In 1967, California Gov. Ronald Reagan signed into law the Lanterman-Petris-Short (LPS) Act, co-authored by Assemblymember Frank D. Lanterman ( R) and State Senators Nicholas C. Petris (D) and Alan Short (D). The intent of the LPS Act was to end the inappropriate lifetime commitment of people with mental illness; and firmly establish the right to due process in the commitment process while significantly reducing state institutional expense.

The LPS Act set precedent for modern mental health commitment procedures across the U.S. and ended most state hospital commitments by the judiciary system – except in extreme criminal cases.  

In the 49 years since its passage, there have been significant changes in the mental health delivery system. These changes adversely impact a patient’s ability to obtain prompt evaluation and treatment as required by law.

Statewide, it’s estimated that approximately 1,000 individuals are on a 5150 hold in an emergency department on any given day. California hospitals see more than 1 million individuals with a behavioral health diagnosis in their emergency departments annually.

OSHPD data estimates that 65 percent of emergency department visits for individuals with a behavioral health diagnosis do not result in an inpatient stay. Our community-based mental health system should have more crisis resources available so patients aren’t forced to seek care at a hospital, but rather in a less restrictive setting that is more appropriate for their needs.

There is currently no consistent statewide policy for holds, leaving a patchwork system for California’s 58 counties to interpret on their own. This fragmented and inconsistent application of the LPS Act puts patients and the public at risk.

The reality is that California has a disproportionate dependence on hospital emergency departments, which leaves patients with mental illness languishing for hours, days and sometimes weeks - awaiting psychiatric assessment and treatment because there are no clear guidelines. The result is hospital emergency departments sometimes filled with individuals who don’t need hospital-based psychiatric care.

The LPS Act is meant to protect the patient and the public from harm. Today, it makes sense to preserve that intent and at the same time protect California’s hospitals from overcrowding while offering the most appropriate care for people in crisis.