Why mentally ill deserve our support of CARE Court proposal
People arguing against the CARE Court concept currently being hashed out in the Legislature would rather keep the status quo. This allows the sickest people with brain disorders who cannot recognize their illnesses to “die with their rights on” — homeless, incarcerated or in the back rooms of family homes.
The governor is not stepping in to “make us criminals.” That has been happening for decades to people trapped in their own malfunctioning brains and being allowed to suffer on our streets.
What is broken is our current system. And, as we are witnessing, not everyone can self-direct their treatment and recovery path when they are deep in psychosis. These citizens are our most vulnerable who need help to get better.
The pushback against this legislation is coming from disability rights groups who are not medical doctors and do not understand these complex brain diseases. They lump in brain illnesses such as schizophrenia and other psychosis spectrum disorders with lesser conditions that do not involve psychosis.
When psychosis occurs, brain changes disable a person’s decision-making capacity. Psychosis hijacks your brain. In 50% of cases, the affected person is unable to recognize they are sick. The word to describe this symptom is anosognosia, and it is the No. 1 barrier to seeking treatment. It takes an average of 10 years for someone with schizophrenia to get needed treatment. By then, hopes for a meaningful recovery are severely diminished. These people have much higher suicide rates than the general population and a reduced lifespan of 20 to 30 years.
We see the results of anosognosia — trying to convince people who think they aren’t sick to get medical treatment — on our streets and in our jails and prisons. The longer people are in untreated psychosis, the worse their prognosis. We have a responsibility to provide compassionate care at the onset of illness. These are treatable medical conditions that need immediate care by doctors for best recovery outcomes.
At the rollout of Governor Newsom’s CARE Court concept, he used the proper term “brain health” to describe these severe brain illnesses. Schizophrenia and related disorders are not “behavioral” or “mental” conditions — they are physical diseases of the brain, our body’s most important organ. The behaviors are indicators of the brain malfunctioning due to the underlying pathology.
CARE Court will help most vulnerable
Unfortunately, our state’s 55-year-old Lanterman-Petris-Short Act is based on outdated notions of what serious brain diseases are and how they need to be treated. Criteria for involuntary treatment is not medically based. They are based on dangerousness and open interpretations of grave disability. We keep trying to build a better system of care on a faulty foundation. CARE Court is trying to work in the margins to get our sickest into care and on a path to recovery and living their best lives.
It’s time to address the elephant in the room that decision makers across our state are loathe to discuss. Why is California allowing groups who have no understanding of complex brain illness and psychosis dictate to doctors when and if a very sick person can be given lifesaving medical treatment? Why are we giving these groups the power to stop legislation that can save the lives of those who lack decision-making capacity?
Compassionate involuntary treatment is not an ideological construct — it is a medical necessity in cases where a person is unable to make lifesaving treatment decision for themselves. It is our collective duty to honor our fellow citizens’ right to prompt, effective healthcare. Delaying treatment is a violation of an individual’s human right. Every day a person is in psychosis is truly a matter of life and death — especially if they are unsheltered on our streets, or in our jails.
Bold change is needed to save lives. The CARE Court concept is promoting bold change. Let’s give it a chance. Our most vulnerable are depending on us.
This story was originally published May 6, 2022 at 1:45 PM.