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California high court upholds faster mental health care transfers for unfit defendants

The waitlist for mentally incompetent defendants to be transferred from jail to treatment centers has grown by over 500% over the last eight years, according to the ACLU of Northern California.

SAN FRANCISCO (CN) — California defendants deemed unfit to stand trial will no longer be allowed to languish in jail for months without treatment after the California Supreme Court on Wednesday upheld a previous court ruling banning the delays as unconstitutional.

Joined by two California chapters of the American Civil Liberties Union, five family members of defendants judged as incompetent to face trial sued the California Department of State Hospitals in July 2015. The plaintiffs argued that the state was forcing defendants with disabilities to remain in dangerous jail environments, denying them necessary treatment and violating their due process rights.

Under state and federal law, defendants judged to be lacking in their capacity to understand the nature of criminal court proceedings and charges against them cannot be tried or sentenced. The California Department of State Hospitals or Department of Developmental Services are required to transfer those defendants out of jail to facilities where they can be evaluated and treated. Some patients can regain the ability to participate in court proceedings if a judge finds they have been restored to competency.

In March 2019, Alameda County Superior Court Judge Winfred Smith granted the plaintiffs' motion for a writ of mandate to make the state speed up transfers from jail to treatment centers. He found the state “systematically failed to provide due process” to defendants awaiting treatment. Judge Smith ordered the state to send those individuals to state hospitals or other treatment facilities within 28 days.

The state appealed that ruling, arguing the court’s 28-day deadline was “arbitrary and improper.” This past June, California’s First Appellate Court of Appeal rejected the state's argument, finding the deadline was “appropriate and necessary” because “too many of these defendants’ due process rights continue to be violated due to lengthy waits in county jails.”

On Wednesday, the California Supreme Court rejected the state’s latest appeal in the case, meaning California must now comply with the March 2019 order requiring it to send unfit-for-trial defendants to treatment within 28 days.

About 4,000 people deemed mentally incompetent by the courts are held in county jails each year and placed on a waitlist for admission to state hospitals and treatment centers. The waitlist has soared by over 500% over the last eight years from 262 defendants in July 2013 to 1,687 people in February 2021, according to the ACLU Foundation of Northern California.

In a statement Wednesday, ACLU lawyer Michael Risher said the state has not done enough to address the crisis of leaving defendants in need of treatment languishing in jail for months. He said the state should consider outpatient treatment for those defendants.

“State officials cannot build their way out of the state hospital bed shortage, or keep putting people away in locked facilities,” Risher said. “Research shows that outpatient treatment is just as effective and far less expensive than inpatient treatment. The state must emphasize community-based treatment in order to get people the treatment they need.”

The plaintiffs are represented by the ACLU Foundations of Northern and Southern California and the law firm Sullivan & Cromwell LLP.

Laura Kabler Oswell, a Sullivan & Cromwell partner and co-counsel in the case, said in a statement that her clients and colleagues are thrilled that the state's high court decided to let the Court of Appeal’s “well-reasoned decision” stand.  

“This is an important vindication of the constitutional rights of people declared incompetent to stand trial awaiting treatment in California jails,” Oswell said.

The California Department of State Hospital did not immediately return a phone message requesting comment Wednesday evening.

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