Mental Health

Make It Top Priority

In October we enjoyed a robust discussion at Vanguard University of Southern California on the subject of the Lanterman Petris Short Act and solutions that your community can utilize to improve the Mental Healthcare System in California.

The Problem

Lanterman–Petris–Short Act of 1967

The Lanterman-Petris-Short Act was a big mistake and we need to reevaluate what California has been doing for the last fifty years. The standard for determining who needs psychiatric care shifted from “need for care” to “harm to self or others.” People who are in need of care, are being neglected; some are even left to languish on the street or in jail.

Although the LPS Act intended to reduce abuses in the mental health system, it went too far in preventing involuntary civil commitments for the severely mentally ill. Worse, the statutory changes released people from the institutions, relegating them to the streets and often to jail – all during the vast shifts in social mores of the 1960s further complicating the treatment of mental illness.

A Solution

Senate Bill 640 - Mental Health Services: Gravely Disabled

In January of 2020, Senator John Moorlach will be revitalizing Senate Bill 640 which was held by the Senate Health Committee this year. It would broaden the definition of “gravely disabled” to include someone who “is incapable of making informed decisions about” the basic necessities of life, such as shelter, food, and clothing, without significant supervision from another person. This would be a revision of the Lanterman-Petris-Short Act of 1967.

By considering SB 640 in 2020, the Legislature and Californians will have significantly more time to examine its full implications. For example, we could offset increased hospital expenses by tapping funds from the Mental Health Services Act, the 2004 initiative that taxes millionaire incomes at 1 percent to help the mentally ill.

Expert Panel

Jeff Nagel

County of Orange

Jeffrey A. Nagel is the Behavioral Health Director for the County of Orange. Dr. Nagel received his Ph.D. in Clinical Child Psychology from the University of North Texas and has worked in the public behavioral health system for nearly 30 years. He has a history of work in the public mental health system from direct service provision to system management.

Commander Joseph Balicki

Orange County Sheriff's Department

Commander Joseph Balicki, a 33 year veteran of the Orange County Sheriff’s Department, is the Area Commander for the Custody Operations Command. He is responsible for implementing the Sheriff’s jail mental health initiative. Additionally, he is the department’s representative on the County’s Stepping Up Initiative, a nationwide effort to reduce the number of people with mental illness in jail.

Dr. Heather Huszti

CHOC Children’s

Heather Huszti, Ph.D., is a licensed psychologist and Chief Psychologist at CHOC Children’s as well as the Section Chief for Pediatric Psychology. She is the director of training for the Psychology Training Program at CHOC Children’s. Dr. Huszti has also served as a principal investigator on a number of federally funded research projects with a focus on adherence.

Dr. Sina Safahieh


Sina M Safahieh, MD, is a psychiatrist certified in child, adolescent, and adult psychiatry. As the Program Director of ASPIRE at Hoag, a teen outpatient mental health program, he is particularly interested in assisting patients with mood disorders, technology addiction, and ADHD. Other areas of expertise include bipolar disorder, schizophrenia, and psychotic disorders, and substance abuse/dependency.

Matt Holzmann

National Alliance on Mental Illness

Matt Holzmann is the Chair of Government Relations for the Orange County affiliate of the National Alliance on Mental Illness. Haozmann teaches on mental health and is an internationally recognized expert on system change in behavioral health. He has family members with mental illness and has over 35 years of experience in high technology manufacturing.

Marshall Moncrief


Marshall Moncrief, MFT, MBA, is a licensed therapist specialized in treating addictions and co-occurring disorders. Currently, Marshall is the Chief Executive Officer of Mind OC, a nonprofit organization advancing Be Well Orange County, a robust, community-wide, cross-sector coalition creating tomorrow’s system of mental health and substance use care.


John Moorlach

Senator John Moorlach Represents the 37th Senate District of California. He has been working to end homelessness and improve mental health infrastructure since charring the Orange County Commission to End Homelessness. There he implemented Laura’s Law, a tool to mandate assisted outpatient treatment.

This year, Senator Moorlach introduced Senate Bill 640 to expand the definition of “gravely disabled” to be a person who, as a result of a mental health disorder, is incapable of making informed decisions about basic personal needs for food, clothing, or shelter, without significant supervision and assistance.

The Senator has been a member of the Select Committee on Mental Health since 2018. The committee is authorized and directed to identify the best methods and current trends in mental health treatment. On this committee, he participates in hearings, writes legislation, advocates for critical budget items, and produces relevant reports to improve mental health treatment in California.

Key Findings

Fixing LPS

  • Anosognosia is the condition in which a person with a disability is unaware of its existence. Parents have the fiduciary power to compel children under 18 year are treated. Once a child is over 18, there is no way for family members to force a loved one to continue or start treatment without a court ordered conservatorship.
  • LPS has to be a pathway to care but the barriers to a conservatorship are too high because conservatorship evidentiary standards are too high (beyond a reasonable doubt). Families are burdened with many legal hurdles.
  • Public guardians, or conservators are available in the absence of a family member.
  • The average hospital stay for someone with a mental illness related emergency is 7 days. That is not usually long enough to create a plan to manage psyche problems.
  • Systems of community care can work, but the resources are lacking. Waiting for a determination of status or appropriate placements can be long, beyond commitment.
  • The same services are offered by public and private services, yet costs are different. There are also no protocols for psychiatric patients and not best practices for standards of care.
  • Certifications of hospitals is too difficult and needs to be streamlined.
Law Enforcement
  • There are 5 LPS beds in the Orange County Jail, yet there are 1,900 mentally ill people in jail, 40% are considered homeless.
  • Orange County does not have enough beds for women. The sheriffs are trying to improve but certifications to apply treatment by the state are difficult, which prevents new beds from opening.
  • Mentally ill patients can be used as pawns if a public defender can use insane defense, for that reason, some prisoners are not treated.
  • Medication may be hard to track if inmates don't self-identify as having a mental illness. Keeping people on medications is difficult without stabilizing. An inmate won't be released unless stabilized.
  • Project Kinship works with former inmates as they are released from jail. It helps them work through the system, have benefits turned back on, and continue systems of care once released.
  • Stigma still exists surrounding mental health, which means there may be future challenges with schooling, insurance, or admittance into the military.
  • It is difficult to get approval to build mental health facilities because local residents don’t want to live or work near mental health facilities.

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