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In Passing AB 1424, California Supports the Right to be Well

California's Assembly Bill 1424 (AB 1424), recently signed by Governor Gray Davis, is a substantial reform of California's mental health laws, allowing better assessment and treatment of those incapacitated by severe mental illnesses. Because of the vision and hard work of committed legislators and advocates, judicial officers will be able to consider psychiatric history when making determinations concerning court-ordered treatment.

AB 1424 is the brain-child of Assemblywoman Helen Thomson (D-Davis), a former psychiatric nurse who understands too well the critical importance of giving families and the mental health system tools to ensure that people with severe mental illnesses are able to receive timely, consistent, and appropriate treatment. Assemblywoman Thomson is a powerful crusader for those with mental illness too sick to help themselves.

AB 1424 would never have become law without the unflagging work of the members of the California Treatment Advocacy Coalition (CTAC) and its leaders - Carla Jacobs, Randall Hagar, and Chuck Sosebee. Along with the Treatment Advocacy Center, CTAC is dedicated to reforming California's Lanterman-Petris-Short Act (LPS) so that people too sick to access treatment voluntarily can be helped.

California's Lanterman-Petris-Short Act was designed when we knew little about mental illnesses or how to treat them. In the three decades since this act was passed, our understanding of severe mental illnesses has changed dramatically.

The LPS Act is badly out of date. We now know that schizophrenia and manic-depressive illness, the most common forms of severe mental illness, are diseases of the brain -- just as are Parkinson's and Alzheimer's. We now know that approximately 50 percent of individuals with these diseases, including those who have never been treated, have impaired insight into their own illness. They do not realize they are sick and, therefore, often do not accept treatment voluntarily.

We now know that the underlying tenets of the LPS Act are incorrect. To subject Californians with severe mental illness to laws not based on scientific fact is preposterous. Passage of AB 1424 is the first step to right this wrong.

AB 1424 recognizes that people can "present" well at commitment hearings despite being significantly affected by a severe mental illness. Acknowledging that medical history is critical in making treatment decisions concerning mental illness - as with any other adverse medical condition - will help judicial officers make better informed determinations on if court-ordered treatment is necessary. AB 1424 also recognizes that people who are remanded to treatment should not be treated adversely by the insurance community.

California has, thanks to AB 1424, taken a significant step toward how the most progressive states provide enlightened care to those most overcome by mental illness. California still lags well behind, but with passage of AB 1424, it begins to demonstrate the intent to catch up.

More specifically, AB 1424 will:

• require that the historical course of the person's mental illness be considered when it has a direct bearing on the determination of whether the person is a danger to self/others or gravely disabled;
• require that relevant evidence in available medical records or presented by family members, treatment providers, or anyone designated by the patient be considered by the court in determining the historical course;
• require that facilities make every reasonable effort to make information provided by the family available to the court; and
• require that the person (a law enforcement officer or designated mental health professional) authorized to place a person in emergency custody (a "5150") consider information provided by the family or a treating professional regarding historical course when deciding whether there is probable cause for hospitalization.

Additionally, the bill clarifies that no insurer may utilize any information regarding whether a beneficiary's psychiatric inpatient admission was made on a voluntary or involuntary basis for purposes of determining eligibility for claim reimbursement. This will prevent insurance companies from refusing to pay based upon a person's legal status.