Program aims to revise conservatorship process for people with mental health issues

October 27, 2018
The San Diego Union-Tribune
By Gary Warth
October 4, 2018


Assemblywoman Lorena Gonzalez Fletcher added San Diego County to a bill that created a pilot program that could result in more people with mental health issues placed into conservatorships. (File photo)






It could be a bit easier for judges in San Diego County to order people with mental issues into conservatorship next year under a new pilot program created by a recently signed bill.

Whether it will be implemented, however, is unclear. Even the state legislator who included San Diego in the pilot program has her doubts.

“San Diego is so far off from having the services necessary for this,” state Assemblywoman Lorena Gonzalez Fletcher, D-San Diego, said about provisions in Senate Bill 1045, which was signed by Gov. Jerry Brown on Sept. 27.

The bill makes a subtle but possibly significant change in what a judge may consider when ordering a person into a conservatorship, meaning a guardian or protector is appointed to make decisions for someone deemed incapable of making responsible decisions.

Specifically, it would affect people with serious mental illnesses and substance abuse problems who have refused treatment and have been detained at least eight times in 12 months for psychiatric evaluation under Section 5150 of the California Welfare and Institutions code.

Under the bill, which becomes state law next year, a judge can consider a person’s past medical history in making the decision, including past 5150 holds, which could lead to more people ordered into conservatorship. It’s unclear whether judges can consider that history under existing law.

Advocates for the change have said it could help get treatment for more people with mental health problems, and it would be especially helpful for homeless people who refuse treatment for their mental issues.

The pilot program created by the bill has many provisions, including requirements for adequate housing and support services for people placed in conservatorship. The program could begin next year in San Diego, Los Angeles and San Francisco, but county leaders in each must agree to opt in.

State Senators Scott Wiener (D-San Francisco) and Harry Stern (D-Canoga Park) were co-authors of the bill, which originally would have affected only Los Angeles and San Francisco. Gonzalez Fletcher included San Diego when the bill was before the Appropriations Committee, which she chairs.

“I think this adds to the discussion as we start getting serious about these issues,” Gonzalez Fletcher said. “If they don’t use it, they don’t use it. But I’m so desperate to find anything we could do to nudge the county toward long-term strategies. We can only do so much at the state level.”

Gonzalez Fletcher said she has met with San Francisco Mayor London Breed about the program and believes that the Bay Area is ready for it.

“We don’t have that kind of leadership in San Diego County,” Gonzalez Fletcher said.

Gonzalez Fletcher’s husband, Nathan Fletcher, is running for for San Diego County Board of Supervisors, but she said she has not talked with him much about the bill.

Supervisor Ron Roberts, chair of the San Diego Regional Task Force on the Homeless, acknowledged that he was still trying to get up to speed on the pilot program, but disagreed that the county couldn’t meet the demands the bill requires for housing and support services.

“From what I know, it looks like something we could use as part of our tool box,” he said. “We’ve got a pretty aggressive mental health plan we’re doing right now.”

Roberts said the county has shown leadership in the area and has a proven track record of success. Project One for All, he noted, is a county program that has helped connect 800 homeless people who have mental problems with services and housing.

“I don’t know if she’s aware of the things we’re doing,” he said about Gonzalez Fletcher. Roberts acknowledged that it could be hard to find the additional housing for people in the new program, but he thought it could be done.

Some people who have followed the bill, however, are not confident it will do much good. San Diego mental health advocate Linda Mimms was troubled that a person must have had at least eight 5150 detainments in a year before a judge considers conservatorship.

“If you had to have a heart attack eight times before you’d get treatment, most likely you’d be dead,” she said.

Mimms shared her criticism of the bill on a Facebook page focused on mental health laws, where she wrote that the program should not be limited to people with addictions.

“We need a much better law that doesn’t make us jump through all these hoops to get severely mentally ill (people), both with and without addiction, into rapid treatment before extended psychosis makes their condition worse and their recovery longer and harder,” she said.

D.J. Jaffe, author of the book “Insane Consequences: How the Mental Health Industry Fails the Mentally Ill,” also posted on the page.

“What a way to pretend you are doing something when doing nothing,” he wrote about the bill.

The pilot program goes into effect Jan. 1 in San Diego, San Francisco and Los Angeles.




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