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California Law Extends Involuntary Commitment and Detention to Substance Abusers

For years, California has struggled with a growing homeless population, reaching 171,000 in late 2023. Though that’s less than one-half of 1% of state residents, lawmakers responded with reforms to the state’s mental health system in SB 43, which Gov. Gavin Newsom (D) signed into law on October 10, 2023.

The legislation revises the existing Lanterman-Petris-Short Act, which provides for involuntary commitment of those deemed a danger to themselves or others, as well as those who are “gravely disabled.” SB 43 expands the definition of “gravely disabled” to include not only the mentally ill but also people who, due to a “severe substance use disorder,” are unable to provide for their basic needs such as food, clothing, shelter, personal safety or medical care.

Substance use disorders include both drug and alcohol abuse, making chronic drug users and alcoholics subject to involuntary commitment and detention if they can’t provide for their basic needs. The homeless are prime targets for the new law, since many have substance abuse problems. SB 43 specifies that even private hospitals and medical staff will not be held civilly or criminally liable for detaining people deemed “gravely disabled.”

A person may not be deemed “gravely disabled” if he or she “can survive safely without involuntary detention with the help of responsible family, friends or others,” the law says. Otherwise, periods of detention can last for 72-hour evaluations, 14 or 30 days for “intensive treatment,” or six months for “post-certification intensive treatment.”

Newsom called the law “a major overhaul of our mental health system,” one that will help “ensure no one falls through the cracks, and that people get the help they need and the respect they deserve.” He did not explain how the state will pay for so many more determinations that someone is “gravely disabled,” much less how involuntarily commitment provides them “respect.” Funding for expanded treatment programs to handle additional patients has also not yet been allocated.

The law took effect at the beginning of 2024, but counties can postpone implementation for two years. The law was endorsed by the California chapter of the National Alliance on Mental Illness but opposed by disability rights advocates, who fear coercing people into treatment not only deprives them of rights but will also prove counterproductive. In San Diego County, which voted to delay implementation one year, Behavioral Health Director Luke Bergmann worried that “[t]he revolving door at the emergency department for people with substance use disorder will just spin faster.” The State Department of Health Care Services is responsible for collecting data and publishing annual reports on the impact of SB 43, including the number of people involuntarily committed and detained. See: Calif. SB 43 (2023-2024).

PLN has long opposed civil commitment of sex offenders, not least because it opens the door for involuntary commitment of other groups deemed socially undesirable. California already incarcerates over 100,000 citizens and keeps another 350,000 under supervision, Prison Policy Initiative estimates. With the new law, that number could swell by 25% or more.   


Additional source: AP News

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