The URL can be used to link to this page

Home My WebLink AboutMINUTES - 04182000 - D3 Contra To: BOARD OF SUPERVISORS Costa ,• FROM: Supervisor Joe Canciamilla '` ,' County DATE: April 18, 2000 SUBJECT: CONSIDER ADOPTION OF A RESOLUTION OF SUPPORT FOR ASSEMBLY BILL 1800, AN UPDATE OF THE LANTERMAN PETRIS SHORT ACT SPECIFIC REQUEST(S)OR RECOMMENDATION(S)AND JUSTIFICATION RECOMMENDED ACTION: 1. Consider adoption of the attached resolution of support for Assembly Bill 1800, which provides for an update of the Lanterman Petris Short Act related to services for the mentally ill. 2. If the Board of Supervisors acts to adopt the attached resolution, authorize the Chair of the Board to prepare a transmittal letter to be sent to our State legislative delegation. BACKGROUND INFORMATION: The Lanterman Petris Short Act (5150 of the Welfare and Constitutions Code) was enacted to integrate severely mentally ill persons with services in the community where care would be provided in a more cost-effective, humane setting. But current provisions of the act require that a person be found to be an immediate danger to self or to others, or be gravely disabled, before being involuntarily held. As a consequence, state hospitals were emptied virtually overnight by placing mentally ill persons back on the street even though sufficient services and funding were not in place to provide the treatment and housing options necessary for them to function in our communities. Access to quality public mental health services has improved, and will hopefully continue to improve as policy makers give increasing attention to the needs of the mentally ill. Changes are necessary, however, in the current legislation in order to allow for more effective involuntary intervention for those who are so severely mentally ill that they refuse medical treatment and deteriorate further without it. Assemblywoman Helen MacLeod Thomson has introduced a bill, AB 1800, which will implement the changes needed in this Act. A summary of the changes intended with the passage of AB 1800, along with additional information, is attached for your review. CONTINUED ON ATTACHMENT: _ YES SIGNATURE: y� RECOMMENDATION OF COUNTY ADMINISTRATOR fi6MM DATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON -April-18, 2000 _ A OTHER: X— REFERRED to the Mental Health Commission for report to the Board of Supervisors on Ma 9, 2000. vOTE OF SUPERVISORS: X UNANIMOUS(ABSENT none ) AYES: NOES: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE ABSENT: ABSTAIN: BOARD OF SUPERVISORS ON THE DATE SHOWN. ATTESTED April 18, 2000 cc: County Administrator's Offlce PHIL BATCHELOR,CLERK OF THE BOARD OF Dr.William Walker,Director—Health Services SUPE ORS AND COUNTY ADMINISTRATOR BY PUTY TIS Boarb of SupenAsors of Contra Costa Count2p in the Mattero f Resolution No. 8u the Passage 0 As "t5 29 Bill 1800 s one of even five Americans experiences a menta(bisorber in ani given near,anb half of all ave such bisorbers at some time in their lives;anb Wnear( two-t�rbs of those suffering from mental illness never seek treatment of anN kinb;anb W EAS7 e positive menta(health of all our citizens contributes to a more hea(th�anb successful communitN;A 4`4, VVHEIR W curre t law boes not provibe anvr legal authority to intervene earlier to prevent menta(illnesses from becomin more severe or to give the mbiviNat a better opportunitN for more effective treatment,nor is there nN legal requirement or provision for the necessary structureb anb superviseb follow-up mental hea care necessary in the communitN upon release from involuntarN betention;anb WIMR1ASj AssemblN Bill 1 will upbate anb reorganize the 3o Near olb invo(untarN commitment anb treatment taws o f the nterman Petris Short Act to provibe more timet v intervention for the mentaf fv�it(in a more time anb s restrictive setting;anb W MBJWj Assemb(N Bill 1800 w (b create a six--month assisteb outpatient program option for those who are stable anb wou(b