California law establishes a process for involuntary care and treatment for individuals who are severely and chronically mentally ill. Severely mentally ill individuals who have a history of frequent involuntary in-patient psychiatric hospitalizations may be referred to the Public Guardian for a mental health conservatorship when certain conditions exist.
The Public Guardian is authorized by the County Board of Supervisors to conduct investigations to determine if an individual meets the criteria for a mental health conservatorship. The process begins when a psychiatrist, at a designated mental health facility, evaluates and determines that a Orange County resident, has a mental health diagnosis, requires continued treatment but either refuses to accept treatment voluntarily, or lacks the capacity to consent for treatment and is unable to provide for his or her needs of food, clothing and shelter. A physician’s declaration outlining the justification of a mental health conservatorship is sent to the Public Guardian prior to the expiration of an involuntary hold placed upon the individual. Upon receiving doctor’s evaluation and recommendation, the referral is reviewed to ensure legal requirements are met. Legally sufficient declarations are sent to counsel with instructions to petition for a general mental health conservatorship and temporary letters of conservatorship of the person.
Once the petition is filed, the Public Guardian’s temporary letters of conservatorship is the legal basis for continued involuntary detention and treatment for an individual until a court hearing is held. Temporary mental health conservatorship letters are effective for 30-days unless extended by the court.
During the temporary conservatorship period, a Deputy Public Guardian, will consent for continued treatment and placement of the proposed conserved individual and initiate an investigation to determine if a conservatorship should be established for one year. A comprehensive report is sent to the court providing information about an individual covering medical condition and history, psychiatric diagnosis with sufficient facts to indicate if this person is able to provide for food, clothing and shelter. In addition educational, vocational, and social history is provided. If it appears a conservatorship is warranted, the investigator will also recommend the most appropriate person to take on that responsibility. If no one is able or willing to take on the fiduciary responsibility, the investigator will recommend the Public Guardian. Once a person is recommended for conservatorship, the investigator will also determine if there should be disabilities imposed upon the person placed under conservatorship. The disabilities may include the right to possess a driver’s license, the right to vote, the right to enter contracts, and the right to consent to certain medical treatment. The right to own firearms is lost whenever an individual is involuntarily hospitalized in a psychiatric facility according to state law.
The typical services given to a person placed under a mental health conservatorship under the jurisdiction of the Public Guardian is the assignment of a Deputy Public Guardian to oversee mental health treatment and placement in the least restrictive setting recommended by professional clinical staff. The assigned Deputy also applies for benefits, marshals assets, pay expenses, coordinates the management of real and personal property with internal partners, prepares the court required inventory and appraisal and ensures the processing of court accountings. If the conservatorship terminates by operation of law or by the conservatee’s death, the deputy will ensure that assets are returned to the conservatee and when necessary in conjunction with relatives make funeral arrangments.