ASSISTED OUTPATIENT TREATMENT

Coalition on Homelessness, SF (coh@sfo.com)
Mon, 27 Dec 1999 17:49:33 -0800


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ASSISTED OUTPATIENT TREATMENT FOR THE MENTALLY ILL

There is a full-scale attack of the rights of people with mental 
disabilities throughout the nation. The goal of this campaign is to 
expand forced mental health treatment.

Current California law - the Lanterman, Petris & Short Act (LPS) - 
allows involuntary commitment of people who, as a result of a mental 
disorder, are in danger to themselves or others or are gravely 
disabled.

AB 1028 proposes sweeping changes to the LPS Act, including: widening 
the criteria for commitment to the perceived need for treatment, 
increasing in-hospital detention time, initiating court-ordered 
involuntary outpatient commitment and decreasing those safeguards to 
the rights of persons with psychiatric disabilities now in place.

We believe that people with psychiatric disabilities are entitled to 
the same rights and freedoms that any American citizen enjoys, and 
that recovery and therapeutic relationships cannot exist in an 
environment of coercion. Our reasons for opposing the proposed 
changes in the law include the following:

o Changing the LPS  Act is unwarranted because the current commitment 
laws are adequate and provide necessary safeguards of individual 
liberties. Under the current law, in Los Angeles County alone 43,000 
people were involuntarily committed to 72 hour holds in 1998. 20,000 
were held involuntarily for an additional 14 days. Moreover, current 
commitment laws already allow for outpatient commitment.

o Studies indicate that people diagnosed with major mental disorders 
account for a very small percentage of violence in American society. 
In spite of this knowledge, proponents of the expansion of forced 
treatment are conducting a campaign to link mental illness with 
violence, exploiting public fears of crime, and promoting forced 
treatment as a public safety measure.

o Most people with psychiatric disabilities are competent to make 
decisions about their treatment. According to the MacArthur Treatment 
Competence Study, most patients hospitalized with serious mental 
illness have abilities similar to persons without mental illness for 
making informed treatment decisions. Mental illness does not 
invariably impair decision making capacities. In spite of this 
knowledge, proponents of the expansion of forced treatment assert 
that persons with mental disabilities are incapable of making 
decisions and "lack insight" into their condition.

o Proponents of increased forced treatment argue that there are new 
wonder drugs that provide safe and effective treatment for people 
with mental illness, yet studies indicate that there may be yet be 
harmful side effects with these new wonder drugs, that the successes 
of drug trials are often exaggerated (JAMA 11/10/99), and for at 
least 2 out of 3 people drugs do not appear to play a role in 
recovery.

o The expansion of forced treatment will not stop treatment 
non-compliance. In fact, researchers have found that forced treatment 
causes noncompliance. The Well Being project, a research survey of 
mental health clients, found that 55% of clients interviewed who had 
experienced forced treatment reported that fear of forced treatment 
caused them to avoid future treatment at all costs.

o It should be noted that with the increase of people with mental 
health issues inside the criminal justice system, it is clear that 
these people aren't able to access the voluntary community-based 
services they seek.

o The bill, co-authored by Assemblywoman Helen Thomson and Sen. Don 
Perata, is supported by the National Alliance for the Mentally Ill. 
It should also be noted that this group receives financial support 
from various pharmaceutical companies - to the tune of $12 million in 
the last three years. That relationship in itself is questionable. 
People who care about civil liberties and our Constitution should be 
very concerned about this.

o Senate President Pro Tem John Burton, (D-San Francisco) has stated 
he is skeptical
of the need for a major overhaul of the law. He also says he intends 
to press for more money to strengthen California's failing 
community-based mental health services.

(Special thanks to the California Network of Mental Health Clients 
for their timely analysis of AB 1028)


END FORWARD

**In accordance with Title 17 U.S.C. section 107, this material
is distributed without charge or profit to those who have
expressed a prior interest in receiving this type of information
for non-profit research and educational purposes only.**



*******************************************************
HOMELESS PEOPLE'S NETWORK <http://aspin.asu.edu/hpn>
6,000+ POSTS by or via homeless & ex-homeless people
Nothing About Us Without Us - Democratize Public Policy
*******************************************************

Coalition on Homelessness, San Francisco
468 Turk St.
San Francisco, CA 94102
vox: (415) 346.3740
Fax: (415) 775.5639
coh@sfo.com
http://www.sfo.com/~coh
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***********************************************************

HOMELESS PEOPLE'S VIEWS, News, Alerts, Actions & Research

6,000+ ONLINE POSTS by or via homeless & ex-homeless people

HOMELESS PEOPLE'S NETWORK http://aspin.asu.edu/hpn

***********************************************************

<bold>ASSISTED OUTPATIENT TREATMENT FOR THE MENTALLY ILL


</bold>There is a full-scale attack of the rights of people with mental
disabilities throughout the nation. The goal of this campaign is to
expand forced mental health treatment. 


