Forced mental health treatment in California may soon be getting a huge boost in funding, using a projected windfall of taxpayer money from recently passed ballot initiative Proposition 63, the Mental Health Services Act (MHSA). In the months leading up to November's election and during the statewide stakeholder input process that followed, voters and supporters of the MHSA have been told that these funds, an expected $275 million for this year and $750 million for subsequent years, paid for with a one percent state income surtax on incomes of over a million dollars, would only be used for voluntary, community-based services that were client-centered and supported choice, autonomy and self-determination. But when the California Dept. of Mental Health (CA DMH) released its draft plan requirements for county mental health administrators on February 15, they contained a provision that would allow MHSA funds to be used for "involuntary services" if certain criteria were met.
In the month and a half following CA DMH's release of the draft plan requirements, mental health clients throughout the state have spoken out against these provisions at stakeholder meetings, and the California Network of Mental Health Clients (CNMHC) has released a position paper strongly opposing the forced treatment provisions.
Dismissing clients' demands to remove this language, CA DMH Deputy Director Carol Hood announced Tuesday and Wednesday at MHSA stakeholders meetings in Los Angeles and Sacramento that the CA DMH intends to keep the forced treatment provisions in the requirements. Hood went on to say that the agency is preparing a checklist that it will make available to counties interested in using MHSA monies to implement involuntary outpatient commitment law AB 1421 ("Laura's Law"), explaining how to make their proposals "consistent with the MHSA". Laura's Law, which was signed into law two years ago by then-Governor Grey Davis, expands criteria for court-ordered forced treatment, but requires counties to pay for it themselves, which has kept them from implementing forced treatment under the Law, up until now. African Americans and other people of color have been disproportionately subjected to court-ordered forced outpatient treatment in New York State, as shown in a recent study. New York's "Kendra's Law" has been opposed by a coalition of clients, service providers and civil rights lawyers, who are trying to stop NY Governor George Pataki from renewing the law and making it permanent in June.
Mental health clients who had been attending the state-level stakeholder meetings had expressed concern that the CA DMH might not listen to them on this issue. CNMHC members distributed a flyer at last week's meetings to remind the DMH of the MHSA's promise of transforming the system from a "fail-first" model based on force and coercion to a "clients-first" model embracing choice, autonomy, independent living and self-determination. The flyer and position paper were distributed at both the Los Angeles and Sacramento stakeholder meetings. But none were quite prepared for Hood's announcement, which many clients have called a large-scale betrayal of trust.
The 50 or so clients at Wednesday's meeting, many of whom had gathered signatures and campaigned for Prop 63, were devastated at the news. Some left the meeting in despair, while others decried Hood's announcement as a dangerous move away from the promised client-centered, voluntary services toward force, and a huge slap in the face to the many clients and psychiatric survivors who worked tirelessly for two years to support the measure and have been participating in its planning and implementation. At the end of the meeting, clients, family members and advocates at twelve out of perhaps 20 tables in the large room voiced their strong objection to any MHSA funds being permitted for forced treatment. The prevailing mood as stakeholders left was one of shock and dismay; yet many clients were galvanized by a shared desire to take action and stop the proposed plans from taking effect.
The CA DMH has extended its official deadline for public comment to Monday, April 11, but they are not expected to release their final plan requirements to the county mental/behavioral health departments until early to mid-May, so client activists plan to keep the pressure up until then.
The CNMHC has launched an international letter-writing campaign to tell the CA DMH that forced and coercive treatment, far from being transformational, represents a dangerous retreat from the voluntary, community-based, client-centered, culturally competent services and supports that California voters were promised when they voted for Prop 63.
To contact MHSA Staff:
Toll-free voicemail (within California):
(800) 972-MHSA (6472)
By Fax: (916) 653-9194
By Email: firstname.lastname@example.org
California Department of Mental Health
1600 Ninth Street, Room 130
Sacramento, CA 95814