Senate Leaders Team Up with LA County Officials to Dig Into Mental Health Crisis Impacting Jails

Senate Leaders Team Up with LA County Officials to Dig Into Mental Health Crisis Impacting Jails

ProTem Mike McGuire and other Senate leaders joined Lindsey P. Horvath, Chair of the Los Angeles County Board of Supervisors, for a real-life glimpse into LA County courts and jail for severely mentally ill defendants.

Amidst unprecedented wait times for treatment beds, misdemeanants declared incompetent to stand trial (MIST) can be kept in jail while severely mentally ill while in need of treatment. Many have symptoms too acute to be eligible for mental health programs such as diversion.

Even if they are eligible, since participation is voluntary, many find themselves uninterested or unable to accept services when offered.  Although Community Assistance, Recovery and Empowerment (CARE) Court or conservatorship are options, CARE Courts are still in the process of being fully instituted. Conservatorships have other challenges such as lengthy proceedings, and in many cases, the courts often hesitate to establish something as onerous and long-lasting as a conservatorship.

“It will take all levels of government to scale the vast network of behavioral health beds and treatment options required to meet the needs of our most acutely ill community members,” said Board Chair Lindsey P. Horvath. “Los Angeles County has made positive strides in reducing the time MIST patients spend in detention because we know jail is not an environment conducive to recovery and healing. And yet, we know we have a long way to go. I welcome our state leaders and our continued partnership to urgently build capacity for appropriate care and recovery-based treatment spaces.”

Three years ago, Governor Newsom signed Senate Bill 317 (Stern, 2021), which reduced the amount of time MIST defendants spend in jail, by allowing them to obtain credit for time spent in behavioral health treatment instead. The goal was to get them into treatment and out of custody, where many are a danger to themselves or others. However, under this law, unless proceedings are initiated for CARE Court or a conservatorship, MIST defendants who refuses treatment may still have their cases dismissed.

MIST patients historically risked decompensating in the jails without medical treatment while waiting for alternative care. While significant strides have been made to reduce the jail population and to provide improved and more timely care, without expanded bed capacity across the continuum of care, particularly in LA County, a real challenge remains in ensuring MIST patients receive appropriate care when in custody and upon release.

“It is not fair that we process people and cut them loose. I refuse to stand by and watch our MIST Californians neglected year after year,” said Senator Henry Stern (D-Los Angeles). “In the Legislature we have to untie the hands of LA County to help get MIST. defendants better care after they’ve been arrested to improve their chances of succeeding in treatment. It has to be all hands on deck to help combat our overpopulation on the streets and in jails with real treatment and follow-up care, which we know MIST individuals desperately need.”

Since 2015, Los Angeles County has diverted 3,500 individuals from jails into community programs.

In 2021, the rate of rearrests within 6 months was 15.9%. In 2022-23, the 2 years after these laws were passed, the 6-month rearrests rate doubled to 31.4%, according to the Office of Diversion and Reentry (ODR). Additionally, over the last year, the percentage of MIST referrals accepted by ODR into their program declined by 10-15%.

To address these gaps in care, Senator Stern is carrying Senate Bill 1400 to provide the County with more options for treatment of MIST defendants, including CARE court, conservatorships, and enhanced medical treatment in the jail system itself.

In concert with new Prop 1 funds, Los Angeles is on track to dramatically expand behavioral health services and establish earlier diversion methods for MIST defendants. Until those changes are implemented, these vulnerable individuals are languishing in our jails, being released onto the streets, and cycling in and out of our justice system. At a time when solutions are drastically needed to combat not only the mental health crisis but also homelessness and recidivism, we should be prioritizing care.