I live in Alameda County of California where there are more than 900 "5150" involuntary 72-hour holds for mental evaluation each month. These are actual holds, not the many assessments (if a crisis team is available) that are quickly dismissed because of the narrow criteria "probable cause to believe that the person is, as a result of a mental health disorder, a danger to others, or to themselves, or gravely disabled".
Walk around downtown Oakland or Berkeley and you'll see that to be considered "gravely disabled" you’d have to already be half-dead from starvation, dehydration, or for not washing for a year.
By law we can't arrest someone before a crime is committed, and someone has to volunteer for a psych evaluation—if a bed or evaluator is even available—unless an authority decides that the 5150 criteria applies.
If a person refuses evaluation but is clearly delusional, talking about violence, and their family is begging to have them evaluated after years of untreated erratic behavior, homelessness, and threats, you’d think that would merit a compelled psychiatric evaluation. I’ve learned over eight years that without a diagnosis, authorities don’t take you seriously.
From my experience, it doesn't. Laura's Law would help, but it's only a first step.
From families like mine whom I've spoken with, many 5150ed delusional people are often released asap with or without diagnosis or treatment, only to be later 5150ed and released again and again. Or they are eventually jailed because there aren't enough psychiatric resources available, so they deteriorate and there are plenty of jails.
This is a huge inefficient waste of taxpayers money and a danger to the vulnerable mentally ill who are much more likely to become victims than perpetrators of violence. And without treatment, brain damage from mental illness increases over time.
This cycle seems to be a stop-gap method that has been applied over decades since deinstitutionalization. As quoted in the Sisti/Segal/Emanuel JAMA article, "in 1955, 560,000 patients were cared for in state psychiatric facilities; today there are fewer than 45,000...about the same as it was in 1850". Even if the closing of state hospitals was justified, there has been little provided to replace mental health treatment on the community level.
There is a crisis here and no one is listening. Mental health professionals are so used to saying the same things over and over about what can and can't be done, the truth has gotten lost. "This is how the system works," they say. But it’s not working.
We can try new approaches to treating the mentally ill. A homeless person may refuse evaluation and treatment in a locked hospital environment, but if we had permanent on-site mental health evaluators in homeless shelters as well as the crisis teams who are called in when there’s a “situation”, we might get better evaluation results and cooperation from the homeless population.
Would it be possible to use the money saved from lowering prison populations to convert some jails into unlocked safe shelters or respite centers where people can be evaluated and even treated?
We need to look at the long game, not half-hearted short-term fixes.
Let's be more realistic about the situation. Mentally ill people need more help and sooner. If not, we already know what happens. Look at the streets and look at the news.
Bring Back the Asylum
I live in Alameda County of California where there are more than 900 "5150" involuntary 72-hour holds for mental evaluation each month. These are actual holds, not the many assessments (if a crisis team is available) that are quickly dismissed because of the narrow criteria "probable cause to believe that the person is, as a result of a mental health disorder, a danger to others, or to themselves, or gravely disabled".
Walk around downtown Oakland or Berkeley and you'll see that to be considered "gravely disabled" you’d have to already be half-dead from starvation, dehydration, or for not washing for a year.
By law we can't arrest someone before a crime is committed, and someone has to volunteer for a psych evaluation—if a bed or evaluator is even available—unless an authority decides that the 5150 criteria applies.
If a person refuses evaluation but is clearly delusional, talking about violence, and their family is begging to have them evaluated after years of untreated erratic behavior, homelessness, and threats, you’d think that would merit a compelled psychiatric evaluation. I’ve learned over eight years that without a diagnosis, authorities don’t take you seriously.
From my experience, it doesn't. Laura's Law would help, but it's only a first step.
From families like mine whom I've spoken with, many 5150ed delusional people are often released asap with or without diagnosis or treatment, only to be later 5150ed and released again and again. Or they are eventually jailed because there aren't enough psychiatric resources available, so they deteriorate and there are plenty of jails.
This is a huge inefficient waste of taxpayers money and a danger to the vulnerable mentally ill who are much more likely to become victims than perpetrators of violence. And without treatment, brain damage from mental illness increases over time.
This cycle seems to be a stop-gap method that has been applied over decades since deinstitutionalization. As quoted in the Sisti/Segal/Emanuel JAMA article, "in 1955, 560,000 patients were cared for in state psychiatric facilities; today there are fewer than 45,000...about the same as it was in 1850". Even if the closing of state hospitals was justified, there has been little provided to replace mental health treatment on the community level.
There is a crisis here and no one is listening. Mental health professionals are so used to saying the same things over and over about what can and can't be done, the truth has gotten lost. "This is how the system works," they say. But it’s not working.
We can try new approaches to treating the mentally ill. A homeless person may refuse evaluation and treatment in a locked hospital environment, but if we had permanent on-site mental health evaluators in homeless shelters as well as the crisis teams who are called in when there’s a “situation”, we might get better evaluation results and cooperation from the homeless population.
Would it be possible to use the money saved from lowering prison populations to convert some jails into unlocked safe shelters or respite centers where people can be evaluated and even treated?
We need to look at the long game, not half-hearted short-term fixes.
Let's be more realistic about the situation. Mentally ill people need more help and sooner. If not, we already know what happens. Look at the streets and look at the news.