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Fact Sheet:
TALKING POINTS---Why LPS Must Be Reformed

In California, when it comes to getting help for someone overcome by the symptoms of mental illness -- the law is often our worst enemy. Under our law -- for people too sick to realize their own need -- there is no treatment available. Instead they eat out of dumpsters, shunning outreach attempts, hallucinating and delusional, too frequently ending in our jails and prisons.

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.

Here are just some of the reasons why LPS must be reformed:

The Lanterman Petris Short Act (LPS) was written 30 years ago before much was known about severe medical nature of mental illness. Today we know that mental illness is a brain disorder that responds to treatment. Yet for every person with these illnesses who is receiving treatment, there is another who is not. Scientific research shows that that many people with mental illness do not accept treatment voluntarily because they do not recognize they realize they are sick. This lack of insight is not willful denial but instead results from the malfunctioning of the part of the brain which regulates a person’s self-awareness and judgment. The Lanterman-Petris-Short Act must be reformed to provide treatment for people too sick to recognize their need for it.

For those who do not voluntarily access treatment because of the symptoms of their illness, the LPS Act now requires either a person with mental illness to become a danger or be unable to utilize food, shelter or clothing before they can be hospitalized. This is too late. People with mental illness who do not recognize they are ill and thus cannot or will not accept voluntary services should be provided treatment before they become a danger. The criteria of the LPS must be reformed to allow people treatment before they become dangerous.

Some people with mental illness become stuck in a "revolving door." They become ill, enter the hospital, partially improve, and then leave the hospital. Regrettably, they are not able to maintain their health after being released and decompensate (most often due to medication compliance), needing involuntary hospitalization again. If there was "Community Assisted Treatment" (AKA outpatient commitment), such patients could be required by court order to maintain their medication, housing and rehabilitation services once in the community until they have broken out of this cycle of repeated hospitalizations, homelessness and jailings. Many other states offer this treatment option for people in need of support and supervision but not the greater restrictions of inpatient care. The LPS must be reformed to provide for court-ordered outpatient treatment, thus allowing people the help they need to recover in the community.

Mental illness does not exist in a vacuum. Just like "history" is important when a doctor does a general medical exam, the history of a person’s illness is important when judges and doctors are considering the need for court-ordered treatment and conservatorships. Under LPS, courts do not typically consider psychiatric history. If the patient can "straighten up" for a few minutes they are released, no matter how great the need for treatment. The LPS must be reformed to explain that psychiatric history should be considered when making any legal determination on the need for treatment.

The current LPS system is far too complex. Currently a person refusing medication can only receive a hearing to determine whether the refusal is based on an informed decision (versus delusional thought) if the hospital applies for it. If the person is too ill to make an informed consent, needed treatment is delayed. If the person is capable of informed consent and thus most likely ineligible for court-ordered treatment, this is an abridgement of their civil rights as it delays access to immediate due process.

Moreover, while a person who is gravely disabled can be granted a needed conservatorship, a person who has been involuntarily hospitalized as "dangerous to self or others" may not. Thus the commitment of a person who continues to be suicidal must, by law, be terminated at the end of 31 days, even if they are still planning to kill themselves. This must stop. Any person who remains too seriously ill to care for themselves or accept court outpatient treatment--regardless of the criteria under which they were originally hospitalized--must be given continuing care under the conservatorship law. LPS must be reformed to provide both the protection and treatment to all who need it.

***This document was compiled by the California Treatment Advocacy Coalition***

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