The mental health crisis in urban areas has become so severe that cities and states are desperate for ways to address the problem. But oftentimes, that means fierce opposition from a host of left-wing groups that would ordinarily be allied with blue state mayors and governors.

Advocates for the homeless and civil liberties groups are making it very hard to address urban mental health problems, resulting in quality of life issues for everyone.

The mentally ill are often homeless, which presents its own set of problems. And, although medication usually does a good job of regulating moods and behaviors, homeless mentally ill people don’t always take their medication, leading to tragedies.

By some estimates, up to 13% of all violent deaths in Los Angeles and New York are the result of homeless attacks. There is also an epidemic of attacks on the homeless by other homeless perpetrators.

How to address these seemingly intractable, unsolvable problems?

California Gov. Gavin Newsom is taking the risky political step of initiating “mental health courts” in every county in his state. It’s risky because he is going to anger homeless advocates who don’t think that people with no fixed address need to be treated any differently than anyone else — even if they’re mentally ill. And some of the aspects of Newsom’s plan run afoul of mental health and civil liberties advocates because non-compliance could lead to involuntary incarceration.

Building a lot more affordable housing would be a start. But clearly, something dramatic has to be done to address the epidemic of mentally ill homeless people.


Under the plan, which requires approval by the Legislature, all counties would have to set up a mental health branch in civil court and provide comprehensive and community-based treatment to those suffering from debilitating psychosis. People need not be homeless to be evaluated by a court.

But if approved, they would be obligated to accept the care or risk criminal charges, if those are pending, and if not, they would be subject to being held in psychiatric programs involuntarily or lengthier conservatorships in which the court appoints a person to make health decisions for someone who cannot.

Newsom will have a devil of a time getting this through a dubious legislature. But perhaps taking a more holistic approach to the problem of mental health is worth trying.

The key to the program will be treating the mentally ill as sick and unable to make many decisions on their own. If they’re not going to take their medication and eliminate the risk to society they pose, they need to be involuntarily committed in order to protect the rest of us.

Yes, there’s a risk of abusing such a system by committing people who may not need to be segregated from society. But making an error in the other direction can lead to tragic deaths. As with anything else in life, we must accept some risk so that all are able to live more safely.

But that bit of common sense won’t work in California.

“At this point there are a million questions and a million things that could go horribly wrong,” said Kevin Baker, director of government relations for ACLU California, in an email. He said homelessness is caused by skyrocketing housing costs “and we won’t solve homelessness, mental health, or substance abuse problems by locking people up and drugging them against their will.”

“Drugging them against their will” is polito-speak for helping the mentally ill who don’t understand that they are being helped. Psychotropic drugs are not perfect and cause worrying side effects in some people. But in the vast majority of cases, they allow the patient to rejoin the world and can lead to a more satisfying and fulfilling life.

Newsom should be commended for going outside of his comfort zone to propose a new way to look at mental health issues. But it appears that too many of his radical left friends are so wedded to their orthodoxy that helping people has to take second place.

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