In 30 years of treating and advocating for those suffering from severe psychiatric disorders, rarely have I seen the opportunity for concerned individuals to significantly and beneficially reform an entire mental health system. The current campaign by the California Treatment Advocacy Coalition (CTAC) to reform the Lanterman-Petris-Short Act (LPS) offers just such a possibility. Californians have the chance to change a law that has ended up protecting the right to be psychotic into one grounded on the indisputable certainty that the first and best solution for mental illness must be treatment. CTAC is striving to secure treatment for so many who so desperately need it. I urge you to take part in this effort.

LPS, which governs the provision of care to those overcome by mental illness, is an anachronism developed over three decades ago. It takes no account of subsequent developments concerning the cause and nature of mental illness or the effective medications now available that can control or substantially alleviate the symptoms of all but a small percentage of those suffering from psychiatric disorders.

Only in the most limited of circumstances does California’s present law allow those who refuse care because of the symptoms of mental illness to be helped. LPS prohibits the treatment of those who become delusional, hallucinatory and/or psychotic unless they are an obvious danger to others or themselves or unable to provide for the most minimal amounts of food, clothing and shelter. This standard determines when your state may help citizens unable to make rational treatment decisions because of their illness, but it is not a clinical standard. If they are not immediately dangerous, your law requires Californians to ignore thousands in need of care--that makes no sense.

CTAC is the guardian of Assemblywoman Helen Thomson’s 2001 legislative package, particularly of Assembly Bill 1421. AB 1421 would create three innovative pilot programs that would provide the intensive services of an assertive community treatment team combined with the ability to require that those most overcome by mental illness stay in treatment while living in the community. If successful, these programs could quickly be extended statewide, furnishing treatment to thousands who without help will end up homeless, in jail, or worse. And eligibility for entry into AB 1421's programs would be judged on a clinical standard--one that does make sense.

AB 1421 will encourage the use of court-ordered outpatient treatment, which is now available in California only in the most limited circumstances. I have personally used outpatient commitment 15 – 20 times in the District of Columbia (where it is available) and can attest that it is both humane and effective for individuals who are not aware of their own illness.  Once the individual understands that a court has ordered them to comply with treatment, they almost always do so.  In the years I used outpatient commitment, I never once had to have the patient involuntarily rehospitalized.  Studies of outpatient commitment in D.C. as well as other states (e.g. Arizona, Iowa, North Carolina) have shown it to be highly effective.

It is a cruel distortion of the concept of liberty to leave seriously mentally ill individuals untreated, to fend for themselves on the streets and in jails.  It is a tragedy for the individual, for their family and for society.  AB 1421 would provide those lost to mental illness with a fair chance--a bridge to recovery.  I ask you to join the California Treatment Advocacy Coalition and help secure the passage of this vital reform.

Sincerely,