California: Lock-Up The Homeless!

But not for long

Earlier this week, California Governor Gavin Newsom signed Senate Bill 43. The bill changes the law on the forcible detainment of the Golden State’s “gravely disabled” homeless population.

The key change: the definition of “gravely disabled.” The term now decribes…

a condition in which a person, as a result of a severe substance use disorder, or a co-occurring mental health disorder and a severe substance use disorder, is, in addition to the basic personal needs described above, unable to provide for their personal safety or necessary medical care.

Notice the phrase “or a co-occurring mental health disorder.”

Previously, the law required substance abuse and a co-occurring mental health disorder. Now addiction is enough to force a homeless person into treatment.

Studiously avoiding the word detainment, Newson’s official statement hails SB43 as humane and effective:

Conservatorship can help break the cycle of repeated crises including arrest and imprisonment, psychiatric hospitalization, homelessness, and even premature death – and instead provide the care that can restore mental health and end the conservatorship.

Under the new law, the State can force California’s homeless alcoholics and addicts into a 72-hour evaluation and treatment “hold,” and/or 14-day and 30-day periods of “intensive treatment.”

According to a report by the Substance Abuse and Mental Health Administration (SAMHA), 38 percent of America’s homeless population abuse alcohol. Another 26 percent abuse drugs.

There is overlap, of course. And the number seems conservative. But the stat indicates that at least half of America’s homeless population are alcoholics and/or addicts.

At last count, California is home to more than 170k homeless people. Using SAMHA’s stat, some 85k of them now qualify for forcible detainment.

There are plenty of bureaucratic hurdles, safeguards and caveats. But there’s no doubting the new law’s impact.

Assuming widespread, rigorous enforcement, detention of homeless alcoholics and drug addicts will remove large numbers of desperate and dangerous individuals from the general public – temporarily.

Or will it?

For all but a small percentage of homeless addicts, incarceration in a state-certified drug treatment facility has zero appeal. If nothing else, it removes access to their drug-of-choice, throwing them into painful withdrawal.

California’s homeless population will know they face this new “danger.” They will avoid contact with police, social workers and hospitals. They will resist forcible detention in no uncertain terms.

In short, the new law increases the danger to police, hospital staff and social workers. And the homeless, who will no longer seek/accept treatment for health issues.

At the same time, there’s no guarantee of success. Addiction is a chronic disease. The idea that homeless addicts will be “cured” by 14 or 30 days of “intensive treatment” is delusional.

According to the National Institute on Drug Abuse, the relapse rate for addicts who’ve received treatment is 40 to 60 percent.

NIDA doesn’t specify what treatment the survey sample received, the time period between treatment and relapse, or the number of relapses.

Even so, it’s safe to assume that 30 days isn’t enough treatment for recovery to “take” – recognizing that relapse is virtually inevitable.

What should the taxpayer-funded standard for homeless addicts be? Six months? A year? The “right” answer requires a historical perspective…

In 1963, President John F. Kennedy signed the Community Mental Health Act. Another law with the best of intentions – that led directly to our current homelessness crisis. wikipedia:

The purpose of the CMHA was to build mental health centers to provide for community-based care, as an alternative to institutionalization. At the centers, patients could be treated while working and living at home. Only half of the proposed centers were ever built; none was fully funded, and the act didn't provide money to operate them long-term. Some states closed expensive state hospitals, but never spent money to establish community-based care.

Any call for extended treatment of the homeless population’s addiction raises the specter of re-institutionalization. And?

Given the scope and scale of the homelessness crisis, it’s time for society to put on its big boy pants and face the need to build large residential mental health care facilities and drug addiction centers.

Not the cruel dumping grounds shown in One Flew Over the Cuckoo’s Nest. Carefully-supervised hospitals that treat alcoholics and addicts with kindness, dignity and respect. A safe place where their other needs can be addressed.

Under what conditions the homeless could be forcibly detained/committed to these residential facilities, how they’re treated, the length of their stay and the hospital’s funding is all a matter for debate.

The need to remove the homeless from the streets, for their sake and society’s, is not.