A 5150 Designation Should Not Always Be The Answer

I want to preamble this article by stipulating that the majority of times, if not all in which people are detained under a 5150 designation, are done at the behest of concerned citizens and with the welfare of the subject as a priority. As a Police Review Commissioner I hear cases in which citizens that have been designated under a 5150, express their concerns at the diagnosis and contest the validity of the process.  

Mental Health involuntary detention policies are based on Welfare and Institutions Code 5150 and 5651.7. These codes allow the County Mental Health Director and/or designees to submit an application for involuntary detention. Section 5150 states in part “when any person, as a result of mental disorder, is a danger to others, or to himself or herself, or gravely disabled, a peace officer, member of the attending staff, as defined by regulation, or an evaluation facility designated by the county, designated members of a mobile crisis team provided by Section 651.7, or other professional person designated by the county may, upon probable cause, take, or cause to be taken, the person into custody and place him or her in a facility designated by the county and approved by the State Department of Mental Health as a facility for 72-hour treatment and evaluation. One needs to understand that once the process is initiated , the effects can be comparable to an unstoppable freight train. From the 911 call to the visitation and evaluation( depending on the circumstances) to the call to the Mental Crisis Unit (if available) to the transport to a hospital or psychiatric institution for a possible hold and 72 hour evaluation, it is all based on escalation. Some cases are dismissed at the hospital before sent for additional detention but the designation, and in most cases of non indigent individuals, the financial cost can be quite high. The longer the detention, medical need or medications, the higher the cost. I will grant that loss of life and liability issues for police departments and mental health agencies can also be quite high if they do not act properly. A moral obligations also exists.

The concern arises when people with disabilities, stress , mental issues or none of the above are victims to landlords with possible ulterior motives of eviction due to rent control issues, a disgruntled neighbor, ex spouse or frankly when an unfriendly individual makes a call with an intent to harm. Could the erratic behavior then exhibited by the individual being evaluated not be a direct response to the circumstances, stress about the consequences of the 5150 designation or the reality of having uniformed personnel in their home? 

Police officers are allowed to make an entry into a home if they specifically feel that danger to the person is imminent and that failure to act could result in harm or a tragic end . Not all citizens are used to interacting with police officers in a positive manner. This could be due to the section of town in which they live in, past interactions with law enforcement or general mistrust of the government which could certainly become aggravated by a mental issues or stress. In the past as was seen in the civil rights protests of the 1950s and 60's, the anti-war demonstrations of the 60s as well as other social justice demonstrations like ACT UP and the Anti- Apartheid Movement, law enforcement agencies were used to suppress their actions with disastrous results.

Is it possible that some assessments are done in too much of an expeditious manner? Have 5150s become so common that their designation is almost automatic and seen as the easiest remedy? Could de-escalation methods and steps be used to re-asses the situations as they unfold? Most cases between the initial interaction to the designation are quite short. Common sense must also be exercised in order to minimize a wrong diagnosis and the complications that it will create.  

The work of our law enforcement officers, mental health care providers and medical teams are of the utmost importance to our community. The concern is raised when the expeditiousness of the process and a possible quick to judge mentality railroads the rights of the individual. The road to good intentions can be paved with unfortunate mistakes. In an economy in which people are loosing their jobs, homes and health care, our mental health services will be put to a test.

In 5150s situations, all parties involved must take a concerted and methodical approach to and during the escalation process and use their judgement efficiently. Courtesy, compassion and common sense must continue to dictate the way in which we treat everyone. http://www.examiner.com/article/a-5150-designation-should-not-always-be-the-answer