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County votes to sponsor state legislation to detain severely mentally ill people who refuse life-saving medical treatment

by City News Service • January 30, 2018

LOS ANGELES – The Los Angeles County Board of Supervisors voted Tuesday to sponsor state legislation that would allow social workers and law enforcement officers to detain severely mentally ill people who refuse life-saving medical treatment.

Under existing law, only mentally ill people who pose a danger to themselves or others or are “gravely disabled” can be held for involuntary evaluation and treatment in a psychiatric setting. The definition of gravely disabled focuses on an individual’s ability to care for his or her own physical needs, to find shelter and food to survive.

Supervisor Kathryn Barger has urged her colleagues since October to consider expanding that definition to include an inability to seek care due to a mental disorder, telling colleagues about a woman she had seen on Skid Row who was bound to die soon without being forced to accept help.

“It is quite clear that the status quo mental health care system is inefficient and in need of thoughtful change,” Barger wrote in a motion co- authored by Supervisor Mark Ridley-Thomas. “While this recommended amendment to state law will not address all of the problems local jurisdictions face, it is a critical component which will allow for the humane treatment of those who are suffering from a mental illness and at risk of substantial physical harm or death.”

The board approved the motion on a 4-1 vote, with Supervisor Sheila Kuehl dissenting. Kuehl has expressed concern that expanding the definition could violate the civil rights of homeless people. She also warned that a county-sponsored bill to change state law would be unlikely to pass, citing her past experience as chair of the state Senate’s Health and Human Services Committee.

According to a Jan. 10 report to the board from Department of Mental Health Director Dr. Jonathan Sherin, a “significant number” of the 831 deaths of homeless people in Los Angeles County in 2017 were due to preventable or treatable medical conditions, listing cardiovascular disease, pneumonia, diabetes, cancer, cirrhosis and severe bacterial infections as some of the causes.

A survey of mental health leaders showed widespread support for amending the definition of grave disability, according to that report.

Sherin included data on homeless deaths, which have been rising at a faster pace than homelessness itself, jumping by more than 80 percent in the last four years, from 458 in 2013 to 831 in 2017. During that same period, the number of homeless individuals countywide has increased by roughly 46 percent, based on a point-in-time count in January of each year.

The data did not indicate how many of those who died were suffering from a mental illness that may have impaired their ability to seek treatment.

However, the percentage of homeless individuals suffering from mental illness has been increasing and an estimated 30 percent of the county’s homeless population suffers from serious mental illness, according to data from the Los Angeles Homeless Services Authority.

“In order to meet our ethical obligations to this population and our communities, it is our stance that the county should pursue legislation that would adjust the definition of gravely disabled to include individuals with serious physical health needs,” Sherin said.

The motion suggests amending existing language that defines gravely disabled as “a condition in which a person, as a result of a mental health disorder, is unable to provide for his or her basic personal needs for food, clothing, shelter” to add “or medical treatment where the lack or failure of such treatment results in substantial physical harm or death.”

The definition is similar to that followed by 37 states, according to the motion.

Proponents argue that the change would be “constitutionally precise” and require a finding of physical harm so the criteria could not be misapplied. Grave disability would still have to be proven beyond a reasonable doubt in order to enforce treatment.

“Allowing the most vulnerable to languish and even die on the streets without a lifeline to medical care is inhumane,” Barger said. “With (Tuesday’s) action, we can move forward to employ an effective approach to help deliver lifesaving treatment and care for those desperately in need and add California to 37 other states who consider medical treatment a basic human need for those suffering from a mental illness.”

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Filed Under: Health, Politics

5 comments for "County votes to sponsor state legislation to detain severely mentally ill people who refuse life-saving medical treatment"

  1. Pete says

    January 31, 2018 at 10:04 pm

    Focus on the abused children you have ignored that are now dead! Where is that topic? Look at Gabriel! Great program but all the funds the government just gave for a bullshit program could be used to help monitor the social workers jobs and the sheriff response to abuse of children…. Dont you think? If anyone cares that is.

  2. Outspoken Dep says

    January 31, 2018 at 9:20 pm

    The bill is one of the stupidest bills to be thought of. How is a law enforcement officer to know of someone’s medical history, if they are fit to be on their own? Again wanting cops to put.another hat on to put a bandaid on a gunshot wound. How about try and fix the homeless issue? Provide more resources for those folks instead of bogging down an over run emergency room.

    And beside if a person wants to refuse treatment, necessary medical treatment i.e decent amount of bleeding, an obvious injury but they refuse a cop can do the hold, 5150 WIC, now will it last for the 72hrs probably not. More than likely to fix the problem then the doc will let them go.

    And why is this just for the “homeless?”

    This will do nothing.but cause more problems.

  3. Reader says

    January 31, 2018 at 11:02 am

    This law WILL NOT assist the homeless, in fact, this gives law enforcement MORE leeway to detain, arrest, and go after people without their consent because what? They are “mentally incapable” of taking care of themselves? Gimme a break.

  4. Alexis says

    January 31, 2018 at 6:46 am

    “Social workers and law enforcement officers to detain severely mentally ill people who refuse life saving medical treatment!” You need to clean house in both departments before you start rounding up the homeless. Oh, I could go on for days about this sham, but no one is listening.

  5. Tim Scott says

    January 31, 2018 at 12:49 am

    While this seems like a “lifeline to treatment” as described by Kathleen Barger, it seems far more likely to be a play to her right wing constituents that want to see cops handed the authority to round up the homeless with a simple “well, you look crazy and off to jail you go.”

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