Mental Health Crisis Is a Crime, But it Shouldn’t Be
Los Angeles Downtown News
By Councilmember Jose Huizar
October 23, 2017

DTLA – Recently, I was walking in DTLA when I was unexpectedly approached by someone in the throes of mental illness. I was startled and felt threatened. The individual quickly turned his attention elsewhere and so did I, only to run into another person in the midst of a mental health crisis. This time the individual was surrounded by police officers.

As someone who has invested hundreds of hours and staff time to offer up solutions to address homelessness, that night left me struggling with questions that are as important for the future of Downtown as they are for basic human dignity. They include: Who do you call when you witness someone in the middle of a mental health crisis? And what can we do to help prevent a person’s mental illness from escalating into a crisis?

I’m not alone with these questions. Social media is buzzing with people in Downtown with similar, if not more dramatic, stories and concerns, both from a public safety standpoint and a humanitarian perspective.

Certainly, if a person is violent and a threat to themself or others, we must call 911. But who do you call when someone is muttering to herself, sitting against a wall half-naked, clearly needing help but lacking the ability to act in her own best interest?

A police officer shouldn’t be the first response. Police are not mental health professionals, yet they continue to field most of the calls for service in a rapidly expanding DTLA.

The statistics are sobering. This year’s Greater Los Angeles Homeless Count found about 6,000 homeless individuals in Downtown, with 4,600 of them on the streets and in the shelters of Skid Row. The other 1,400 sleep outside of Skid Row, with 90% of those individuals living without shelter. It is estimated that one-third of our homeless neighbors suffer from mental illness.

Work is being done. We have begun an intensive outreach program in Skid Row (dubbed C3, for City, County and Community) that is now the model for the entire County. I also spearheaded the City’s effort to adopt our first ever Comprehensive Strategic Plan, helped establish the City committee tasked with addressing homelessness, and co-authored Proposition HHH that will provide $1.2 billion for permanent supportive housing over a decade.

Los Angeles County is the arbiter of mental health response and is primarily responsible for medical and social services. The County, and in particular Supervisor Mark Ridley-Thomas, who I have worked with on the Skid Row C3 program and other initiatives, has done a lot.

Like the City, the County is providing hundreds of millions of dollars with taxpayer support (though Measure H) to provide support services. The City and County both have Homelessness Strategic plans for the first time and we are coordinating on this like never before.

Still, the County needs to do more to address the mental-health crisis in Downtown Los Angeles and throughout the city and county.

So, again I ask, who do you call?

The County Department of Mental Health offers its services at (800) 854-7771, but there are only a handful of teams providing street-level mental health services to the homeless community. That’s not enough, and we can’t poach from our proactive outreach work to respond to crisis calls.

To its credit, the County has expanded our C3 model to areas throughout the city and county, including one additional team dedicated to DTLA outside of Skid Row. That is a great start, but as Downtown News wisely pointed out in a recent editorial, that is hardly enough.

Here’s what is needed from our County partners to catch people in a mental health crisis before they fall through the cracks:

A significant expansion of dedicated teams of experts who can better respond in real time to people caught in a non-threatening mental health crisis. The City has expanded the use of LAPD “SMART” teams, which pair County mental health workers with patrol officers, but with over 33,000 calls for service last year, these teams can’t respond to everything, let alone work proactively. We need an accelerated expansion of mental health teams.
Mental health clinicians in city jails to assist people arrested during a mental health crisis.
An overhaul of what occurs after a 72-hour “involuntary hold” for people who are a danger to themselves or others due to a mental health crisis. People are too often released into the streets, just for the vicious cycle to begin again. Our county hospitals need to provide more thorough plans upon discharge of such patients, including connecting them to long-term services.
How do we care for those dealing with severe mental health issues who cannot care for themselves? Beyond temporary hospitalization, a court-ordered conservatorship can provide long-term oversight, medication and care. This will require more residential and mental-health facilities, the staff to navigate the judicial process for approving individual conservatorships, and judges who are aware of the systemic failure of using the streets as de facto mental health facilities.
Unless we put resources toward the long-term care of those suffering from mental illness and the prevention of a mental health crisis, the police will remain our first responders. Letting mental illness deteriorate into a crisis means we’ll keep treating it like a crime, instead of the healthcare issue that it is.

José Huizar represents the 14th District on the Los Angeles City Council.