Mayor London Breed is supporting a package of mental health conservatorship reform bills in the California legislature, expressing frustration that people with mental illness are deteriorating on the streets and calling for more options to get them into treatment.

Conservatorship, a controversial issue statewide, is when a judge appoints a conservator to make decisions about treatment for people with serious mental illnesses or chronic alcoholism who can’t care for their basic needs.

Breed joined other big city mayors in California on a virtual news conference Monday to back a package of eight bills introduced by State Senator Susan Talamantes Eggman, a Democrat from Stockton.

In a passionate message, Breed said she is “truly committed to helping those struggling with mental illness and addiction” but “frustrated” by the lack of options to help people. She said San Francisco has tried to “fill in the gaps” in existing conservatorship laws with new programs and added voluntary treatment, but “we are not doing enough.”

“San Francisco has invested millions to support this population but unfortunately the current tools we have are just not working. We are a city that leads with compassion, but what we are allowing to happen… is far from compassionate, ”she said. “It is too many on our streets and it is really a disgrace. We see people every day who are in crisis. “

The bills intend to reform the 1967 Lanterman-Petris-Short (LPS) Act that attempted to reverse mass institutionalization of people with mental illness by creating a system of court-ordered treatment based on specific requirements. A political movement has been growing in recent years to reform the half-century-old law and mental health treatment.

Governor Gavin Newsom pushed for reform last month by proposing Care Court, which would create a mental-health-focused arm of the civil courts in every county, as a step before conservatorship. The plan would require counties to provide comprehensive treatment to those suffering from debilitating psychosis or be sanctioned if they don’t. The people in the program would have to accept the care.

Conservatorship has long been a controversial issue in California, with disability rights advocates and critics protesting that mandated treatment violates civil liberties, pointing to Britney Spears’ case as an example. Critics also argue that more available and quickly accessible voluntary treatment would help instead. But proponents – among them mental health professionals and families whose loved ones are struggling – say the laws are too limited to help those who are too sick to care for themselves and lead to people deteriorating and even dying on the streets of San Francisco and cities across California.

In an effort to offer more options, San Francisco three years ago started a pilot program that aimed to help between 50 to 100 people struggling with severe mental illness and substance use. The city has only conserved two people so far under it, and blames bureaucratic delays and complicated requirements under the program.

Breed said she’s been pushing to reform conservatorship laws since 2018. She added that she has personally worked with the health department to connect mentally ill people – some with families and friends who want to care for them – to resources and programs, only to find them “Right back on the streets.”

She described a man she’s known for many years who developed dementia and “started to get a little violent and confused” and ended up losing his housing. He is still homeless, she said.

“When I see individuals like him, I get frustrated that we can’t do more,” Breed said. “If we were out there in that same condition, I would want someone to step in and do something, no question.”

Breed and the mayors of Sacramento, San Diego, Riverside and Fresno backed the proposed reforms.

The eight bills aim to address different issues, including “modernizing” the definition of “grave disability” under the LPS Act, the standard under which someone is conserved, from simply being unable to provide their own food and shelter to “unable to provide for the basic needs of personal or medical care or self-protection and safety. “

Other bills will streamline data about outcomes for people under conservatorships, regionally assess needs for treatment resources, create a dashboard to track mental health treatment beds, and set up a system to help counties reach their mental health treatment goals.

Another bill in the package would add an additional 30 days to allow someone to stabilize before considering conservatorship. Other bills would require courts to consider a report filed after an investigation about whether someone should be conserved and consider evidence. It would also clarify that courts are allowed to order medications as part of a treatment plan under assisted outpatient treatment.

California has a shortage of mental health beds compared to other states. The legislature pumped $ 6 billion into mental health reform this past year, including more than $ 2.2 billion to build, buy and rehab property to expand behavioral health treatment. These funds include $ 150 million, plus $ 55 million of federal funding, for mobile crisis support teams to people experiencing a behavioral health crisis.

Mallory Moench (she / her) is a San Francisco Chronicle staff writer. Email: mallory.moench@sfchronicle.com Twitter: @mallorymoench

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