Current California law - the Lanterman, Petris & Short Act (LPS) -
allows involuntary commitment of people who, as a result of a mental
disorder, are in danger to themselves or others or are gravely
disabled.


AB 1028 proposes sweeping changes to the LPS Act, including: widening
the criteria for commitment to the perceived need for treatment,
increasing in-hospital detention time, initiating court-ordered
involuntary outpatient commitment and decreasing those safeguards to
the rights of persons with psychiatric disabilities now in place. 


We believe that people with psychiatric disabilities are entitled to
the same rights and freedoms that any American citizen enjoys, and that
recovery and therapeutic relationships cannot exist in an environment
of coercion. Our reasons for opposing the proposed changes in the law
include the following:


o Changing the LPS  Act is unwarranted because the current commitment
laws are adequate and provide necessary safeguards of individual
liberties. Under the current law, in Los Angeles County alone 43,000
people were involuntarily committed to 72 hour holds in 1998. 20,000
were held involuntarily for an additional 14 days. Moreover, current
commitment laws already allow for outpatient commitment.


o Studies indicate that people diagnosed with major mental disorders
account for a very small percentage of violence in American society. In
spite of this knowledge, proponents of the expansion of forced
treatment are conducting a campaign to link mental illness with
violence, exploiting public fears of crime, and promoting forced
treatment as a public safety measure.


o Most people with psychiatric disabilities are competent to make
decisions about their treatment. According to the MacArthur Treatment
Competence Study, most patients hospitalized with serious mental
illness have abilities similar to persons without mental illness for
making informed treatment decisions. Mental illness does not invariably
impair decision making capacities. In spite of this knowledge,
proponents of the expansion of forced treatment assert that persons
with mental disabilities are incapable of making decisions and "lack
insight" into their condition.


o Proponents of increased forced treatment argue that there are new
wonder drugs that provide safe and effective treatment for people with
mental illness, yet studies indicate that there may be yet be harmful
side effects with these new wonder drugs, that the successes of drug
trials are often exaggerated (<italic>JAMA</italic> 11/10/99), and for
at least 2 out of 3 people drugs do not appear to play a role in
recovery.


o The expansion of forced treatment will not stop treatment
non-compliance. In fact, researchers have found that forced treatment
causes noncompliance. The Well Being project, a research survey of
mental health clients, found that 55% of clients interviewed who had
experienced forced treatment reported that fear of forced treatment
caused them to avoid future treatment at all costs.


o It should be noted that with the increase of people with mental
health issues inside the criminal justice system, it is clear that
these people aren't able to access the voluntary community-based
services they seek.


o The bill, co-authored by Assemblywoman Helen Thomson and Sen. Don
Perata, is supported by the National Alliance for the Mentally Ill. It
should also be noted that this group receives financial support from
various pharmaceutical companies - to the tune of $12
<italic>million</italic> in the last three years. That relationship in
itself is questionable. People who care about civil liberties and our
Constitution should be very concerned about this. 


o Senate President Pro Tem John Burton, (D-San Francisco) has stated he
is skeptical 

of the need for a major overhaul of the law. He also says he intends to
press for more money to strengthen California's failing community-based
mental health services.


(Special thanks to the California Network of Mental Health Clients for
their timely analysis of AB 1028)



END FORWARD


**In accordance with Title 17 U.S.C. section 107, this material

is distributed without charge or profit to those who have

expressed a prior interest in receiving this type of information

for non-profit research and educational purposes only.**




*******************************************************

HOMELESS PEOPLE'S NETWORK <<http://aspin.asu.edu/hpn>

6,000+ POSTS by or via homeless & ex-homeless people

Nothing About Us Without Us - Democratize Public Policy

*******************************************************

Coalition on Homelessness, San Francisco

468 Turk St.

San Francisco, CA 94102

vox: (415) 346.3740

Fax: (415) 775.5639

coh@sfo.com

http://www.sfo.com/~coh

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