If AB 1300 helped people access emergency care during a mental health crisis, counties, doctors, people living with mental health conditions, and their families would be the first in line to support it. Instead, the bill represents California’s hospital lobby trying to cut care under the guise of helping those most in need.

Statewide, many hospitals lack psychiatrists and emergency room staff are not required to have the specialized training needed to support people at risk in a psychiatric crisis. It’s no wonder, then, that a 2014 survey by the National Alliance on Mental Illness found 44 percent of individuals with serious mental health conditions rated their experience in emergency rooms as “bad” or “very bad,” compared with only 20 percent who rated the experience “good” or “very good.”

Too often, those seeking care reported they were treated disrespectfully, encountered staff who didn’t communicate or listen effectively, or were made to feel ashamed of their condition.

Severe mental health conditions can be expensive when ineffectively treated and people living with untreated conditions often don’t have private insurance. Since treating mental health emergencies isn’t as profitable as other medical emergencies, California hospitals have cut 40 percent of their acute psychiatric care capacity over the last 20 years. It’s this hobbling of hospital psychiatric care — coupled with a statewide underfunding of community mental health services — that leads to bottlenecks in our emergency rooms, not California’s long-standing law that protects people who need crisis intervention from being turned away from ERs.


Current law requires someone who, due to a serious mental illness, is at risk of harming themselves or another person to be evaluated by a designated, trained mental health or medical professional before being discharged.

AB 1300, sponsored by the California Hospital Association and authored by Assemblyman Sebastian Ridley-Thomas, D-Los Angeles, removes these lifesaving protections. Under this bill, there is no guarantee that someone brought to the ER by paramedics or law enforcement on a “5150” hold will ever be seen by a psychiatrist, receive medication or treatment, or have family members notified. A person can be released from the ER by an untrained staff member, if the overstretched hospital staff lacks the expertise to intervene.

Hasty releases from the ER can lead to untreated symptoms and run-ins with law enforcement, setting in motion the hospital-to-prison revolving door and the criminalization of mental illness. Law enforcement agencies across California know this — and are partnering with mental health experts on training and procedures designed to de-escalate crisis situations and connect people with help they need. This progress will be lost if an officer brings someone in crisis to an emergency room, only to have them returned to the street to fend for themselves.

AB 1300 reverses course on the progress California is making and puts people with serious mental health conditions at greater risk — that’s why its opposed by the California Behavioral Health Directors Association, the National Alliance on Mental Illness-California, and the Union of Doctors and Dentists.


If California hospitals were serious about helping people living with mental illness access timely care, they would invest in acute psychiatric care and preventive services, and work collaboratively with mental health clients, families and experts to develop thoughtful policies that reduce the impact on our emergency rooms.

Instead, they are pushing AB 1300 to abdicate their responsibility to treat people in mental health crisis. Mental health clients, family members, doctors and county mental health agencies urge the Legislature to reject this disingenuous and dangerous bill.

Barlow is executive director of the County Behavioral Health Directors Association of California.