Davis Signs Bill To Allow Counties To Establish Programs for Court-Ordered Mental Health Treatment

Gov. Gray Davis (D) on Saturday signed a bill (AB 1421) that authorizes court-ordered involuntary treatment for up to six months for people with mental illness who "consistently avoid treatment because they do not recognize the need for it," the San Francisco Chronicle reports. Under current state law, only individuals who "pose a significant and immediate threat to themselves or others can be forced into hospitalized treatment" for as many as six months (Salladay, San Francisco Chronicle, 9/29). The new law authorizes counties to launch programs that allow the courts to oversee outpatient treatment of mentally ill residents (Sanders, Sacramento Bee, 9/29). Counties that decide to establish the programs must provide teams of mental health professionals with staff-to-client ratios of not more than one to 10. The programs will serve patients ages 18 and older with recommendations from physicians that they "cannot survive safely in the community without supervision" and have histories of non-compliance with treatment. In addition, patients must have undergone hospitalization twice in the past 36 months, committed or threatened violent behavior, refused treatment or a "substantially deteriorating" condition (Office of the Governor release, 9/28). The legislation does not provide the counties with funds to implement the programs. Davis said, "This legislation will help end the cycle of hospitalization, quitting treatment and relapse" (Sacramento Bee, 9/29).

Some advocates for the mentally ill said the new law will return California to a "coercive" system of treatment at a time when the state has reduced funds for voluntary programs. In addition, some advocates said the threat of a court order often prompts patients into voluntary treatment (San Francisco Chronicle, 9/29). Virginia Knowlton of Protection and Advocacy said that the law will "make a dysfunctional mental health delivery system even more dysfunctional" (Sacramento Bee, 9/29).