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KEY REFORMS OF ASSEMBLY BILL 1800

Introduced by Assemblywoman Helen Thomson on January 27, 2000, Assembly Bill 1800 will dramatically improve the provision of psychiatric care to Californians who are incapable of making informed medical decisions because of the effects of mental illness. AB1800 includes numerous improvements of the current law governing the placement in treatment and care of those overwhelmed by mental illness. Below are descriptions of AB1800’s three most significant proposed reforms.

AB1800 Expands California’s Restrictive Standard for Treatment Placement

AB1800 would allow people to be placed in psychiatric care when they are incapable of making informed medical decisions and likely to come to serious harm, including psychiatric harm, without treatment. AB1800 would permit not only those who are dangerous to themselves or others to be given needed treatment, but would allow those who are incompetent and very sick to also be helped.

More specifically, AB1800 expands the existing definition of "gravely disabled" to include someone for whom there is, as a result of a mental disorder, an acute risk of physical or psychiatric harm to the person in the absence of treatment. The bill defines "psychiatric harm" as an exacerbation or escalation of symptoms or behaviors during the 30 days prior to detention which render it more likely than not that the person will meet one of the current treatment placement standards, dangerousness or unable to provide for essential needs. Thus AB1800 will reform the law so that people with mental illness can be helped when they are obviously deteriorating towards rock bottom, rather than only after they hit it.

AB1800 Combines Determinations of Treatment Placement and Authorization

AB1800 combines hearings for both treatment and detention. Currently, one hearing (probable cause) is held to certify that the person fits the criteria for hospitalization. A separate hearing (Riese or medication hearing) is held if the person refuses medication. This hearing only occurs if the hospital applies for it. Thus, a person can be kept in a hospital, but still not be treated. AB1800 combines the decision regarding detention and the capacity to refuse medication into one automatic, up-front hearing. Thus AB1800 provides greater protection of civil rights by ensuring the patient immediate access to due process and

ensures quicker treatment for those who do not have the capacity to make informed decisions about their need for medication.

AB1800 Encourages Less Restrictive Court-Ordered Treatment in the Community

AB1800 includes an outpatient treatment option that would permit court-ordered care on an outpatient basis. Community assisted outpatient treatment (a.k.a. outpatient commitment) allows qualifying individuals to choose, in lieu of inpatient care, a 180-day period of supervised and mandatory treatment in the community. This valuable treatment mechanism leads to shorter and less frequent inpatient hospitalizations.

Community assisted outpatient treatment also compels mental health providers to care for those most overcome by mental illness. Hearing officers are able to red flag those most in need of treatment. The system must respond because there is a judicial order requiring services for each individual in community assisted outpatient treatment.

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