTT
Hemet

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Los Angeles Times
April 29, 2001, Sunday, Ventura County Edition

Letter's Desk�

TREATING THE MENTALLY ILL

* I support passage of Assembly Bill 1421 to amend the Lanterman-Petris-Short Act, which bars doctors, judges and counselors from compelling seriously mentally ill people to be treated unless it can be proven they are a danger to themselves or others. As a physician in private practice, as a volunteer in clinics and homeless shelters, and as a concerned citizen I strongly recommend it.

Many of our homeless, vagrant population are mentally ill. They are unable to care for themselves and demean a society that should be more caring of the less fortunate.

Our public health organizations track, treat and sometimes detain those who are a danger to themselves and likely to contribute to the spread of disease. It is my opinion that we have a similar obligation to those who have mental illness and to the welfare of the community as a whole.

JOHN A. KING
Ojai

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Long Beach Press Telegram
Wednesday, March 21, 2001

Letters

Homeless

Congratulations to the Press Telegram for highlighting the hidden tragedy of homeless children.

My sister-in-law, who suffered schizophrenia, lived for nearly two years on the streets with her little boy. Her problem was not a lack of housing or job skills. She and the child were on the streets because her broken brain pursued her delusions and paranoia rather than the medication and treatment that could have helped.

Our hands were tied. It was her civil right to live on the streets with her son. An antiquated law, known as the LPS Act, required that she be dangerous before help could be given.

When she finally qualified for treatment, it was too late. She taxied 75 miles, with the child in tow, and brutally murdered her 78-year-old mother.

For the mentally ill population, we will never be able to stem homelessness until we face up to the fact that some are just too ill to accept even the best of support services. For these, and their children, we must first reform this vicious law.

Last year Assemblywoman Helen Thomson introduced a bill to prevent such tragedies. Passing the Assembly with a large majority, it was held in the Senate without vote. Legislation will be introduced again this year. For the children�s sake, let�s pray it is enacted.

Carla Jacobs
Long Beach

Jacobs is a board member of the National Alliance for the Mentally Ill.

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You can find out who your Assemblyperson is at:

http://www.assembly.ca.gov/acs/acsframeset9text.htm

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California Treatment Advocacy Coalition
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