People with mental illnesses who are in conservatorships are being held in Los Angeles County jails even after their criminal charges are dropped, according to a report released Tuesday by Disability Rights California.
Similarly, they are staying months in county psychiatric hospitals after doctors have agreed that it’s safe for them to leave, the report said.
The issue is partly one of capacity. Facilities where they could be sent after being released from jail or hospitals are often full and have months-long waiting lists.
But Disability Rights California, a nonprofit that advocates for people with disabilities, criticized L.A. County for transferring them only to locked facilities, when they could be safely treated in unlocked community settings such as group homes or supportive housing.
In recent years, the county Board of Supervisors has approved almost $400 million for more locked facilities but failed to adequately fund less restrictive community housing, the report said.
The report examined a subset of jail inmates in conservatorships — those whose care is overseen by the L.A. County Office of the Public Guardian because no friends or family can take on the task. The people in the report, who also include those in locked healthcare facilities such as psychiatric hospitals, have been assessed by doctors or jail staff as not dangerous and able to leave.
A person is placed in a conservatorship when a judge determines that they cannot care for themselves and names a third party to be responsible for them.
Many conservatees with mental illnesses stayed in the jails for months after their charges were dropped, according to the report.
Some were put in conservatorships after they were found incompetent to stand trial and still weren’t well enough to stand trial after two years of treatment.
In December, the L.A. County Sheriff’s Department, which runs the jails, adopted a policy that ended its practice of holding people in conservatorships after their criminal case has been resolved, the report said. But as of February, according to the report, nearly 130 such people were still waiting to be transferred from a jail to a mental health facility.
According to the report, this is “flatly illegal” under a state law that requires conservators to place people “in the least restrictive alternative placement.”
L.A. County is also violating the federal Americans with Disabilities Act when it holds people with mental illnesses in locked hospitals months beyond what’s deemed medically necessary by their doctors, the report said.
The U.S. Supreme Court has ruled that the unavailability of beds is not a defense to confine people in hospitals.
The county Department of Mental Health said in a statement that it is committed to providing healing and recovery to people with serious mental illnesses, including those whose conservatorships are overseen by the county.
“Where possible, we aim to place and treat clients in the least restrictive setting available in alignment with California’s Welfare & Institutions Code and to support our clients’ journey toward well-being, self-sufficiency and belonging in a community,” the statement said. “We are taking the allegations set forth by the Disability Rights California report seriously, will be examining their findings, and are always exploring ways to ensure clients are in the least restrictive and most appropriate settings to meet their needs.”
In the county’s inpatient psychiatric hospitals, people under conservatorships stay “for months or years after they are ready for release” while the county waits for a locked bed in a “less restrictive” setting, the report said.
Asked how many of the patients were ready to be discharged, county staffers responded, “All,” according to the report. Two patients had been at L.A. County General Hospital’s acute inpatient psychiatric unit for 423 days and 593 days, the report said.
The report also highlighted the cost of keeping people with mental illnesses locked up — $19,760 per person a month in the county jail’s mental health unit and $46,600 per month in the county inpatient psychiatric unit, according to the report.
The Office of the Public Guardian, which is part of the county mental health department, oversees the care of about half, or 2,300, of the people in mental health conservatorships, including those not in the jails.
According to a joint report in January from county Mental Health Director Lisa H. Wong and Health Services Director Dr. Christina R. Ghaly, the county’s mental health court judges have imposed “an incredible number” of court-ordered sanctions, including daily fines, on the public guardian’s office for failing to place conservatees in treatment in a timely manner.
In response, the county started moving some conservatees to mental health urgent care centers after they were authorized to leave jail. But the centers are designed for outpatient care and short stays, the county report said.
This story originally appeared on LA Times
