Mayor Breed backs mental health bills to reform mandatory treatment and address street crisis: ‘It’s a shame’

Mayor London Breed is backing a package of mental health guardianship reform bills in the California legislature, expressing frustration at the deterioration of people with mental illness on the streets and calling for more options for get them on treatment.

Guardianship, a controversial issue statewide, occurs when a judge appoints a conservator to make decisions about the treatment of people with serious mental illnesses or chronic alcoholism who cannot provide for their basic needs.

Breed joined other major city mayors in California at a virtual press conference Monday in support of a package of eight bills introduced by State Senator Susan Talamantes Eggman, a Democrat from Stockton.

In an impassioned post, Breed said she was “truly committed to helping people struggling with mental illness and addiction” but “frustrated” with the lack of options to help people. She said San Francisco has tried to “fill in the gaps” in existing guardianship laws with new programs and additional voluntary treatment, but “we’re not doing enough.”

“San Francisco has invested millions to support this population, but unfortunately the current tools we have just don’t work. We are a city that leads with compassion, but what we allow to happen…is far from compassionate,” she said. “There are too many on our streets and it’s really a shame. We see people who are in crisis every day.

The bills seek to reform the Lanterman-Petris-Short (LPS) Act of 1967 which attempted to reverse the mass institutionalization of people with mental illness by creating a court-ordered treatment system based on specific requirements. A political movement has grown in recent years to reform the half-century-old law and treatment of mental health.

Gov. Gavin Newsom pushed for reform last month by proposing Care Court, which would create a civil court branch focused on mental health in each county, as a step before guardianship. The plan would require counties to provide full treatment for people with debilitating psychosis or face punishment if they fail to do so. People enrolled in the program should accept the care.

Guardianship has long been a contentious issue in California, with disability rights advocates and critics protesting that mandatory treatment violates civil liberties, citing the case of Britney Spears as an example. Critics also argue that more readily available and readily accessible voluntary treatment would be quite helpful. But supporters – including mental health professionals and families with struggling loved ones – say the laws are too limited to help those who are too ill to care for themselves and lead to deterioration. and even to the deaths of people on the streets of San Francisco and cities across California.

In an effort to provide more options, San Francisco launched a pilot program three years ago to help between 50 and 100 people struggling with serious mental illness and addiction. The city has retained just two people so far, and blames bureaucratic delays and complicated program requirements.

Breed said she has been pushing for reform of guardianship laws since 2018. She added that she has personally worked with the health department to connect people with mental illness — some with families and friends who want to take care of them – to resources and programs, only to find them. “back on the streets.”

She described a man she has known for many years who developed dementia and “started to get a little violent and confused” and ended up losing his accommodation. He is still homeless, she said.

“When I see individuals like him, I get frustrated that I can’t do more,” Breed said. “If we were out there in the same state, I would want someone to step in and do something, no doubt.”

Breed and the mayors of Sacramento, San Diego, Riverside and Fresno supported the proposed reforms.

The eight bills seek to address different issues, including “modernizing” the definition of “severe disability” under the LPS Act, the standard under which a person is retained, from the mere fact of being unable to providing one’s own food and shelter to “the inability to support themselves”. basic needs for personal or medical care or for self-protection and security.

Other bills will streamline data on outcomes for people under guardianship, assess treatment resource needs regionally, create a dashboard to track mental health treatment beds, and set up a system to help counties to meet their mental health treatment goals.

Another bill in the package would add an extra 30 days to allow someone to stabilize before considering guardianship. Other bills would require courts to review a report filed after an investigation into whether someone should be retained and review the evidence. It would also clarify that courts are authorized to prescribe medication as part of a treatment plan in assisted outpatient treatment.

California has a shortage of mental health beds compared to other states. Legislature plans to inject $6 billion into mental health reform in coming years, including more than $2.2 billion to build, purchase and rehabilitate properties to expand behavioral health treatment . These funds include $150 million, plus $55 million in federal funding, for mobile crisis support teams for people in behavioral health crisis.

Mallory Moench (her) is a staff writer for the San Francisco Chronicle. Email: [email protected]: @mallorymoench

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