Conservatorship: Inside California's System of Coercion and Care for Mental Illness

(Part two) A conversation with author and NYU professor Dr. Alex Barnard

Season 4 | Episode 3 | October 5, 2023


Is involuntary psychiatric treatment a solution to the intertwined crises of untreated mental illness, homelessness, and addiction? In recent years, elected officials and advocates have sought to expand the use of conservatorships, a legal tool used to require someone deemed “gravely disabled" (e.g., unable to meet their needs for food, clothing, or shelter as a result of mental illness) to take medication and/or be placed in a facility (often locked) under the care of a guardian for a defined period (usually one year at a time).   

This is Part Two to a conversation with Professor Alex Barnard. Two years ago, Heart Forward interviewed Barnard who was in the initial stages of his research into California’s laws under the umbrella of the Lanterman-Petris-Short Act adopted over 40 years ago. It would be advisable to listen to that interview first. Since that time, he has managed to publish a book which is an excellent resource, and that is the focus of this interview. 

Conservatorship is an incisive and compelling portrait of the functioning—and failings—of California’s conservatorship system. Drawing on hundreds of interviews with professionals, policy makers, families, and conservatees, Professor Barnard takes readers to the streets where police encounter homeless people in crisis, the locked wards where people receiving treatment are confined, and the courtrooms where judges decide on conservatorship petitions. 

He will make a case that California’s state government has abdicated authority over this system, leaving the question of who receives compassionate care and who faces coercion dependent on the policies and priorities of California's 58 counties, the financial incentives of for-profit facilities, and the constraints of under-resourced clinicians. He gives a voice to the desperate struggles of families to obtain treatment for their loved ones and the challenges people with mental illness themselves face getting the services they want and need. He challenges us to walk a mile in their shoes and the shoes of their family members who are often left adrift.


Resources for this episode:

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Long-Awaited Research Findings Signal Need to Pay Attention to Our Fragile System of Licensed Facilities Serving People with Mental Illness

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