1. The current law provides very important due process rights for individuals before they can be treated involuntarily and during a course of involuntary treatment.

2. It prevents anyone who is willing to accept treatment voluntarily from being involuntarily committed.

3. It addresses the need for people who are mentally ill and a danger to themselves or others to be involuntarily treated.

4. It recognizes that people who are severely disabled by mental illness and not willing to receive treatment voluntarily should receive involuntary treatment for their own present and future well being and it sets the criterion for severity as those who are currently so ill as to be unable to provide for their own basic necessities of life. It thus avoids the trap of trying to predict possible severity of illness in the future and it avoids sweeping too many people into the net of involuntary treatment which can be a violation of individual rights and is not a panacea since voluntary treatment is much more desirable. Specifically, it excludes people from involuntary treatment who are exhibiting symptoms of mental illness, possibly even severe symptoms, but not so severe as to prevent them from taking care of their own basic necessities of life.

1. The criterion of grave disability may require that a person can’t be involuntarily treated until he/she is evicted from their family home, board and care home, etc., thus possibly putting himlher in serious risk of harm on the street and creating unnecessary agony for his/her family.

2. The use of the word "shelter" in the definition of grave disability has resulted in people with serious mental illness who sleep under a bridge, freeway overpass, or in a doorway being held to have shelter and therefore to not meet the criteria for being gravely disabled.

3. Some counties refuse to allow the psychiatric history of the patient to be heard in commitment hearings because of their interpretation of the current LPS law. The result is that the hearing officer can not get a complete understanding of the present condition of the patient and may easily make erroneous decisions regarding commitment, usually on the side of inappropriately releasing the patient.

4. Patient confidentiality rights may prevent hospital staff from being able to obtain important information regarding the patient’s psychiatric history and their behavior prior to hospitalization. This can result in the staff being inadequately prepared in the certification hearing that may then result in the patient being inappropriately released at the hearing. This also interferes with the staff being able to make the best possible treatment plan for the patient.

5. There is a major structural defect in the present definition of grave disability! As we all know, serious mental illness, particularly schizophrenia and bipolar disorder, strikes most people in the age range of 15 to 23 or so. And even before that first major decompensation, there has been a gradual deterioration in the functioning of the ill person over a period of at least a year or more. The result of this gradual deterioration is that the person becomes increasingly dependent on others, usually their parents, for their basic needs of food and shelter even before their first major decompensation. Since the deterioration was gradual, their inability to manage food and shelter on their own was never obvious to others. Therefore, at that decompensation when they are presented for hospitalization while living with their parents, their inability to manage food or shelter is almost impossible to prove, even though their need for involuntary treatment may be obvious. Therefore, if they are not dangerous to self or others, they will almost certainly not be certified for treatment. In this situation, which is created by the nature of the illness, the grave disability criterion of inability to manage food or shelter is grossly inappropriate and must be replaced by another criterion that must be appropriate and not too broad or inclusive.

1. This is a very vague and subjective standard that would be extremely difficult to decide in a court of law with any degree of confidence. This requires a prediction of the future condition of a person that a psychiatrist can’t do with any reliable accuracy and, without a lot of psychiatric training, a judge, a hearing officer or a jury can’t do accurately at all. This would leave the judge, hearing officer or jury at the mercy of the psychiatrist’s subjective opinion with all of its potential inaccuracies, thus effectively returning us to the situation that we had before the passage of the LPS Act. We firmly believe that any grave disability standard should be based only on the current condition (including history) of the person, not on any prediction or expectation of the condition of the person in the future. To do that creates a very slippery slope open to serious abuse.

2. Consider an informed mental health consumer who is basically doing fairly well but who has an escalation of symptoms, possibly because of stress or because their medications aren’t working as well as they were. What many do now in this situation is voluntarily go to see their psychiatrist to get their medications adjusted. However, under the above definition of grave disability, it seems rather obvious that there would be some fear that since they now might be thought to meet the new involuntary commitment standard and since they would not want to be involuntarily treated, they would likely be reluctant to get help, thus possibly leading to further deterioration. We certainly don’t want to encourage this reluctance.

3. This type of definition of grave disability, based not exclusively on the person’s current condition but rather on a prediction of the future condition of the person, casts far too broad a net. It almost certainly would inappropriately commit numerous people to involuntary treatment, treatment that would otherwise be provided on an outpatient basis, which is much better treatment, much better for the person involved.

4. The newest and most hopeful trend in the treatment of mental illness is the movement toward recovery from serious mental illness, particularly including schizophrenia. This has been partly facilitated by the newer medications of the last decade. However, recovery requires a lot more than medication and in some cases can be facilitated

even after a period of medication is completed. Recovery is a very delicate process involving, among other things, increased hope and self-confidence within the consumer, particularly in the face of widespread pessimism among many mental health professionals. It is widely accepted that recovery has many setbacks on the road toward improved functioning. Some such setbacks can be fairly serious. On the recovery road, consumers are encouraged to learn about their disability sometimes by experimentation. Obviously, this can lead to setbacks. One of the worst things that might happen to an individual on such a road is to be committed for involuntary treatment, undermining both hope and self-confidence, during a serious setback. This is clearly antithetical to the recovery process. This new definition of grave disability that was in AB 1800 makes it too likely that an individual’s recovery process might be seriously derailed during a setback by a too easily obtained inappropriate involuntary treatment commitment.

1. There is a complete lack of oversight of the various counties’ procedures and actions as they pertain to the LPS act. There is little uniformity among the various counties in their interpretation and administration of the LPS act. For example, in some counties, if a person with mental illness gets his food by eating out of a dumpster, it is said he is not gravely disabled by being unable to provide for food.

2. There is virtually a complete lack of training about mental illness for the hearing officers and other adjudicators and for patient’s right’s advocates, all of whom make life-altering decisions for mentally ill people.