California Should Try Involuntary Treatment for Seriously Mentally Ill, Report Recommends
California should consider a pilot compulsory outpatient treatment program for individuals with serious mental illnesses who refuse treatment, a new state-sponsored study by the Rand Corp. states. Ever since California moved mentally ill patients out of institutions, a "growing number of critics" have said that compulsory, or involuntary, treatment is necessary for patients "before they cross the threshold into violence," the Los Angeles Times reports. Last year, Assembly member Helen Thomson (D-Davis) sponsored a bill that would have established a compulsory outpatient program. That measure, however, was blocked by state Senate Leader John Burton (D-San Francisco), who feared it "posed too broad an infringement on patients' rights." Burton commissioned the Rand study to investigate the issue further. Overall, the Rand study findings, scheduled to be released today, concluded that intensively treating and following up with patients in their communities "produced the most successful results." But the report "skirt[ed] definitive conclusions" on the issue of compulsory treatment and "could not ... conclude whether involuntary outpatient treatment is more effective than voluntary alternatives," the Times reports. The report recommends that California undertake a pilot project similar to one underway in New York, where 512 people were committed to involuntary treatment in the first 14 months, "far fewer than expected." Another 837 people agreed to voluntarily participate in treatment after being referred, the Times reports.
But Sally Zinman, executive director of the California Network of Mental Health Clients, an organization that represents mentally ill patients, said, "Taking [patients'] rights away isn't the answer. The answer is to put real effort and money into building the right kind of system." She added that individuals with psychiatric problems often "need a range of services," such as transportation or job placement, that will "draw them voluntarily into treatment programs." Other mental health experts, however, suggest that involuntary treatment is necessary for "patients who don't believe that they need help," and thus "pose a danger to themselves or society." Such compulsory treatment supporters favor a "carefully monitored involuntary system that intercedes before a patient sinks too far," the Times reports. Mary Zdanowicz, executive director of the Treatment Advocacy Center, cited a report showing that patients who refuse treatment are 63% more likely to "turn violent." Carla Jacobs, a National Alliance for the Mentally Ill board member, said that while she would support a pilot program studying compulsory treatment, she recommends lawmakers "simply launch an aggressive and well-financed statewide effort that would provide involuntary outpatient treatment." For their part, state lawmakers have not yet come to an agreement on the issue. Burton, however, "applauded" the study's recommendation of increased intensive treatment services. He added that while he would "consider a pilot project to study involuntary treatment," he "was not prepared to endorse the approach on a broad scale" (Bailey, Los Angeles Times, 2/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.