News & Opinion » Feature

Emergency Call

Alameda County has the highest rate of psychiatric detentions in the state, but has failed to adopt a law that could help severely mentally ill adults.



Daryl Podborny died on April 28, 2011, shot to death by a Dublin policewoman whom he allegedly punched and knocked to the ground at 1:30 a.m. near an Interstate 680 on-ramp. Podborny was 53 years old and had lived on the streets of that city for more than twenty years. He had been married once and had a daughter, had worked as a painter, and was honorably discharged from the Army in his early twenties after two years of service following high school in Dublin. His sister, Cathy Box, described him in a recent interview as outgoing, popular, hardworking, and considerate — until sometime in his late twenties, when his personality began to change.

Gradually, Podborny's demeanor grew dark. "He said somebody pulled stuff out of his leg and he'd look at his ID card, look in the mirror, and say his identity was changing and somebody messed with his head; all kinds of things. He got to be real paranoid," Box said. "One time, he was trying on pants and he didn't like them so he got real mad and he was going to hit my dad. And then his mind got worse and worse."

Over the years, Podborny was booked into Santa Rita jail in Dublin seventeen times, mostly for fighting and drunkenness. He was arrested in Los Angeles on suspicion of assaulting a law-enforcement officer and arrested in Livermore on suspicion of assaulting a first responder. According to Box, their mother tried to convince him for years to get mental treatment but he refused and she finally stopped asking to avoid upsetting him.

Box said that her mother's death left her brother distraught and may explain why he confronted the police officer and was fatally shot. She also said her mother was told by someone who called from the jail that Podborny appeared to be mentally ill. "But they just turned him out to the streets again."

Podborny's torments are by no means isolated. Year after year, Alameda County confines more people for psychiatric evaluation than any other California county except Los Angeles, even though five counties besides Los Angeles have much larger populations. The five acute-care hospitals in Alameda County authorized to evaluate people suspected of being a danger to themselves or others handled nearly 16,500 such emergency psychiatric cases during the year ending July 2009, according to the most recent data available from the California Department of Mental Health. San Diego County, with the next highest number, had less than two thirds as many, but had more than twice the total population. Of all counties in the state, Alameda has by far the highest rate of such detentions per capita, and many of those patients return again and again.

There is a California law that could enable the families and partners of severely mentally ill adults to get help for them if they refuse psychiatric treatment. It's called Laura's Law, named after Laura Wilcox, a 19-year-old woman who was fatally shot along with two other people, and a third who was wounded, by a seriously mentally ill man whose parents failed to convince him to continue psychiatric care.

The measure, which became a state law in 2002 and is being used successfully in Nevada County, Wilcox's home, is narrowly focused. It applies only to severely mentally ill adults who have had recent multiple arrests, had been repeatedly hospitalized for psychiatric reasons, acted violently, and refuse treatment. Under the law, those adults may be evaluated by county mental health professionals at the request of their family members or living partners, and, if necessary, ordered by a court to receive treatment as an outpatient. But the law is coercive only to the extent that it relies on the gravity of the court — the "power of the robe" — to compel seriously mentally ill individuals to accept treatment. Drugs cannot be administered involuntarily and there is no consequence if the patient refuses to comply with the court-assigned treatment program, except a judge can order him or her to be held for evaluation for 72 hours to determine whether in-patient treatment is needed.

The legislature left it up to counties to decide whether to implement Laura's Law, but neither Alameda nor Contra Costa County has chosen to do so. The deputy director of Alameda County Behavioral Health Care Services, Barbara Majak, said that she believes the law could be viewed as forcing people into treatment against their will. "I think there are a lot of questions about the efficacy of involuntary care," she said. Though under Laura's Law no one can be forced to comply with a judge's order to get treatment as an outpatient, Majak maintained that "constituents would see that court order as an involuntary treatment."

But without Laura's Law, acute-care hospitals in the East Bay amount to revolving doors for severely mentally ill adults. And the problem has only become worse year after year. Nearly 3,800 more people were detained and evaluated in Alameda County as suspected threats due to mental illness during the year ending July 2009 than four years earlier, even though the population of the county dropped by nearly 24,000 people during that time.

On February 18, another tragedy occurred involving a seriously mentally ill adult, this time in the Berkeley hills. Daniel Jordan DeWitt, the 23-year-old grandson of the late Al DeWitt, who was an Alameda city councilman, was arrested on suspicion of fatally bludgeoning Peter Cukor, 67, in the driveway of Cukor's home near Tilden Park.