SB 43, a bill intended to reform conservatorship laws in California, has faced several criticisms and concerns, which suggest it could face legal challenges and have negative impacts on certain communities.

1. Rights of People with Mental Illness: The San Francisco Public Defender’s Office has expressed serious concerns about SB 43. They argue that the bill’s expansion of the definition of “gravely disabled” could lead to more people with mental health disabilities being involuntarily detained in locked facilities. This, they argue, contradicts the rights and autonomy of these individuals and could lead to substandard treatment in government facilities rather than appropriate community-based treatment.
2. Impact on Unhoused and BIPOC Communities: Human Rights Watch has highlighted that SB 43 may disproportionately affect unhoused individuals and BIPOC (Black, Indigenous, and People of Color) communities. They point out that treatment is more effective when individuals are housed, and that the expansion of involuntary treatment without adequate housing support can destabilize communities. Additionally, there’s concern about the potential for racial bias in diagnosing mental health conditions, which could lead to a disproportionate number of BIPOC individuals being placed under involuntary state control.
3. Strain on the Healthcare System: Voice of San Diego reports concerns that SB 43 could strain emergency rooms and the treatment system in San Diego. The law could lead to a spike in instances where police transport people with severe substance use disorders to local emergency rooms for short-term holds. This could increase pressure on a treatment system that is already struggling to provide care, especially for low-income and homeless individuals.
4. Concerns About Coercion and Ineffectiveness: Critics of SB 43 argue that involuntary treatment, particularly for substance abuse disorders, can be counterproductive. Effective outcomes usually arise from voluntary compliance, and coerced or involuntary treatment could be seen as an overreach of the state’s power, potentially exacerbating disparities for marginalized populations.
5. Legal and Ethical Implications: There are also broader legal and ethical implications associated with SB 43, especially regarding the expansion of criteria for determining grave disability and the incorporation of substance use disorder as an indicator. This raises questions about the balance between civil liberties and the need for treatment, as well as concerns about predicting future outcomes for individuals’ mental health.

In summary, while SB 43 aims to address issues in mental health care and conservatorship, its potential negative impacts on individual rights, marginalized communities, and the healthcare system, as well as concerns about coercion and the effectiveness of involuntary treatment, indicate that it could be challenged in court and may have unintended consequences that could ultimately prove costly for taxpayers and increase homelessness.