Mental Health Advocates Debate Use of Forced Care

VENTURA —  Cindy Soto says the state put the civil rights of a sick man before her daughter’s safety.

Soto told 330 advocates for the mentally ill on Thursday that if Steven Allen Abrams, a man with a history of psychological problems, had been forced into treatment, he might not have plowed his Cadillac into 30 children at a Costa Mesa playground. Two children died in the 1999 attack, including Soto’s 4-year-old daughter, Sierra.

“Do you think Mr. Abrams is better off in prison than he is in a treatment program?” she asked. “Am I better off without my daughter? There is nothing civil or right about that.”

Soto, like others taking part in the second annual Call to Action conference in Ventura, demanded reform of the 1967 Lanterman-Petris-Short law, which makes it difficult to forcibly treat the mentally ill.

“It’s like someone having a heart attack in front of you,” she said. “Do you just stand there and say, ‘Gee, would you like some help?’ No, we’d jump right in.”

Her sentiment was shared by others who came to discuss a wide range of problems confronting the mentally ill. They talked about the critical housing shortage for the mentally ill, their increasing numbers in jails and the lack of mental health care workers.

But each time, talk returned to the sickest people, those who don’t believe they are ill, refuse to take their medicine and end up being a danger to themselves or society.

“Right now, [clients have] to be a threat to themselves or to others before you can treat them,” said Jim Matthews, president of the Ventura County Chapter of the National Alliance for the Mentally Ill. “We don’t want to lock people up. We want to treat them.”

The Lanterman-Petris-Short Act stresses community and voluntary treatment over indefinite confinement. It allows for a person displaying severe mental illness to be picked up and held for 72 hours for treatment and evaluation. That can be extended to 14 days or longer in the most severe cases.

Many supporters of reform--which include law enforcement officials, judges and attorney groups--are now backing legislation sponsored by Assemblywoman Helen Thomson (D-Davis) requiring, among other things, that severely mentally ill people be treated as outpatients under court order.

If they don’t show up for scheduled appointments, mental health workers would track them down and forcibly give treatment.

Carla Jacobs, a Los Angeles County mental health commissioner and member of the national board of directors for the National Alliance for the Mentally Ill, said involuntary treatment has shown success in other states.

She said not treating the most seriously ill is inhumane and stigmatizing.

In her view, the perfect candidate for involuntary treatment is someone who has repeatedly gone through hospitalizations, and when released, doesn’t take prescribed medication.

“We have had 30 years of trial and error, and it’s been mostly errors,” she said.

Not everyone supports the idea.

Clyde Reynolds, executive director of the Turning Point Foundation, said it is premature to talk about involuntary care when there is insufficient voluntary treatment.

“I understand a lot of their frustration, and it is an issue that has the potential to split the mental health community,” said Reynolds, whose Ventura County foundation offers housing and treatment to the mentally ill. “We won’t know what we need until we fully fund the current system.”

But such reasoning was cold comfort for Soto. She said the current laws prevent those needing treatment from getting it until it is too late.

“Broken brains and a broken system don’t make a good match,” she said.