benefit from uperviseb,comprehensive treatment on an out-patient basis;anb ViREASt this upbate will also provibe appropriation of$35o million to provibe the communitN services necessary to implement such a pr ram;anb WBIMEAS, the passage of AssemblN Bill 1800 ,tl prevent the toss of billions of bottars per Near paib out in excessive sick leave anb tow-probuctivit ough untreateb bepression in the work place, woulb eliminate the loss of f unbs paib b the State for multip invotuntarN holbs for people who bo not seek out mental health services anb wit(assist our criminal jus 'ce system bN provibing a sa f etv�net for the bisproportionate number of untreateb menta(lN i((persons w are incarcerateb. NOW, 'I'HEMBMM,BE IT RESOLVED that the B rb of Supervisors of the CountN of Contra Costa,California,boes herebN approve a resolution of support or the passage of AssemblN Bill 1800. PASSED b�unanimous vote of the Boarb Members present on 18th baN of Aprit, _000. i hereb�' certif v�tbat tl�e foregoing is a true anb correct copN o f a rtesolution entered o e minutes of the Boarb o f Supervisors on Z, bate a f oresaib. Witness mN banb anb the at of Boarb of Supervisors a f f ixeb on tbis 10 of Aprit�2 0, PHIL BATCHEI,DIt Cierof t�e Boal of Supervisors anb Country Abministrator . BN`- - DeputN robuceb b;V j r% r joe Canciamilta f isty V Resolution not adopted. STATE CAPITOL CHAIR R0.Box 942849 SELECT COMMITTEE ON / / SACRAMENTO,CA 94249-000$ MENTAL HEALTH ! (918)319.200$ T.}T.�•�i.LL�..VV FAX(9 16)319.2108 CO-CHAIR +' ''/�` i'�' y� LEGISLATIVE ETHICS COMMITTEE ST 50LACOUNTY ,, L 4 i 6 � ASL -C• 555 MASON STREET,SUITE 275 �+VV STA COMMITTEES VA(707) 5 -8 95888 AGRICULTURE (707)455-$025 FAX(707)455.0490 APPROPRIATIONS HELEN MACLEOD THOMSON HEALTH YOLO COUNTY LOCAL GOVERNMENT 712 MAIN STREET WATER,PARKS,AND WILDLIFE WOODLAND,CA 95895 ASSEMBLYWOMAN,EIGHTH DISTRICT (530)882.78$7 SELECT COMMITTEES FAX(530)408•0770 ASSISTANT SPEAKER PRo TEMPORE CALIFORNIA PORTS e-mail CALIFORNIA WINE helsn.thomson0ssssmbly.ca.gov INDIAN GAMINGNATIVE AMERICAN REPATRIATION webalte RURAL ECONOMIC DEVELOPMENT http://www.assembly,ca.gov/thomsarJ SCHOOL FACILITIES FINANCE JOINT COMMITTEE FAIRS ALLOCATION AND CLASSIRCAMON SUMMARY OF AB 1800 Assisted outpatient treatment for the severely mentally ill • Creates a voluntary contractual 6-month Assisted Outpatient Treatment Program for those who have been certified for involuntary commitment and qualify for treatment on an outpatient basis. • Appropriates $350 million to provide the community services necessary to implement the program. • Allows greater access to community mental health services by expanding the existing criteria for "gravely disabled" when the patient's prior history of mental illness again presents clear evidence of a recurrence which poses a serious risk of substantial deterioration that is likely to result in serious harm to the person in the absence of treatment. • Streamlines the hearing process by combining in one probable cause hearing the certification that the person meets the commitment criteria and a determination whether he/she has the capacity to consent to or refuse psychotropic medication. • Eliminates the separate "Riese" hearing which requires the determination of capacity only in the event the patient refuses medication. • Provides that the burden of proof at trial for determining grave disability or a danger to others be by clear and convincing evidence. Extends the 14 day hold to 26 days and eliminates the second 14 days. • Extends the postcertification period to one year for those demonstrated to be dangerous to others to provide more consistent and effective treatment as is provided those in conservatorships for grave disability. • Requires treatment criteria in prison to conform to the new community standards. 