A perspective…

My perspective on mandated mental health treatment was recently broadcast on KQED radio in San Francisco. Here’s the link:


It’s a complicated and controversial subject, and there are many things to be said from many different angles.


About jamesmatter

Marriage and Family Therapist (MFT) in private practice in San Francisco. I work with adults, adolescents, and couples, with focus on substance use and abuse and co-occurring disorders (having both a mental illness and an addiction).
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2 Responses to A perspective…

  1. 03alwi says:

    The problem is that people in high places come up with these ideas and courts of law approve them but no one cares to explain how to properly execute these things. The families which have such unfortunate individuals are hardly made part of the decision.Even if they are their contribution is minimum. I think you hit the nail on the head there!

  2. jamesmatter says:

    As a commenter said on the KQED web site, people from NAMI, the National Alliance for Mental Illness, actually supported the law. There’s a very complex discussion that needs to take place about things like this.

    Back when Agnews State Hospital in Santa Clara county was closed, the population of the Santa Clara County Jail doubled the same year. Clearly the people who were de-institutionalized were at high risk for moving from one place to another. Not good. Currently, the largest locked mental health facility in California is the psych wing of LA county Jail. Not good. We want people to get care; we don’t want to criminalize mental illness.

    Mandating people into treatment is, in my opinion, a very slippery slope. My guess– and we could find the numbers if we wanted to– is that the number of mentally ill people killed by law enforcement greatly exceeds the number of mentally ill people who kill or harm others. It’s the fear of some irrational (yet somehow fiendishly clever) madman that drives people. All the deaths I’ve heard about involve people who are psychotic and not at all clever– not the insane geniuses found in movies.

    The other force driving something like Laura’s law is families who are at their wits’ end trying to deal with intractable problems created by mentally ill family members. These stories are truly tragic, usually protracted struggles involving a lot of people. But part of the protracted struggle is based on the mentally ill person inevitably falling into the public health system, which is vastly under-resourced for everything, with mental health care usually being a low priority into the bargain. Prop. 63 in California has been very helpful, diversifying the kinds of care that can be extended to people with mental illness. But I feel very strongly that the area that gets too little effort is that of de-stigmatizing mental illness, which is a job anyone can start on at any time.

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