L.A. County's Mental Health Care System Continues To Fail The Sickest. Will 2024 Bring Some Relief?

Many of the stories LAist covered in 2023 focused on the tragic outcomes that can happen when the mental health care system fails the people who are sickest. Several families whose stories were reported said they were exasperated from trying to get their loved ones the kind of mental health care they need.

This year, I hope to write more people driven stories that illustrate where and how the system of care has broken down. In the new year, there will be more state and local resources than ever dedicated to mental health issues. I’m interested to see if it will be enough to address some of the issues I reported on in 2023.

In March, I looked at a recent spike in suicides within the L.A. County jail system , and why families continue to decry what they see as a dismal situation for incarcerated people living with serious mental illness. In April, I wrote about Oscar Leon Sanchez , whose family said he was struggling with his mental health and was in crisis when before he was fatally shot by L.A.

police during a crisis. And in August, I wrote about tagging along with a street medicine team whose leader said they need more help treating unhoused people with mental health conditions where they are. And then there was the story of the Campos family , who lost their son in an accident on Interstate 5.

Frank Campos was 29 and an artist whose childhood bedroom in Duarte overflowed with charcoal drawings, sculptures he created. Campos also lived with schizophrenia and was on his way from a locked, in patient facility to a lower level of care in 2021 when he jumped out of the car on the freeway and was hit by a truck.

Before Campos’ death, his family was actively involved in his care. His mother became his conservator so she could guide treatment and medications. She said she wanted her son to remain in a locked facility so that he could recover, but he was discharged on Feb. 22, 2021 to a lower level of care and was en route when he died.

I talked with Enrico Castillo, a UCLA psychiatry professor, who said Los Angeles has about half the per capita mental health hospital beds than what is recommended by national medical consensus guidelines. “So many places today are discharging patients with higher and more acute needs than they might have discharged in the past,” Castillo said.

He said hospitals are sometimes “financially disincentivized” to hold people in expensive levels of care. And I heard that the default is to discharge people quickly. LA County supervisors say thousands more mental health beds are needed. I’ll be interested to see if any of the solutions state and county leaders have introduced will move the needle on how we care for the most vulnerable.

This year saw several pieces of legislation passed that were aimed at getting people help. The new CARE Court program launched in December and will allow family members and others to petition a court to order a care plan for someone with mental health needs. Many families are hopeful it will give them leverage to get a loved one into lifesaving care.

The law says the program is voluntary, but there are still concerns from civil liberties groups who argue the program is too coercive and could strip individual rights. As always, my goal is to focus on individuals and families struggling to make the mental health care infrastructure work for them in the hopes that it can make a seemingly intractable system easier to navigate..