Forced treatment provision of California mental health initiative draws support from patient families

SAN FRANCISCO (KPIX 5) — A state proposal that would provide more help for the mentally ill includes a provision that would force some patients into treatment, a provision that’s generating both criticism and support.

Governor Gavin Newsom’s Community Assistance, Recovery and Empowerment (CARE) Court initiative would grant more authority to a civil court judge to mandate treatment. Disability rights groups say that’s a violation of civil liberty. But some family members of the severely mentally ill say it may be the only way for them to survive.

There were only seven people at Tuesday’s press conference by the group Families Advocating for the Seriously Mentally Ill (FASMI)  — no crowd of supporters, no street full of marchers. But they’re used to that. Despite the happy pictures of smiling families posted outside the Alameda County Administration Building, families dealing with severe mental illness are often alone in the fight to get help for their loved ones. 

Patricia Fontana said parents go through a range of emotions.

“Was it anything I could have done?” she said. “How could I have done it differently? You know, anger that you cannot get help.”

Fontana’s son grew up a smart, motivated kid and was a student at UC Berkeley when he began to feel something happening to his mind. Within two years he was sleeping on the heating grates outside his former classrooms. He’s now 38 and for the last 14 years has been living on the streets.

“They don’t see it as something wrong with themselves, you know?” she said. “My son would tell me, ‘You’re the one that’s crazy, I’m not crazy.'”

And that’s why FASMI is supporting Newsom’s CARE Court proposal which offers some level of mandatory treatment. They say delusional people will not get the help they need unless they are compelled to do so.

“If someone is deteriorating and they will not cooperate voluntarily, then we think, yes. You don’t just let them go live on the street,” Fontana said.

But a state agency called Disability Rights California is at odds with Newsom’s proposal. A statement on their website says, “In fact, it will do more harm because studies show forced treatment lessens the likelihood of people seeking voluntary treatment in the future.” 

 DRC favors a system that allows mentally disabled people to “retain full autonomy over their lives without the intrusion of a court.”

But psychiatrist Dr. Alice Feller, who has worked with people with major mental illnesses for more than 40 years, said full autonomy only makes things worse for them. 

“The problem with honoring this delusional state is that, without treatment, the illness becomes more severe and more intractable,” said Feller.

That’s what happened to Fontana’s son and now she fears he will never get the help that could have changed both their lives.

“It’s like you’re watching this train wreck,” she said, “and it’s coming and it’s coming and you can’t stop it.”