1/7/00 Printed on Recycled Paper STATE CAPITOL CHAIR P.O.BOX 942849 SELECTMNTALMEA TEE ON SACRAMENTO,CA 94249.0008 MENTAL HEALTH d (918)319.2008 PAX(916)319.2108 CO-CHAIR SOLANOCOUNTY California �Lg1*51UfUrt LEC31SLAMVE4GCOM ITTESGOMMfTTEE 555 MASON STREET,SUITE 275 �l� VACAVILLE,CA 95888 STANDNdG COMMITTEES (707)455.8025 AGRICULTURE FAX(707)455-0490 HELEN YOLO COUNTY HEL.E'N MAcLEOD THOMSON HOC GOVERNMENT 712 MAIN STREET WATER,PARKS,AND WILDLIFE WOODLAND,CA 95895 ASSEMBLYWOMAN,EIGHTH DISTRICT (530)882.7887 SELECT COMMITTEES FAX(530)408-0770 ASSISTANT SPEAKER PRo TEMPORE CALIFORNIA PORTS e-mail CALIFORNIA WINE helen.thomsonOassemNly.ca.gov AB 1800 FACT SHEET INDIAN GAMING NATIVE AMERICAN REPATRIATION ""Ite RURAL ECONOMIC DEVELOPMENT hltp://www.assembly.ca.gov/thomson/ SCHOOL FACIU71ES FINANCE JOIRTI COMMIT MF FAIRS ALLOCATION AND CLASSIFICATION CURRENT LPS LAW Provides for involuntary commitment and treatment when a person's mental illness has progressed to the point that they are suicidal, an immediate danger to others or totally unable to function in society. There is no legal authority to intervene earlier to prevent mental illnesses from becoming that severe and to give the person a better chance at more effective treatment. There is no legal requirement or provisions for necessary structured and supervised follow-up mental health care in the community upon release from involuntary detention. WHAT THE BILL DOES Provides $350 million for earlier intervention for those who have a history of mental illness in order to give them access to timely, more effective treatment. It also creates a 6-month assisted outpatient program option for those who are stable and would benefit from well-structured, supervised, comprehensive treatment on an outpatient basis. It also streamlines the hearing process to combine in one hearing both determinations for the need for commitment and the capacity to consent or refuse treatment. PUBLIC INTEREST One out of every five Americans experiences a mental disorder in any given year, and half of all Americans have such disorders at some time in their lives, but nearly two-thirds of them never seek treatment, according to the Surgeon General of the United States. Ten to fifteen percent of state prison and county jails populations are suffering from severe mental illnesses and ninety percent of those who were arrested were not receiving any treatment at the time of the arrest. AB 1800 would update and reorganize 30 year old involuntary commitment and treatment laws to make them a more effective tool for delivering timely services to the severely mentally ill in the least restrictive setting. PAYING FOR TIMELY TREATMENT SAVES PUBLIC AND PRIVATE DOLLARS Today's alternative is businesses paying billions of dollars every year for excessive sick leave and low- productivity through untreated depression in the work place, The state pays for the revolving door of multiple involuntary holds for people who do not seek out mental health services, and our criminal justice system providing the safety net for the disproportionate number of the untreated mentally ill who are incarcerated. We can either pay less in timely humane intervention up front or continue the more expensive status quo of shameful neglect and abandonment of the mentally ill. Printed on Recycled Paper SUPPORT AB 1800 is widely supported by mental health provider organizations, law enforcement, consumers in support of LPS reform, and countless family members who advocate for the mentally ill. OTHER STATES Eight other states have enacted laws to provide structured, supervised assisted outpatient treatment programs for the severely mentally ill, most recently New York's Kendra's Law . It's past time for California to provide more effective and humane commitment and treatment laws for its residents. 4 , 3 STATE CAPITOL CHAIR 41'1.Y-706' P.O.BOX 942849 SELECT COMMITTEE ON y SACRAMENTO,CA 94249.0008 MENTAL HEALTH u� (916)319-2008LaLL FAX(916)319.2108 CO-CHAIR SOLANOCOUNTYLEGISLATIVE ETHICS COMMITTEE 555 MASON STREET,SUITE 275 )��...j.