California is fighting to make it easier to put people under conservatorships.
In 2019, Gov. Gavin Newsom signed a law that was supposed to ease the path to conservatorship in the state’s largest cities, where homelessness has both exacerbated mental illness and made it highly visible. In the three years since, San Francisco has used its new authority to conserve just two people. Advocates always knew the bill would target a relatively small number of people with serious problems, among the larger homeless population.
Why does the state’s program fall short? One of the experts on California’s conservatorship is the sociologist Alex V. Barnard, who teaches at New York University. Barnard has spent years talking to people up and down the conservatorship chain, and his is essential reading for anyone who wants to understand the byzantine process that ends with involuntary medical treatment in a locked bed.One answer is a predictable one: A lack of resources shapes decision-making, from crowded long-term care institutions to overworked public guardians to frenetic hospital emergency rooms to worried parents. Many on the pro-conservatorship side want to lower the bar for what constitutes a “grave disability.
But it’s not judges, for the most part, who are rejecting conservatorship candidates. Rather, this winnowing is the function of a highly stressed system, Barnard observed, in which a strained supply of long-term care beds pushes nondecisions down the chain. “The placement tail ultimately wags the conservatorship dog,” he writes.The court knows the public guardian will have nowhere to put a conserved man.
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