By Sue Pascoe
Editor
County Supervisor Sheila Kuehl was the sole vote against exploring legislation that would allow social workers and law enforcement officers to detain severely mentally disabled individuals who refuse treatment that could save their lives.
The vote by the five county supervisors was taken on October 31 after they heard comments from seven individuals.
According to the existing law, only the mentally ill who pose a danger to themselves or others are deemed “gravely disabled” and may be held for involuntary evaluation.
When trying to help the “Pretty Blonde,” members of the Pacific Palisades Task Force on Homelessness were frustrated by the 5150 hold [when a person, as a result of a mental disorder is a danger to himself or others or gravely disabled, an officer or other professional may take them into custody up to 72 hours].
The “Pretty Blonde” was a young homeless woman in the Palisades, who was service resistant.
In an August 9 story for the Palisades News, Palisadian Nancy Klopper described the second attempt to secure a 5150 hold for the woman.
“At 9 a.m., the Pretty Blonde was spotted at Ralphs. When she exited the market, Simone [Nathanson, a social worker] tried to engage her but was met with an extended arm and fist, along with some undecipherable but angry sounds.
“Rusty [LAPD Officer John Redican] took over and very gently placed her in handcuffs. . . .He tried to talk to her, but she was speaking gibberish. One of the MEU (mental health unit) officers said he didn’t think she met the ‘gravely disabled’ qualification required to take her in.
“When I questioned him about his assessment, he responded ‘She bought a chicken in the market, so she is able to provide for herself.’
“The Pretty Blonde was breathing in fast, short bursts, and it appeared she was headed for a full-blown panic attack. I pointed that out, but the MEU officer responded, ‘She might have sinus problems.’
“It seemed we were looking at the situation in two entirely different ways—that was scary.”
Eventually, the Pretty Blonde was taken to a hospital—covered in lice. After more than five weeks there, she was able to go home with her parents to Europe.
Most of the speakers at the Board of Supervisors hearing reiterated that there are a select number of homeless people who are in desperate need, and because of mental illness do not realize it—reflecting the PPTFH’s experience.
Brittany Weissman, executive director of the National Alliance on Mental Illness, L.A. County Council, said: “There are individuals in dire need of healthcare, yet they refuse treatment because they lack insight into their [mental] illness. . . . Many [homeless] individuals refuse treatment, but are clearly in need of health care. I hear stories from family members, law enforcement agents, providers and clinicians, but the limits of the law insist they turn away from providing lifesaving help.”
Dr. Susan Partovi, medical director for Homeless Healthcare L.A., explained that the “Determination of capacity to make medical decisions” requires doctors to ask a patient if they want the treatment and if they un- derstand the treatment. Patients only need to answer yes or no. They have to have a reasonable reason for their decision—and thus reasons that include delusions and paranoia are not considered adequate reasoning.
Dr. Emily Defraites, a psychiatrist who works at the Veterans Health Administration, said: “It’s a way of determining someone’s wishes versus their brain disorder making them unable to make these decisions.” She told the board that efforts to expand the definition of “grave disability” were aimed at a small segment of those with mental illness.
Sarah Duso read a statement on behalf of Councilmember David Ryu: “I know first-hand the difficulty of balancing the health needs of individuals and their personal rights. There is no perfect answer, but at the moment we clearly are in need of additional tools for medical professionals to provide mental health treatment to those who need it, even if those individuals are not always aware of their mental health needs and are unwilling to accept it.”
Anthony, an outreach worker, spoke about a man living in an alley. “He was released from the hospital after he had a massive stroke. He is severely mentally ill. We’ve had the medics come out, we’ve had everybody come out, but to no avail because he does not meet the criteria. Why can’t we get these people into treatment, so they can be treated for their mental illness and their physical disabilities? It can be done in a humane way.”
Kuehl’s concern was violating civil liberties. At an earlier board meeting, she mentioned that at one time gay and lesbian individuals were judged to be mentally ill.
“I am grateful for the impulse behind this motion and I know it is the best of motives,” Kuehl said, noting that as a former chair of the state Senate’s Health and Human Services Committee, she knows this kind of bill would have a tough time in Sacramento. She would prefer that the county not sponsor the bill.
Public speaker Eric Preven said, “I think Supervisor Kuehl is wise to be wary about what we do, but I think talking about it is a great way to go. . . .I think general health professionals should be able to treat and therefore we should be able to push the envelope even though there’s a lot of resistance from rights groups like myself.”
Supervisor Kathryn Barger commented, “The county is a safety-net provider for a reason and has a moral obligation to ensure that those on our streets who are suffering from grave mental illness, who are living in deplorable conditions and unable to provide for themselves, (for their) basic human needs, receive lifesaving treatment and care.”
According to the Los Angeles Homeless Services Authority and the sheriff ’s department, about 30 percent of the county’s homeless population and about 27 percent of country jail inmates suffers from serious mental illness.
The Board of Supervisors directed the county’s Department of Mental Health staffers to develop a set of recommendations in 60 days.
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