Newsom Signs Bill To Expand Conservatorships For The Severely Mentally Ill

California will expand its standards for involuntary medical treatment to include people whose mental illness or drug addiction inhibits their ability to keep themselves safe, under a bill signed Tuesday by Gov. Gavin Newsom.

SB43 by Sen. Susan Talamantes Eggman, D-Stockton, was sponsored by psychiatric organizations and other health care professionals who said it would get a small but troubled group of people off the streets and into treatment. Disability-rights groups objected to the expansion of involuntary detention and treatment and argued that voluntary care was more effective, but both legislative houses approved the measure unanimously. It takes effect in January.

Current law allows involuntary detention of people assessed as posing a grave danger to themselves or others. They can be held up to 72 hours for evaluation, or longer for treatment.

Advocates of SB43 said it was needed because the law currently applies only to people who are unable to provide their own basic food, clothing and shelter or who are found to be mentally incompetent. One supporter of the bill, Dr. Emily Wood of the California State Association of Psychiatrists, said mentally ill people can currently avoid involuntary treatment by simply saying, without evidence, that they have a plan to feed and shelter themselves.

That allows many to fall through the cracks of the system and to suffer, and sometimes die, on the streets, advocates said. They include San Francisco Mayor London Breed, who has urged state lawmakers to make it easier to compel more people into treatment as she grapples with dreary conditions on the city’s streets.

“This is not about throwing people away, locking them up and throwing away the key,” Breed told the Chronicle while the bill was moving through the Legislature. “This is about wanting to see people live with dignity.”

The bill expands the definition of those deemed “gravely disabled,” widening the group of people who can be detained and evaluated for involuntary treatment to include people whose mental illness, drug addiction or alcoholism inhibits their ability to keep themselves safe or seek medical care.

“Like many things that are decades old, it has long been time to make some adjustments to the law to address the realities we are seeing today on our streets,” Eggman wrote in a statement. “SB43 maintains the strong due process protections provided in (existing law), while expanding the criteria for making a ‘gravely disabled’ determination, so that the most severely ill can get the help they need and the dignity they deserve.”

The new law will also allow a medical expert to testify in court about a person’s medical records even if they were written by a different health care provider. Those hearings are the basis of conservatorship, which can include involuntary treatment for mental illness and addiction.

Debra Roth, a lobbyist for Disability Rights California, contended SB43 went too far by allowing people to be placed in psychiatric detention if they could not adequately clothe themselves.

“We think that is just wrong,” she said while the bill was under consideration. “This bill will subject more patients to the trauma of involuntary detention.”


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