A report<\/a> by Sacramento advocacy group Quarter Turn Strategies, published in January, found that counties, including San Diego, do not accept evaluation requests under this law, instead directing inquiries to first responders, whether law enforcement officers or mental health response teams.<\/p>\nDespite being law since 1967, 5200 is \u201clargely unavailable in practice,\u201d the report says, and most counties lack \u201cwritten policies, procedures, or publicly accessible processes\u201d for handling petitions.<\/p>\n
This gap has real consequences, the authors argue. The mental health system is largely crisis-driven, with interventions happening in response to an emergency need.<\/p>\n
There is disagreement around how well this emergency system works.<\/p>\n
In a statement this week, a spokesperson for the county\u2019s behavioral health department said that existing resources are adequate to get those with serious mental health needs into treatment.<\/p>\n
\u201cIn modern practice, the county\u2019s mobile crisis clinicians already conduct these on-scene assessments,\u201d the statement said. \u201cThese teams receive extensive training to determine whether someone should be brought to an LPS-designated facility for further evaluation and treatment.\u201d<\/p>\n
LPS is short for the Lanterman Petris Short Act, legislation passed in 1967 that governs involuntary treatment statewide.<\/p>\n
But a growing number of people, like Cenedella, say those who seem to need the most help often don\u2019t get the comprehensive mental health evaluations that could lead to appropriate care.<\/p>\n
Instead of requiring county behavioral health departments to get involved directly, the bill proposes that such requests be added to the existing CARE Court process.<\/p>\n
CARE Court allows a wide range of people in the community, from family members to first responders, to file a petition if they believe someone diagnosed with schizophrenia or some types of bipolar disorder need more comprehensive treatment.<\/p>\n
The courts consider the CARE Act process voluntary, and some people refuse to participate. Generally, this would\u00a0 disqualify them, but Blankspear\u2019s bill would allow a petitioner to ask the court for an evaluation if they believe the person\u2019s unwillingness stems from \u201cthe severity of their mental disorder or lack of insight into their mental disorder.\u201d<\/p>\n
The courts would require anyone making such a request to provide \u201cany supporting records, reports, or other evidence available to the petitioner, setting forth facts sufficient to establish probable cause.\u201d<\/p>\n
When the law that governs CARE Court was being written, many advocacy groups insisted that coercion is ineffective and that modern mental health care favors treating people in the least restrictive settings possible.<\/p>\n
Blakespear said she believes that it\u2019s possible to protect a person\u2019s rights while also taking action when grave disability erodes someone\u2019s capacity for rational decision-making.<\/p>\n
\u201cWe have to acknowledge that there is a very small subset who will need to be involuntarily committed in the same way that people with advanced Alzheimer\u2019s (disease) are put behind a door that\u2019s locked for their own safety,\u201d she said. \u201cInvoluntary commitment conservatorships, the removal of people\u2019s rights to make every decision for themselves, is in the best interest of them and society, and I don\u2019t personally shy away from that.\u201d<\/p>\n
\u201cWe don\u2019t have to go back to \u2018One Flew Over the Cuckoo\u2019s Nest\u2019,\u201d she added, referencing the 1975 film that depicted the horrors of forced mental health treatment.\u00a0\u201cWe have had enormous advancements in both medical care and understanding of civil rights and behavioral health needs, and we are able to be much more protective of people\u2019s human rights while also treating their mental illness.\u201d<\/p>\n
The county said it is reviewing the bill, but predicted it would likely have a narrow effect. Most residents with severe mental illness, an emailed statement says, already have access to evaluation and treatment.<\/p>\n
\u201cIn rare, exceptional situations, a court-ordered evaluation could be useful, but generally only for a person who is both unknown to the local mental health system and physically isolated,\u201d the county\u2019s statement said.<\/p>\n
The county said it is \u201caware of recent public discussions around a historical process referred to as a 5200 petition,\u201d but that this process \u201chas largely been rendered obsolete by the expansion of modern mental health services and access points.\u201d<\/p>\n
The statement, which does not address specific individuals due to privacy concerns, pushes back against the notion that allowing 5200 petitions will help get more people with severe mental illness into treatment.<\/p>\n
\u201cContrary to recent claims, these code sections do not create a new treatment pathway or authorize long-term detention,\u201d the county said. \u201cWhen read in full, they allow a court \u2014 under narrow circumstances \u2014 to order only an evaluation that may result in a standard 72-hour evaluation and treatment hold.\u201d<\/p>\n
Meyer, who co-authored the Quarter Turn Strategies report, and other advocates say the normal avenues of detention and treatment are not being properly applied to those with severe mental illness.\u00a0<\/p>\n
In a follow-up email Friday, the county said it is committed to \u201censuring that individuals who meet criteria are appropriately connected to evaluation and care.\u201d San Diego County\u2019s financial commitment to mental health care has grown dramatically. Behavioral health spending hit $1.2 billion this year, a nearly 300% increase over the $440 million spent in the 2015-2016 budget year.<\/p>\n
San Diego Mayor Todd Gloria said Blakespear\u2019s bill is part of a broader effort to fix gaps in county behavioral health systems.<\/p>\n
But even as lawmakers propose new tools, Gloria said, the larger issue is whether existing tools are being used effectively.<\/p>\n
At a gathering of California\u2019s big-city mayors this week, Gloria argued that counties are failing to pull their weight in responding to homelessness, mental illness and addiction.<\/p>\n
\u201cThere are dollars that are flowing to our local government counterparts at counties, and they have to get in the game,\u201d he said, adding that cities are left with \u201ca sanitation department\u201d and \u201ca police department.\u201d<\/p>\n
\u201cNeither of those are appropriate tools for responding to somebody that\u2019s dealing with addiction and mental illness,\u201d he said.<\/p>\n
\u201cI can point to every shelter bed that we\u2019ve created, but that\u2019s not a mental health institution,\u201d he said in an interview with The San Diego Union-Tribune. \u201cPeople fail out and return to the street and cycle through shelter, cycle through jail. At some point, they need to be put in a clinical setting that can help them address their underlying concerns.\u201d<\/p>\n
While he pointed to reforms such as the CARE Act as steps forward, he said their impact has been somewhat limited in practice. In many cases, he said, \u201cyou end up with programs that started out as compulsory and become voluntary.\u201d<\/p>\n
The result, he said, is a system that continues to miss people who most need, but refuse, treatment.<\/p>\n
\u201cOften, I\u2019m in conversations where people think that existing processes are fine when they clearly aren\u2019t,\u201d he said. \u201cAnyone walking around a major city, really, anywhere in the country, not just in California, knows that we have untreated mental illness.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Every Saturday morning, Phil Cenedella sets up at the corner of Newport Avenue and Abbott Street, just steps…\n","protected":false},"author":2,"featured_media":242200,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[28],"tags":[7,1570,23,100,74,84,76,75,1696],"class_list":{"0":"post-242199","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-san-diego","8":"tag-california","9":"tag-health","10":"tag-local-news","11":"tag-news","12":"tag-san-diego","13":"tag-san-diego-county","14":"tag-san-diego-headlines","15":"tag-san-diego-news","16":"tag-top-stories-sdut"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/242199","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=242199"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/242199\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/242200"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=242199"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=242199"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=242199"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}