Column: These families fire up the ACLU as California debates mental health care

Column: These families fire up the ACLU as California debates mental health care

Bob Britton doesn’t seem like the type to curse the American Civil Liberties Union, but this week he was outside the state Capitol offering some four-letter words for the civil rights organization.

The ACLU is a leading opponent of Gov. Gavin Newsom’s plan to create civil courts to help treat people with severe mental illness. The group says it will lead to “forced treatment” of homeless people, giving police and others too much leeway to trample on the autonomy of those who refuse help.

But as the uncle of someone with a severe mental illness — schizophrenia — Britton says people like his nephew sometimes fail to realize they need help, and ignoring that medical reality isn’t a protection for their civil rights. In fact, it deprives families like his of the opportunity to care for their loved ones.

“So, about the ACLU,” Britton told me seconds after I met him, adding that he considers himself a liberal. He was sitting in a low rocking chair with short sleeved buttons and cute little fish swimming on it. His gray hair was covered in a Panama hat and he looked like he was ready for a day at the beach, like he was about to suggest we get a few beers because it was 5 o’clock somewhere.

“The alternative [to Newsom’s proposal] is prison and forced treatment. So what are your civil liberties there?” he asked no one in particular. The ACLU was not present.

Bob Britton sits in a camp chair outside the Sacramento State Capitol.

Bob Britton, whose nephew has severe mental illness, sits outside the Capitol in Sacramento. “The alternative [to the governor’s proposal] is prison and forced treatment. So what are your civil liberties there?” asked Britton, who supports the CARE Court plan.

(Anita Chabria/Los Angeles Times)

That’s the frustration that drove Britton and other family caregivers on a cloudy August day in the final weeks of the legislative session to wave their signs at lawmakers who have no political need to even acknowledge them.

These families feel their lived experiences are being overlooked in the debate over Newsom’s plan for CARE Court, a civil pathway to mental health treatment. They are tired of serious mental illness being a political issue or even a civil rights issue rather than a medical condition.

Much of the controversy surrounding Newsom’s proposal has focused on what it could mean for homeless people on the street, which is understandable given California’s massive homelessness crisis. But there are also families trying to get mental health care for elderly relatives before they end up on the streets or they end up in the criminal justice system, where again these families usually have no say in how their loved ones are treated.

And these caregivers have no political muscle. They spend more time helping their person than organizing collective action. Many have struggled for decades, banging their heads against a system that talks a lot about compassion but would rather put someone in handcuffs than in a hospital.

“We are not family members who are there to push, command or dictate. We are the family members who have learned how to [handle mental illness] in a respectful way, and we’re willing to learn,” Elizabeth Kaino Hopper told me. “We understand we can’t fix it. We admit that we cannot cure it. But we damn well can be partners. It’s a family. We are not giving up.”

Kaino Hopper’s daughter begins to suffer from mental illness after being assaulted in college. For years she deteriorated until she began living on the streets, sharing a box with other homeless people. One night she pulled a knife on someone when she felt threatened, Kaino Hopper said. Now she’s in jail, found incompetent to stand trial and waiting months for a bed in a state hospital — where she’ll receive enough involuntary treatment to stabilize her to return to criminal proceedings.

It’s a story that’s commonplace to the point of sickening. Mental health is now criminalized and these family members know it all too well.

Britton just returned from Los Angeles, where she attended the felony sentencing of her nephew, who was sent to state prison for two years. To hear Britton tell it, the nephew, whom he asked me not to name, began having episodes of psychosis in his 20s. Britton’s sister bought a trailer for her son to live in, but he woke up the neighbors with his screams and ripped out all the wires.

He ended up living on a highway in Long Beach, where his mother brought him energy bars and clean socks, Britton said.

Somewhere between the trailer and the offramp, Britton said his nephew was in county jail for setting fire to a dumpster on a cold night. When he was released, he was placed in a group home, where he recovered. He was on a treatment plan that included regular injections of an antipsychotic drug. Britton says that when his nephew, who is 44, is on medication, he is “pretty lucid.”

But then he graduated to the studio and the drugs were changed from injectables to pills. His nephew stopped taking them because he “didn’t believe he had any disease,” Britton said. “He kind of likes his delusions. And so he became more psychotic and that led to this.

It’s an assault with a deadly weapon for allegedly throwing a rock at a man who may have yelled at the nephew for getting fat on the ramp.

It’s strange for me to be on the opposite side of an issue from the ACLU, an organization that fights tirelessly for good. I agree with the group’s concern that removing civil rights from anyone, even someone who cannot make their own decisions, should never be done lightly.

In a June blog post titled “Why We Strongly Oppose the Governor’s Care Court Proposal—And So Should You,” ACLU advocates argued that any “proposal that ties care to the courts is retrograde. It reminds us of a dark era when forced treatment of people with serious mental illnesses was the norm. It would undo decades of hard-won progress by the disability rights movement to secure self-determination, equality and dignity for people with disabilities.

And in its official opposition letter to the Legislature, co-authored by more than three dozen civil rights and social advocacy organizations that I also respect, it argued that “The proper framework allows people with disabilities to maintain autonomy over their own lives by provide them with meaningful and reliable access to affordable, accessible, integrated housing combined with volunteer services.”

Critics also charge that CARE Court — which stands for Community Assistance, Recovery and Empowerment Court — may unfairly target black and brown people who are disproportionately diagnosed with mental illness. This is a real concern about the racism that permeates almost every aspect of our unequal society. But I would point out that black and brown people are already over-incarcerated, which means they are already subjected to more coercive treatment than those outside. CARE Court would actually keep more people out of the criminal justice system.

I’m really not condemning any of the ACLU’s arguments – we need to have real conversations about this. But the group concedes that there are many families in California who can’t get treatment or housing for loved ones. These families desperately need any chance to change the terrible outcomes that have become our new norm after institutionalization – homelessness, incarceration and death.

There are many reasons for this—including a lack of supportive housing, treatment providers, and more. But we also lack the accountability and sometimes common sense that the CARE Court can provide.

Because while we accept that our most severely mentally ill are alone in the world, I’ve lost count of the families I’ve met, like Britton and Kino Hopper’s, who have spent their lives in service to their mentally ill loved ones, just to yes at every turn they are told they have no right to interfere. They are told that their opinions are irrelevant and their pleas for help are regressive because they will require their loved one to take medication, at least until they are lucid enough to continue making their own decisions.

But if a mother, sister or uncle has no right to help, no right to have a say in how their loved one is treated, where they end up and what happens to them in their most vulnerable moments, who does?

Our current answer is cops and criminal courts, and it’s a pathetic answer.

This column is part of The Times’ mental health initiative, For Your Mind, an effort to increase coverage of treatment, public policy, wellness and culture related to mental health in California communities.

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