Forty years ago, in 1967, the California legislature enacted the sweeping Lanterman-Petris-Short (LPS) law designed to revolutionize the objectives, means, and procedures through which the state (and private actors using its authority) can intervene to treat those destabilized by serious mental illness. The law, which bears the names of its leading legislative sponsors, came into effect in 1969 and largely became the template on which most other states transformed their approach. Its most visible achievement would be the massive shrinkage of state hospitalization of people with mental illness, but the changes it inspired in the criminal and civil governance of those with severe mental illness extended far beyond deinstitutionalization.
In the spring of 2008, four decades after that pivotal moment, we will gather a group of legal and clinical experts, some academics, some in practice, most who have devoted considerable effort to studying or reforming practice in California, including at Berkeley and UCLA, to discuss the legal and clinical innovations taking place today around interventions for those with severe mental illness and to assess what opportunities seem to be emerging to renew and reinvigorate the governance framework established by LPS.
Our goal is not to outline or debate a path forward, but rather to stimulate the kind of re-imagining of the possibilities for both treating and protecting the rights of those destabilized by mental illness that renewal and reinvigoration of LPS will require. In one fully packed day we aspire to document and begin to digest the recent record of innovation and insight from the practice field that could provide the intellectual and practical resources for that renewal. First among those is a strikingly broad consensus that those destabilized by severe mental illness too often find themselves in the worst possible legal and medical situation, subject to coercive state power in the form either of jail or prison sentences with none of the normative obligation to treat or the clinical expertise to assess that the old custodial system provided.
The California lawmakers who enacted LPS outlined goals to change the way government administered, protected, and provided services to people with mental illness that would win broad support. The law was designed to “end the inappropriate, indefinite, and involuntary commitment of mentally disordered persons,” “protect public safety,” and “protect mentally disordered persons and developmentally disabled persons from criminal acts.”
Great moments of policy reframing inevitably produce a collective memory of what problems required the reform. These memories can harden into myths that block re-evaluation and further reform. LPS was enacted against abusive legal and clinical realities, including a broken state public hospital system, and broad judicial discretion to confine people in mental hospitals with little clinical guidance or legal protection. This background has changed radically from that time in ways both expected and unexpected. The shrinkage of the population committed to public hospitals was anticipated, but the dramatic increase in those destabilized by mental illness among the chronically homeless and in jails and prisons was an unanticipated result of the reform.
Virtually nobody anticipated in 1969 that most of the innovative efforts to integrate clinical and legal expertise under flexible and individualized judicial authority would take place inside the criminal justice process. Ironically, just as LPS was limiting the power of judges as mental health decision makers, the transformation of our nation’s courts and the legal culture toward individual rights was already under way. Furthermore, LPS itself helped crystallize strong legal advocacy movements. Among these was the development of the civil rights bar, including advocates for persons with mental illness and their families. It also often barred family members of those suffering from mentally ill from the process and at times has served as a barrier to treatment for the mentally ill. Recognizing these unintended results, invisible within the LPS framework, provides leverage for realizing new, better informed ways of ensuring protection and treatment for persons destabilized by severe mental illness at times when they lack the insight to protect themselves or others from harm.
The symposium will be digitally recorded and made available on a website for video streaming and podcasting. Publicity for the website’s online content will increase access of the proceedings to a much broader audience of stakeholders, in hopes that this symposium will stimulate discussions of what kinds of renewal and reinvigoration efforts can most effectively leverage emerging forms of innovation, both legal and clinical, to better protect and serve people with mental illness.
We wish to acknowledge the generous financial and logistic support of this program by
UC Berkeley Institute of Governmental Studies and Boalt Hall School of Law
Semel Institute for Neuroscience and Human Behavior at UCLA
The Commonwealth Club of California
The San Francisco Foundation
Planning CommitteeChair Fred J. Martin, Jr.
- Visiting Scholar
- Institute of Governmental Studies
- University of California, Berkeley
- Carol Lamont
- Program Officer, Community Development
- Gloria C. Duffy, Ph.D., M.Phil., M.A
- President and CEO
- Jonathan Simon, J.D., Ph.D.
- Associate Dean, Jurisprudence and Social Policy Program, and Professor
- Boalt Hall School of Law
- Stephen A. Rosenbaum, J.D.
- Lecturer, Boalt Hall School of Law and Stanford University Law School
- Staff Attorney, Protection & Advocacy, Inc. (soon to be renamed Disability Rights California)
- Robert L. Okin, M.D.
- Professor of Clinical Psychiatry
- Former Chief of Psychiatry, San Francisco General Hospital
- Ian A. Cook, M.D.
- Associate Director, Semel Institute Office of Professional & Community Education
- Associate Professor-in-Residence of Psychiatry & Biobehavioral Sciences
- James E. Spar, M.D.
- Professor of Clinical Psychiatry
The Planning Committee gives its sincere thanks for their tireless efforts to Ms. Gloria Bruce of the San Francisco Foundation and Ms. Lisa Weber of the UCLA Semel Institute.
We add our grateful appreciation for the financial support of The van Löben Sels/Rembe Rock Foundation and the San Francisco Foundation.