MENTAL HEALTH: Reform Debate ‘Polarizes’ Providers, Patients
With mental health reform proposals to California's commitment laws expected during the next legislative session, the debate over involuntary commitment of the mentally ill already has become polarized. Continuing a series of mental health issues, the Los Angeles Times reports on the state of California's mental health system, finding that many supporter of mental health commitment reform face a "wall of opposition" from patients' rights groups. At issue is the complex code of law surrounding the detention and treatment of mentally ill patient against their will. Those opposed to any amendment in the law argue that reforms would lead to a "repetition of past psychiatric abuses." Despite advances in medicines that treat mental illnesses, patients' rights advocates assert that it is a "fundamental right" to refuse treatment. Sally Zinman, executive director of the California Network of Mental Health Clients proclaimed, "Give me liberty or give me death!" Reform opponents also contend that the hype surrounding new treatment has been blown out of proportion. Dr. Loren Mosher, former clinical director of the San Diego Mental Health Department, said, "All the public mental health system can do is pass out drugs. People run away from treatment because they experience it as personally uncomfortable and harmful." However, E. Fuller Torrey, a psychiatrist who favors reform, replied, "Being psychotic on the streets is not being free. You are imprisoned by your brain dysfunction." Over the last decade, the theory that actual brain dysfunction associated with mental illness prevents people from realizing that they are sick. Columbia University Professor Javier Amador said, "This unawareness is neurologically based." State Sen. Don Perata (D-Alameda) is set to propose changes to the law next session. He said that current law "just doesn't work in the best interest of the patient, nor the families." But Zinman argues that "[California mental health advocates] have worked hard to come together in a real partnership, and [reform] will just destroy it" (Marquis/Morain, 11/23).
It Takes a 'Village'
While the debate over reform rages on, some "small but aggressive" programs aimed at improving the lives of people suffering from mental illness are showing signs of success. The programs focus on incorporating all facets of treatment and essentially "wrap people in a blanket of services." The Long Beach-based Village is one such program. It offers personalized, multifaceted assistance to help the mentally ill cope with everyday life. Martha Long, director of the Village, said "Basically, we ask people, 'What do you want and need?' ... What we want to do is give people a picture of what their life could be like." Through the program, patients have access to job training workshops, housing assistance and money management; patients are assigned individual case workers. The publicly-funded, 10-year-old program has achieved some degree of success -- last month, 63% of the 276 Village clients lived independently, 25% were employed and 10% were in school. Entrance into the program is more difficult now, as spots only open up every two months -- further proof that the program is working. The program has even earned the praise of California First Lady Sharon Davis, who is urging the development of other programs modeled after the Village. Recently, the program was awarded a share of $10 million in states funds allocated to fighting homelessness and incarceration among the mentally ill (Marquis/Morain, Los Angeles Times, 11/13).