It’s a beautiful fall day in downtown Chico, Hotel Diamond’s dome shines against a blue sky. A woman with a sweeping cart sweeps the street and I can smell the coffee from the shops. I sit on a bench and think, “this is why I love Chico.”
Then an unkempt man shouting incoherent obscenities approaches me. The hallucinations tell me he is schizophrenic, a human being made in God’s image but disabled by an ugly malady. There are about 200 schizophrenics living on our streets or jail and after 35 years as a Public Defender I have come to know a few of them.
One is Kelly. When I first represented her she was a beautiful 16-year-old just showing manifestations of schizophrenia. As the illness progressed and her delusions took over she lost family and social support and was left to the horrors of the street.
When her conduct was too objectionable she was sent to jail. Her verbal out-bursts got her a conviction for “criminal threats” and two years in state prison. She has been in and out of jail over a dozen times. She was 35 when I last saw her in a holding cell at the court. Her head was shaved and she was in a jail garb reserved for someone with a sexually transmitted disease. She swore at me and pounded on the wall. The jail released her back to the street after her 90-day-sentence ended.
Another, I will call HC, developed schizophrenia at age 17, and was arrested for assaulting his mother. Declared incompetent to stand trial he has spent 18 months in jail without treatment. HC’s mother has been to court over 20 times and her plea is always, “I love my son, please help him.” It is clear to her that jail and prison are readily available for a mentally disabled person but secure, humane treatment facilities are not available in our county.
Treatment for a schizophrenic person usually requires an involuntary placement in a secure facility, therapy and medication. The individual must come to realize that they have an illness, and with treatment they can overcome the illness and become the person they desire to be. HC’s mother has come to recognize that the legal framework for involuntary treatment is a conservatorship but this is not being provided in Butte County. Despite the existence of caring, dedicated professional workers the system is broken.
California provides for a person who is gravely disabled as a result of a mental health disorder through the Lanterman-Petris-Short Act. An LPS conservatorship may be involuntary and include a secure facility. The Act includes due process protection for a subject’s rights including the right to a jury trial. The law requires placement in the least restrictive placement. A person may be placed in a “Board and Care” or other secure placement in a community setting. But Butte County lacks this resource. An August 2022 study in Rand Health Quarterly calculates a need in California for 50.5 inpatient psych beds per 100,000 adults, Butte County has one Psychiatric Health Facility (PHF) with a capacity of 16. As a result of the lack of facilities a person gravely disabled will not be accepted for an LPS conservatorship leaving them to remain on the street
Don’t say there is no money. It costs $106,000 a year to house a prisoner in state prison, $60,000 for a cell in jail. On March 3, 2022 Governor Newsom proclaimed the establishment of a new sector within the court system, CARE Court, devoted to aiding individuals suffering from schizophrenia. SB 43 recently signed by the Governor expands LPS conservatorships. Grant money is being provided to counties to pay for Board and Care facilities. We are spending more now to pay for the ravages of this illness than treatment would cost.
Schizophrenia illness is a community problem. There is an entanglement between this aliment and our community. As we provide for those in our midst who are gravely disabled we will enhance the true beauty of our community.
Ronald Reed has been a public defender for 35 years. He is the president of Base Camp Village, a non-profit devoted to helping the homeless.
