The state certainly has a crisis of mental illness and substance abuse, visible on the streets of every city. But can involuntary commitment under SB 43 be part of the solution?
When patients tell me that “the algorithm is hacked,” I cannot help but agree. Yes, your phone is listening to you, the camera on your laptop is watching you and online ads are predicting what you will buy.Even involuntary treatment requires buy-in from patients to be effective over the long term. Yet in interviews, I constantly heard patient complaints about psychiatric facilities that denied even the smallest dignities, like choosing what movie to watch or eating a bag of chips.
Minimizing coercion also means moving people into less restrictive levels of care as fast as possible. Although many insist California doesn’t have enough locked beds for the seriously ill patients who need them, studies have consistently shown that many of the beds that do exist areMost sub-acute facilities in California are private and for profit; clinicians have to engage in what one psychiatrist described as a “beauty contest” to persuade these facilities to admit their clients.
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