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Law change needed to assist mentally ill homeless

LOS ANGELES — The City Council has backed an effort by the county Board of Supervisors to sponsor state legislation that would allow social workers and law enforcement officers to detain severely mentally ill people who refuse life-saving medical treatment.

Under existing law, only mentally ill people who pose a danger to themselves or others or are “gravely disabled” can be held for involuntary evaluation and treatment in a psychiatric setting.

The Board of Supervisors wants to amend existing language that defines gravely disabled as “a condition in which a person, as a result of a mental health disorder, is unable to provide for his or her basic personal needs for food, clothing, shelter” to add “or medical treatment where the lack or failure of such treatment results in substantial physical harm or death.”

The council’s 13-0 vote Feb. 14 approved a resolution that was introduced by Councilmen David Ryu, Mitchell Englander, Jose Huizar and Joe Buscaino. The Board of Supervisors voted in January to sponsor the legislation, and the City Council resolution still needs to be signed by Mayor Eric Garcetti before becoming official.

“Today, the Los Angeles City Council stands with our county partners in calling for this necessary reform to the way we define a grave disability,” Ryu said. “The chronic homeless suffer from much higher rates of schizophrenia, bipolar disorder and other mental illnesses, and to address our crisis of homelessness in L.A., we need to reach these individuals.”

A Jan. 10 report to the board from county Department of Mental Health Director Dr. Jonathan Sherin found that a “significant number” of the 831 deaths of homeless people in Los Angeles County in 2017 were due to preventable or treatable medical conditions, and a survey of mental health leaders showed widespread support for amending the definition of grave disability, according to that report.

The expanded definition is similar to one followed by 37 states, according to the county motion.

“We’ve known for a long time that a third of those experiencing homelessness in the city and county of Los Angeles are grappling with mental health issues — many with severe illnesses that they cannot manage on their own,” Huizar said. “We see it every day on the streets of Los Angeles. The state must act to change this designation to prevent deaths, as well as to give these individuals the opportunity to live a quality life — they deserve no less.”

“Medical intervention is the crucial missing piece as we seek to address the homelessness crisis in Los Angeles,” said Councilman Englander, chair of the City Council’s Public Safety Committee. “Our first responders cannot be effective in assisting those experiencing serious mental health crises if they cannot compel care for those unwilling or unable to help themselves. This change will allow us to deliver life changing services to those that need it most.”

An expanded definition of the state grave disability law would include people who cannot access health care because of mental illness. It would allow service providers and first responders to administer involuntary care to an individual if that individual would face immediate harm or death without such care.

“Before joining the Los Angeles City Council, I served as an LAPD officer for 15 years, and on many occasions, I encountered homeless individuals who were soaked in their own urine or lying in their feces and completely malnourished,” Councilman Buscaino said. “Yet, due to the narrow definition for ‘gravely disabled,’ I was not able to get these people to the medical care they desperately needed. This is why we must expand the definition so that we do not continue to leave people who cannot help themselves to suffer and die on our streets.”

 

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