�,. VACAVILLE,CA 95588 STANDINGCOfJIl�YTEES (707)455-8025 AGRICULTURE FAX(707)455.0490 HPPROPPIA71ONS LTH YOLO COUNTY HELEN MACLEOD THOMSON LOCALGOVERNMENT 712 MAIN STREET WATER,PARKS,AND WILDLIFE WOODLAND,CA 95895 ASSEMBLYWOMAN,EIGHTH DISTRICT (530)662.7887 SELECT COMMITTEES FAX(530)408.0770 ASSISTANT SPEAKER Pito TEMPORE CALIFORNIA PORTS e-mell CALIFORNIA WINE bly.ca.gov helen.thOmaon®aSsem INDIAN GAMINGNATIVE AMERICAN REPATRIATION website RURAL ECONOMIC DEVELOPMENT http://www.assembly.ca.gov/thomson/ SCHOOL FACIt1TIES RNANCE JOINT COMMITTEE INVOLUNTARY TREATMENT STUDIES FAIRS ALLOCATION ANDCLASSIFiCAT10N • The majority of individuals who refuse medication and were informed that a determination had been made that they must accept treatment subsequently accepted medication orally. (American Academy of Psychiatry, 1996) • The majority of patients who initially refused medication retrospectively agreed that the decision to coercively medicate them was correct. (American Academy of Psychiatry, 1996) • The majority of patients who were involuntarily treated retrospectively agreed that they would be more likely to accept treatment voluntarily in the future. (American Academy of Psychiatry 1996; American Public Health Association 117`" Annual Meeting, Chicago, 1989) • The majority of patients who were involuntarily hospitalized retrospectively agreed that they needed to be hospitalized. (American Journal of Psychiatry, 1999) • The majority of patients who had to be court ordered to comply with treatment in the community remained treatment compliant after the court orders expired. (Hospital and community Psychiatry, 1988; Iowa Consortium for Mental Health, Services, Training, and Research, may 1998) Printed on Recycled Paper STATE CAPITOL CHAS ",✓ ,y` e'L) P.O.BOX 942849 r SELECT COMMITTEE ON }..� SACRAMENTO,CA 94249.0008 �! i yC�} / (918)319-2008 T3 A�LL.�1 MENTAL HEALTH FAX(918)319.2108 CO-CHAIR SOLANO COUNTY �("j► �y LEGISLATIVE ETHICS COMMITTEE 555 MASON LLE,CA,SUITE 275 � liforn-a �j gisln f ur� VACAVILLE,CA 95888 C �� STANDING COMMITTEES (707)455.8025 AGRICULTURE FAX(707)455-0490 APPROPRIATIONS HELEN MAUEOD THOMSON LOCAL POLO COUNTY LOCAL GOVERNMENT 712 MAIN STREET WATER,PARKS,AND WILDLIFE WOODLAND,CA 95895 ASSEMBLYWOMAN,EIGHTH DISTRICT (530)882-7807 SELECT COMMITTEES FAx(530)406-0770 ASSISTANT SPEAKER PRO TEMPORE CALIFORNIA PORTS *-moll CALIFORNIA WINE helen.thomson•assembiy.ca.gcv �T INDIAN GAMING website LAC OF 114SIHT NRUARdLECONOMICNt7EVELCPAAENTN http://www,assembly.C..gov/thomson/ ,4 common symptom of severe mental illness SCHOOL FACILITIES RNANCE JOMfT COMMITTEE FAIRS ALLOCATION AND CLASSIFICATION • Impaired insight is a very common symptom of schizophrenia and bipolar disorder (manic depression). Both inpatients and outpatients with schizophrenia and bipolar disorder have shown the same rate of unawareness — approximately 50%. (Husted,J., Journal of the American Academy of Psychiatry&Law, Vol.27,#1,1999) (Amador et al, Archives of General Psychiatry, 1994) • Being unaware of being ill -- lacking insight — is strongly correlated with nonadherence to treatment. (Amador XF; Strauss DH; Yale SA; Gorman JM& Endicott J The American Journal of Psychiatry, 150:873-879, 1993.) • Patients with schizophrenia and schizoaffective disorder with poor insight have very poor adherence to either psychosocial treatment or medication even when they have expressed their desire to participate and work at the program. (Lysaker PH; Pell Mfg; Milstein R; Bryson G &Beam Golet J. Insight and Psychiatry, Vol. 57, November 1994) • Lack of insight not only leads to noncompliance with community treatment but leads to the revolving door of involuntary hospitalizations. (McEvoy JP, F"reter S. Everett G, Geller JL, Appelbaum PS, Apperson LJ&Roth L. (1989). Journal of Nervous and Mental Disease, 177(1):48-51) • Studies of affective disorders find that lower levels of insight are correlated with a poorer course of illness, lack of adherence to treatment and increased involuntary hospitalizations. (Ghaemi