Editorials

Mentally ill Californians shouldn’t die on the street, untreated. The law must change

Homeless in Sacramento - Genny's memorial

Genny Lucchesi died in her sleeping bag in a midtown Sacramento parking lot in February 2015. She was 77, and had been homeless for more than 20 years. At her memorial service, her two distinct "families" came together: the relatives she hurt and
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Genny Lucchesi died in her sleeping bag in a midtown Sacramento parking lot in February 2015. She was 77, and had been homeless for more than 20 years. At her memorial service, her two distinct "families" came together: the relatives she hurt and

Nick Petris had the best of intentions a half century ago when he lent his talent and clout to the law that bears his name, and that to this day governs how California cares for – and too often fails – its mentally ill.

A legislator who represented Oakland and Berkeley for 40 years ending in 1996, Petris set out to end the “tyrannical and oppressive system of incarcerating people so easily” in the state hospital system, which at its height warehoused 36,853 people.

‘Why the hell didn’t you get me treatment?’ ‘Well, because you resisted.’ ‘Well, baloney I resisted! Of course I resisted, because I didn’t know what the hell I was doing.’

But as he recounted in a 1989 oral history, the law “went overboard,” and Petris became tormented by unintended consequences of the California Mental Health Act of 1967, better known as the Lanterman-Petris-Short Act, as they played out in the streets, jails, prisons and morgues.

The Lanterman-Petris-Short Act remains on the books more or less as it was 51 years ago when Gov. Ronald Reagan signed it into law. It must be brought into the 21st century.

We urge legislators, Gov. Jerry Brown and candidates running to replace Brown to focus on the issue. Whoever becomes governor should make improving the care of severely mentally ill people central to their agenda. It’s an issue that directly or indirectly affects us all.

In his oral history, Petris said the Lanterman-Petris-Short Act took three years to develop. Mentally ill people gained freedom, but too often that has meant they are free to wander the streets untreated.

 ‘Don’t I have a right to treatment?’ ” Petris, a Stanford education lawyer who died in 2013, told the oral historian, as if channeling a mentally ill person. “ ‘If I had broken a leg or had a heart attack, you would be swarming all over the place with doctors and nurses and this and that. Why the hell didn’t you get me treatment?’ ‘Well, because you resisted.’ ‘Well, baloney I resisted! Of course I resisted, because I didn’t know what the hell I was doing.’ 

As the act is written, authorities cannot take individuals into custody for 72-hour psychiatric holds and compel treatment unless they are deemed to be a danger to themselves or others, a bar that is too high and too subjective.

By a 4-1 vote, the Los Angeles County Board of Supervisors led by Supervisor Kathryn Barger, a Republican, and Mark Ridley-Thomas, a Democrat, approved a resolution last week calling on the Legislature to revise the act so authorities can more readily require care for severely mentally ill people.

“If someone is bleeding on the corner, I wouldn’t walk by. I would stop and help. We have a moral obligation,” Barger told an editorial board member.

Los Angeles Democratic Assembly members Miguel Santiago and Laura Friedman responded by proposing to amend the law so that mentally ill people could be held and helped if they require “medical treatment where the lack or failure of such treatment may result in substantial physical harm or death.”

A UC Berkeley graduate who had become psychotic, Bertram Hiscock died in a rubber safety room in the Yuba County jail, choking on his own urine and feces, according to the family’s lawsuit.

“We think it will have widespread impact if it is used aggressively,” Santiago told an editorial board member. That could be helpful, but the discussion should not end with one tweak to the 1967 law.

Why, for example, does California incarcerate so many mentally ill people? No expert believes prisons are well-suited to manage people who have lost control of their minds. And yet our state prisons house 36,153 men diagnosed with significant or severe mental illness, nearly 32 percent of the male prisoners. Another 2,545 women have psychiatric diagnoses, 49 percent of all women in state prison, the California Department of Corrections and Rehabilitation reports. The state hospitals at their worst pale in comparison to the number of mentally ill people in prison today.

The remaining state hospitals house 7,000 people, nearly all of whom committed crimes but are too ill to stand trial or are not guilty by reason of insanity. County jails house many thousands of mentally ill inmates.

Some die horribly, as The Sacramento Bee’s Sam Stanton reminded last week, when he report on the death of Bertram Hiscock, a UC Berkeley graduate who had become psychotic. His life ended at age 34 in a rubber safety room in the Yuba County jail last January, when he choked himself by ingesting his own urine and feces, the family’s lawsuit says.

California accounts for a fourth of the nation’s homeless population, 134,000, the U.S. Department of Housing and Urban Development census says. As many as a third are mentally ill.

Assemblyman Santiago tells of the humanitarian crisis in his district on L.A.’s Skid Row, home to 10,000 people who have no shelter. “Urine, feces, blood, vomit,” he said.

In 2017, 831 homeless people died in Los Angeles, many from preventable causes, up from 713 in 2016, the L.A. County Department of Mental Health reported. In Sacramento, 112 homeless people died on the streets in 2017, up from 80 in 2016.

If the law contemplated by Santiago and Friedman had been in place in 2015, perhaps Genevieve Lucchesi would not have died at 77 in a dirty blue sleeping bag in midtown Sacramento. Good people had offered her food and spare change, but none could meaningfully intervene, big-hearted though this city may be, as The Sacramento Bee’s Cynthia Hubert reported. Genny had the right to die on the street.

California voters have shown they want better mental health care. They approved Proposition 63, the landmark Mental Health Services Act of 2004, promoted by Mayor Darrell Steinberg to impose an extra income tax on people earning $1 million or more to pay for mental health care. It generates $2 billion-plus annually.

The need for more beds and housing will be more pronounced if Santiago and Friedman’s bill becomes law. In 2016, the Legislature approved a $2 billion bond to be financed by Proposition 63 to provide housing for homeless people who have mental illness. The bond faces a court challenge, which has delayed funding, unfortunately.

A single change in one 1967 law won’t end homelessness among mentally ill people. But it could avert needless deaths, get some of the most vulnerable among us into needed treatment, and honor the good intentions this state has spent half a century striving toward.

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