Resist the Criminalization of Mental Illness - DEMANDS

Demand #1

POLICE CRISIS INTERVENTION

Police Crisis Intervention is a concept that was developed by various community organizations including Caduceus Outreach Services, Ella Baker Center for Human Rights, Office of Citizen\'s Complaints, Coalition on Homelessness, and Mental Health Board back in 1996.

Community members were responding to the fact that police are often the first to respond to the scene when individuals are in psychiatric crisis. Today, one in four police calls fall into this category.

At the same time, the way in which police have been trained is to utilize a \"command and control\" strategy when they approach individuals. This has led to further trauma of those unfortunate enough to be experiencing psychiatric crisis, and in extreme situations, injury or death on the part of both police and people with mental illnesses.

Community members designed a program to train one police officer on every shift at every precinct on how to respond to calls which were coded as \"individuals acting bizarrely\" by 911 in a more humane and safe manner. Memphis, Tennessee Police Department has enacted almost an exact, and highly successful model in their community. Since then, many more communities around the country, including San Jose have enacted similar programs.

While the police commission approved the program, a proposal that the police department submitted was never funded. At the same time, there was continued resistance among the police departments top brass to this proposal.

In fiscal year 1999/2000, the San Francisco Board of Supervisors funded the project at $180,000. SFPD representatives started meeting with community members to work on designing the curriculum and implementing the proposal. The curriculum was complete in August, 2000, with forty hours of training. Police department concerns were met, such as the need to train all officers, given the high number of calls, and to have police trainers along side consumer and community trainers. The police department responded with a counter proposal to cut the training time in half, and to use half that time for weapons training. Community members strongly oppose this.

To date, this extremely critical training has not been implemented. We are demanding full implementation of Police Crisis Intervention, with comprehensive training.
Demand #2
NO EXPANSION OF FORCED TREATMENT

All individuals in California, including individuals with psychiatric conditions, have a right to refuse medications. This right to refuse treatment exists even if the person is in a psychiatric hold. Existing California law has been in place for 30 years, under the Lanterman-Short Petris Act. It is a sensible compromise between civil liberties and social policy. Current law permits the detention of individuals with psychiatric conditions when they are threatening, violent or suicidal. Individuals who cannot attend to their personal needs or who are dangerous to themselves or others, because of their psychiatric conditions, can be involuntarily detained for treatment and stabilization.

This past year, California legislators considered an expansion of current law that would permit involuntary detention of persons who are deemed by a psychiatrist to face \"serious risk of substantial deterioration\" because of mental illness. The proposal offered no definition of \"substantial deterioration,\" nor any objective guidelines for the psychiatrist to apply in concluding that the individual meets the standard. Virtually anyone with a psychiatric condition or label could be subjected to involuntary detention.

The proposed legislation would have eliminated the constitutional right to refuse treatment, including medications, for a single group of California citizens. Persons with mental health issues are as likely as persons with other chronic conditions such as diabetes or heart disease to take prescribed medications, despite the onerous side effects associated with many psychiatric medications.

This legislation, brought forward by State Assemblymember Helen Thompson, and put forward from Pharmaceutical corporations, family members and organization such as the National Alliance of the Mentally Ill, was never passed. Forced Outpatient Treatment has been recently implemented in a majority of states. It is our sense that this legislation may be brought forward again next year.

Experience shows that the vast majority of individuals with severe mental illnesses choose to use these services when they are funded and available (which they are not now). Involuntary treatment does not result in better outcomes than simply providing access to comprehensive voluntary services.

We are demanding that San Francisco resist all efforts to expand involuntary treatment, and form a sanctuary from this violation of civil rights.
Demand #3

PROTECTION OF HUMAN AND CIVIL RIGHTS OF THOSE LIVING ON THE STREETS

By definition, people who are homeless live in public. A lack of housing forces them to do in public what everyone prefers to do in private. This indignity is one of many reasons we seek to end homelessness. Unfortunately, it has also become the battleground for the most fundamental defense of people who happen to be homeless; the right to exist.

Since 1993, San Francisco police officers have issued over 100,000 citations to homeless people for such so- called crimes as sleeping or sitting in public. San Francisco mirrors a national trend to criminalize homelessness. Police continuously misapply and selectively enforce existing laws in order to harass people who are homeless and move them from parks to neighborhoods to alleys and back into parks. This strategy demonizes poor people and feeds negative public sentiment to target people who experience homelessness, rather than address root causes of homelessness itself.

The flaws in this effort to criminalize homelessness are as numerous as they are obvious. Though no one should ever have to sleep in a park or beg for food, making those acts into criminal offenses does not help the people driven by desperation to commit them. These city ordinances are misguided because they seek to hide homeless people, not end homelessness. They are unjust because they seek to punish people for being poor.

1 in 4 calls San Francisco police officers receive are in response to people in psychiatric crisis. At the same time, it is estimated that 40% of people living on the streets have mental illnesses. Homeless people with mental illnesses are at increased risk of police harassment. When they are cited, it is less likely they are able to follow up with court dates, and because of that are more likely to become incarcerated. Interactions with the police and incarceration have a disproportionate traumatizing effect on people with mental illnesses.

We demand full protection of the civil and human rights of those living on the streets.

Demand #4

CONSUMER DIRECTED MENTAL HEALTH TREATMENT ON DEMAND

Mental health services located in the community have been eroded over the past three decades, and the result is thousands of people with mental health issues being denied services and living on the streets. In fact, last year the City of San Francisco stated in public documents that only one-half of those seeking treatment and qualified for treatment actually received it.

For the past several years, in spite of a budget surplus, the city has continued the erosion of mental health services, by making deep cuts and expanding services only for the very few. In budget year 1999/2000, the Department and the Mayor\'s office conceded and started to build back up the mental health system by expanding outpatient services. The following year they cut millions of dollars from anticipated revenue coming into community mental health services to help put a dent in the deficit at San Francisco General Hospital.

Community mental health services are needed on every level, in every community. The need for outpatient treatment, residential treatment, board and care facilities, supportive housing, and peer services are overwhelming. In addition, there are no crisis services available in the community after hours. Waits for residential services exceed nine months, we have half as many board and care facilities as we had in 1984, only 2% of community mental health clients can be housed in supported independent living, and people are being discharged from the hospitals onto the streets.

Mental health consumers in San Francisco are not just demanding a major expansion of the mental health system - they want major reforms.

In our report entitled \"Locked Out\", a survey of over 300 homeless people with mental illnesses, we found that not only did 92% of those surveyed want treatment, but they knew exactly what that treatment should look like. More then half found that the system failed more then it succeeded - mostly because of the bureaucratic access process. They wanted staff that was caring and respectful, and they wanted programs that helped them be more productive members of society - whether that was jobs, recreation activities or a way to give back to their community.

We demand full consumer directed mental health treatment on demand.