NS&Pope HG, Jr. Lack of Insight in Psychotic and Affective Disorders: A Review of Empirical Studies. Harvard Review of Psychiatry, MaylJune: 22-33, 1994.) (Also see Amador et al, "Unawareness of Illness in Schizophrenia, Schizophrenia, Schizoaffective and Affective Disorders, Archives of General Psychiatry, 1994) • The inability of the noninsightful patients to understand they have a brain disorder or to accurately evaluate their living conditions and plan for daily needs supports the necessity for some form of"community assisted treatment." Without supervision or court order, the person may not seek treatment, or if temporarily coerced into treatment when hospitalized, be unable or unwilling after discharge to comply with the treatment regime. (Husted, J, Journal of the American Academy of Psychiatry &Law, Vol. 27, #1, 1999) Printed on Recycled Paper Compliments or` 1bl�rro HSteo T6+�msan Friday,March 10. 2000 IrOlrio trom, r THE VOICE OF THE WEST EDITORIALS Hop' e or the Mentally In Assembly JCIETY'S TREATMENT of its se- In an effort to turn the tide of a system that verely mentally ill is a disgrace. has not worked for California's mentally ill. It is hardly humane to allow people assemblywoman Helen Thomson, D-Davis, not capable of making rational deci- has written legislation that would both cions for themselves to lie in their own filth streamline the hearing process and extend on the streets as members of the anonymous the time allowed for involuntary treatment. "homeless" population or to face prison The measure,AB 1800, was carefully written terms rather than treatment to protect individual patient options because they cannot rights, to ensure that the pa- differentiate right from What tient had reliable advocacy wrong. �' representation at hearings,to Yet studies show that at the mentally ill favor outpatient, over inpa- least one-third of homeless tient, care and to encourage individuals and approximate- out Of voluntary compliance. But it ' ly 16 percent of inmates in also recognizes that the California jails and prisons homelessness choice for treatment cannot are severely mentally ill — always be left up to the pa- meaning they suffer from and prLson tients themselves, especially schizophrenia, major depres- in the early stages of treat- Sion and other disabling con- is treatment. mens. I ditions. Each year, about Thomson's measure, 1.000 homicides are commit- which is scheduled for its ted across the country by individuals with first legislative hearing in the .Assembly severe mental illness. Health Committee on Tuesday, also would What could change these deplorable cir- set aside$350 million for desperately-needed curnstances is treatment. Even the most in- community services for the mentally ill. sidious brain diseases can be successfully The bill is intended to provide people with treated. Current law, however, makes if very the care they need in the shortest time possi- difficult to provide that treatment to people who don't want it. The Catch-22 is that it ble and also give doctors and the courts a takes treatment for many mentally ill people reasonable amount of time in which to suc- to understand that they would be better off ceed. Thomson's bill would help end the with medication or counseling or both to neglect and criminalization of the state's combat their illness. mentally ill. ra 34 Monday,February 22,199 `%ne Sacramento 8,*e jNi I x 1 ' men, talhealthv,, u-1ft1dU,--&r Legislature tackles flawed re.