A quick note on SB 1416

A quick note on SB 1416
(A) A condition in which a person, as a result of a mental health disorder, is unable to provide for their basic personal needs for food, clothing, shelter, personal or medical care, or self protection and safety. 
 
Revision
A person is unable to provide for their basic personal needs for medical care or self protection and safety when the person is at risk of substantial bodily harm, dangerous worsening of any concomitant serious physical illness, significant psychiatric deterioration, or mismanagement of their basic needs that could result in substantial bodily harm.
 
 
So this amendment lays out new exceptions from the current additions to proving current grave disability laid out in Conservatorship of Guerrero (1999) 69 CA4th 442; Conservatorship of Walker (1989) 206 CA3d 1572; and Conservatorship of Benvenuto (1986) 180 CA3d 1030.
 
However, counsel need be mindful that Conservatorship of Murphy (1982) 134 CA3d 15 still stands in the face of this new revision as likelihood a conservatee will return to grave disability in the future is insufficient ground for LPS Conservatorship. However, it would be beneficial to adjust the legislature to include a calculated perceived likelihood of future relapse in a future senate bill.
 
Back to the issue of determining grave disability from neglecting a serious physical illness due to mental illness, one could make the argument that grave disability and danger to self can ascertained from medical neglect. Since most advocates would contend cite to Conservatorship of Smith (1986) 187 Cal.App.3d 903 and state that bizarre or eccentric behavior is not enough to deprive a patient of their civil liberties. However, counsel should distinguish from Conservatorship of Smith and cite to Doe v. Gallinot (C.D. Cal. 1979) 486 F. Supp. 983 which stated that the “standards for commitment are constitutional only if they require a finding of dangerousness to others or self”. Citing in part from Doremus v. Farrell (D.Neb. 1975) 407 F.Supp. 509, 515, the Doe v. Gallinot court cited that “the threat of harm to oneself may be through neglect or inability to care for oneself”.
 
 
Counsel needs to distinguish from “bizarre or eccentric behavior" and make a showing per Conservatorship of Smith and Doe v. Gallinot that the patient’s inability to treat and monitor a severe health condition has rendered the patient unable to fend safely for food and therefore is a danger to self and currently grave disabled. Their decision not to “take care” of their medical needs does not stem from a voluntary choice or alternative lifestyle. They must make the nexus between the patient’s frank psychosis and their inability to care for their medical needs. For example counsel could show that because the patient hears voices or suffers from delusions, they are internally preoccupied with these voices or delusions, and are unable to in any way attend to their basic medical needs. When asked the patient perseverates on these delusions and is unable to voice or explain the importance of taking care of one’s own needs. Therein lies a case for showing that the patient is not choosing to not attend to his needs, he is incapable of doing so. Through this showing of implicit harm via neglect, counsel can further argue that neglect will result in the patient ending up in the ER or ICU for decompensating medical condition, as would a patient who is being treated for self-injury or a suicide attempt.