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《严重残障:5150 指定的遗留分支》。

Gravely Disabled: The Vestigial Prong of 5150 Designations.

出版信息

J Law Health. 2021;34(2):190-214.

Abstract

Effective July 1, 1972, California's Lanterman-Petris-Short Act (LPS Act) set the precedent for modern mental health commitment procedures in the U.S. named after its authors, State Assemblyman Frank Lanterman and State Senators Nicholas C. Petris and Alan Short, the LPS Act sought to "end the inappropriate, indefinite, and involuntary commitment of persons with mental health disorder"; to "provide prompt evaluation and treatment of persons with mental health disorders or impaired by chronic alcoholism"; and to "guarantee and protect public safety." Despite citing to these articles of intent, the LPS Act violates its own legislative intent through its inclusion of "gravely disabled" in its enforcement of involuntary psychiatric hold designations (also known as "5150 designations"). First, police officers are not required to make a medical diagnosis of a mental health disorder at the time of a 5150 designation; the broad scope of "gravely disabled" increases the number of persons police officers can involuntarily transport, increasing the likelihood of inappropriate and involuntary commitment of persons with mental health disorders. Second, the broad scope of "gravely disabled" produces an onslaught of 5150-designated persons (whether improperly designated or not) being sent to LPS-designated hospitals with limited resources (e.g., lack of beds and psychiatric staff); this results in patients waiting for an inordinate amount of time for a psychiatric evaluation and/or a hospital bed. Third, it is unclear whether the LPS Act sought to provide protection for the mentally ill or to provide protection from the mentally ill in its guarantee of protecting "public safety"; the inclusion of "gravely disabled" in 5150 designations indicates that the LPS Act provided the public with a duplicitous means of removing the mentally ill, impoverished, and houseless from the streets under the guise of "public safety." This Paper suggests the following to help remedy the effects of implementing the broadly defined "gravely disabled" in 5150 designations: (1) Remove "gravely disabled" from the 5150 criteria; (2) integrate the community with mental health advocacy efforts by creating outreach and education programs; and (3) implement a client-centric approach to interacting with persons with mental health disorders through restorative policing and the establishment of a restorative court.

摘要

自 1972 年 7 月 1 日起,加利福尼亚州的兰特曼-佩特里斯-肖特法案(简称 LPS 法案)开创了美国现代精神卫生强制入院程序的先河,该法案以其三位起草者的名字命名,他们分别是州议员弗兰克·兰特曼(Frank Lanterman)、州参议员尼古拉斯·C·佩特里斯(Nicholas C. Petris)和艾伦·肖特(Alan Short)。LPS 法案旨在“结束对精神障碍患者的不适当、无限期和非自愿约束”;“为患有精神健康障碍或慢性酒精中毒的人提供及时的评估和治疗”;“保障和保护公共安全”。尽管该法案提到了这些意图,但它通过将“严重残疾”纳入非自愿精神病院强制留院治疗的规定(也称为“5150 规定”),违反了其自身的立法意图。首先,警察在进行 5150 指定时,无须对精神健康障碍作出医学诊断;“严重残疾”的广泛范围增加了警察可以非自愿运送的人员数量,从而增加了对精神障碍患者进行不适当和非自愿约束的可能性。其次,“严重残疾”的广泛范围导致大量被 5150 指定的人(无论是否被不当指定)被送往资源有限的 LPS 指定医院(例如,缺乏床位和精神科工作人员);这导致患者等待精神科评估和/或病床的时间过长。第三,LPS 法案在保护“公共安全”方面是为了保护精神病人,还是为了防止精神病人受到伤害,这一点并不明确;将“严重残疾”纳入 5150 规定表明,该法案为公众提供了一种双重手段,可以以“公共安全”为幌子,将精神病人、贫困者和无家可归者从街头清除。本文提出以下建议,以帮助纠正在 5150 规定中广泛定义的“严重残疾”的影响:(1)从 5150 标准中删除“严重残疾”;(2)通过创建外联和教育计划,将社区与精神健康倡导工作结合起来;(3)通过恢复性警务和设立恢复性法庭,以一种以客户为中心的方式与精神障碍患者互动。

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