-form of the Dost he Lanterman-Petris-Short Act, either to jail or held briefly in local mental California's landmark mental health health facilities, where they,were stabilized reform legislation of a generation ago, and released into the community until they urgently needs reform of its own. Families of lapsed again,in an expensive,never-ending the mentally ill,!rental health providers.law co ior�ger cannned in hospitals,ton many enforcement officials and social service work- ers have known this for some time.Legislators ended up either homeless or in jail or prison. heard it last week when they received a re ori While only 4.000 patients still reside in state Tram a state task farce of doctors, police and hospitals.an estimated 20,000 to 30,C}00 men- tally ill are in our state prisons and local jails. social workers who have been looking for three tears at the state's broken mental health Sys- �t least an equal number are homeless. tern and the law upon which it is built. The task force has offered 12 recorm-nenda- �'Vhen first enacted 32 years ago.California's tions for change.The most controversial would allow,under certain limited circumstances. lain facilitated the release of tens of thousand involuntary treatment of people witha histarrtr f':rentally ill people from state hospitals. ('psychotic episodes. Critics of-;gat, notion. where many had been involuntarily confined. among them former mental patients who fear in these days, it was easy to commit people — a return :of the forced hospitalizations of too easy.The task force estimates that some 70 past, have raised strong'objections. percent Of'hose who were locked up in drear,r. - sometimes inhumane state hospitals •.v(�re t Assembl:-,vonman .eleaThomson z�:s t :`or no other reason than that rhe r 17--ere Bequal aressure is corning zrom fay-dies o,`here alcoholics,senile,behaved oddly or,_f children. seriously aisturbed people .such as the n orlie di r iptiveiy, wl a wrote Thomson about the plight :si Ellie �anterrr:an-Petris-Short:pct secured for ":dolt schizophrenic daughter ,vho refu:..>^ .; tl.e mentally ll, and those falsely labeied as take z.er :rzedication and disappeared t:c'r sup h, long-}t'eraue due-process safeguards. it ,reeks.The desperate mother bund prayided that ,eagle cannot be involuntarily ter in a �r�r:zr.:s,S shelter in Oakland c1l:ry a2`.Gr ^anfined a less they pose a"danger to them- shed been rape.l epe ate ly. Lawma.iers w-1.1 i:.43ve to be careful hat aelves and fishers.'a Enactment of the reform led t�the release from state hospitals of'thausands reform. does not �1 n!ge the nue-process rights of perfectly sane people. It also permitted the that protect ill sift:z� {s 'aint t azbiitra>r�co�n- :nei2en and abouue. Sat{)n .Set _'Aing a].. `SA.d,Z reiease of.ic zizophrenics. manic depressives N : _n or and others with serious mental illnesses who in the mental health debate agree: ,. � t r�z were supposed to receive less restrictive care vvi.11 work ifthe state fails to crake more tunr!s in community-based programs. available. _he money California nc�ty ;open is e arrest,book,transport, adjudicate,housz: and hat's where the reform broke down. treat the mentally ill in prisons and jails cez:.ix:f Promised support for the truly mentally ill be more usefully and humanely spent to build never materialized.Without it,many of them the comprehensive community-basea mental stopped taking their medications or walked health system that was promised by the earlier away from treatment. Some lapsed into irra- generation of reformers who passed the tionality,were picked up by police and taken Lanterman-Petris-Short dict. l� r t4 `SJ � ✓+"•"'Il ✓Cly� ��+� � ]//'�r�y�} �� h 900 78 y4" �.+•��,.�` .+`�'may''� � A." ,•" m ego a. ��"" �"� �?y �` �c��`"-�.^ �•�� `?.civ a �� .s 1 G- "� SS ✓ ,y A A 0 .s ryro O r m 9 f9 p� t0 m Cp r✓�,'� Gy Si+� �, ,.• 051 �,r' � � q � ' i•�iti ry ,'"P �q � tl n t✓, c' "'� � �:'c� ro, ��,ear,, '�""�+ ` � 1 .� ��.;a r•G r C �, •3 wry'" (" � -•!