New law allows more involuntary mental health holds. Should San Diego County delay its implementation?

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Article by Paul Sisson  |  Read full article in the San Diego Union-Tribune

A new law that significantly expands the rules for involuntary mental health holds takes effect Jan. 1, but San Diego County will consider delaying the change for one year, though it appears that idea will not sail through without significant debate.

The matter is set to come before the county Board of Supervisors for a vote at their regular meeting Tuesday.

Nora Vargas, chair of the county board, said Wednesday that there are concerns that expanding the meaning of gravely disabled at the first of the year could result in a significant increase in the number of “5150” holds that occur, especially among unhoused residents, potentially putting too much additional pressure on emergency medical resources that are already overtaxed.

The concern, she said, is that these holds won’t do much but widen the current revolving door between the streets and local emergency departments if there isn’t a better-laid path for how to make sure that holds turn into long-term treatment rather than a short hospital stay and a discharge back to the streets.

“We need to make sure that, if they end up in a hospital room, in an emergency room, that we know how we’re going to make sure they get what they need,” Vargas said. “You can’t do that just by saying, ‘let’s just open it up, and let’s figure it out as we go.’ I think that’s irresponsible.”

But it would appear that the chair’s stance is not universally held.

Fellow supervisor Terra Lawson-Remer issued a statement late Wednesday afternoon that said she will not vote to delay. Doing so, she said, would amount to slow rolling change that needs to happen now.

“We have to act with urgency in addressing the mental health crisis that is occurring on our streets and in households across San Diego County,” Lawson-Remer said. “Our county should not be delaying the implementation of Senate Bill 43.”

Though Lawson-Remer said she will offer a “friendly amendment” Tuesday to implement the statute on Jan. 1, but to also “evaluate the early stages based on initial data to assess where systemic improvements are needed to ensure people are genuinely getting the help that they need through long-term treatment.”

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