•„',' L i they arrived,Julie demanded they leave. Later that evening, Gonza- Fearing a deadly accident, Gon- Sacramento Bee lez went to see her daughter, who zalez more than once called police. December 20, 199 I told them Julie has a problem.said."I think you're putting some. She is driving carelessly. I told gry"and told her to leave. thing in food to make me an- them a tragedy is going to hap- pen,,'Gonzalez said. On Fathers Day the next year, Like man with mental disor- Julie invited her parents over for y dinner, but just before serving it, ders,Julie appeared normal when she dumped the meal in the gar- confronted by authorities, who bage, Gonzalez recalled. On other said they couldn't do anything for occasions, Julie accused her hus- her,Gonzalez said. band,of harboring strangers in the Julie's brother, Richard Gonza- attic and suspected her neighbor lez, also talked to police officers. was plotting against her. "They felt she could make her own It wasn't until late 1996 that decisions," he said. "i was mad. Gonzalez convinced Julie to Borne Maybe they didn't know she had a with her to the Sacramento Coun- problem.But we knew." ty mental health treatment cen- Matt Powers,deputy chief of op- ter, a locked facility offering treat- ment to voluntary and involun- eratfons for the Sacramento Police tart'mental health patients. Department, said current law re- A therapist interviewed both quires they observe dangerous be- havior before holding someone. mother and daughter. Gonzalez "If this was the mid-1960x, my said they discussed Julie's para- gut feeling is it would have been f` + noia,anger and violent temper. easier to get her committed," he The therapist later asked Gon- said of Julie. "The law used to be zalez if Julie had ever threatened more permissive, and government anyone.She said no, and he decid- could deprive you of your liberties ed not to hospitalize her. with far greater ease. Tragically, "I was disappointed," Gonzalez this is the price that we,as a soei- said. 'They gave her the number ety,pay to protect those liberties." of a counselor (Julie) never After Priscilla was born,Gonza- called." lea approached Julie's obstetrician about her daughter's behavior.He Julie did not meet the criteria suspected depression and sug- for involuntary treatment, Tom gested Julie see him. She refused, Sullivan,county mental health di- telling her mother she was tine. rector, said recently. "Even if she The doctor, who could not be had been admitted, a hearing offi- reached for comment, never fol- cer would have released her be- lowed uD.Gonzalez said. cause there was no way to prove Gonzalez also tried discussing she was a danger to herself or oth- the problem with Julie's social ers," he said. "And she wasn't worker through Aid to Families gravely disabled because she had with Dependent Children, the food,shelter and clothing." county s welfare program. The so- A Sacramento psychiatrist, who cial worker Said she could not dis- spoke on condition of anonymity, cuss her client because of confi- agreed with Sullivan's assess- dentiality rules. menta `The law is so narrow it In spring 1998, Gonzalez again doesn't matter that I am talking brought Julie to the county men- to myself, I am swatting things tal facility. Again she was evalu- out of the air,that I think the dev- ated and let go with a suggestion U is after me. to seek counseling. In early 19971, pregnant with Sullivan, who called Julie "a her third child,Julie left her hus- borderline case,"said if the county band in Walnut Grove. She and had adequate resources a case- her children moved into her par- worker could have seen her the eats'south Sacramento home. next day to try to get her into Her behavior was becoming in- treatment. creasingly bizarre.She moved fur- Julie moved back with her hus- niture and fed her children during band. Twice in the summer of sleepless nights, then pounded on 1998, sheriffs deputies responded her parents' bedroom door de- to calls involving Julie's violent manding to know why they behavior. Her husband made the wouldn't let her sleep. When her first call in July, but Julie had left car didn't work,she suspected her husband had tampered with it. Other nights she loaded her chil- dren in the car with the windows rolled down and sped off along the river toward her huchand';hnma aQ `e co oz m �o cn fA _ Ln 223 IV •• `�`j r N ' y Z 9 � �� ,°K`", � �'�„"�ski• �'� et m 52—