Joseph Perez was accepted into San Luis Obispo County’s Mental Health Diversion Program to address criminal charges he received in the midst of mental health crises.
Courtesy of Lisa Kania
This article mentions suicide and may be troubling for some readers. Please read with care.
An Atascadero man diagnosed with schizophrenia has been fighting for years to get mental health treatment in San Luis Obispo County.
On Wednesday, Joseph Perez and his family finally received a glimmer of hope: The 36-year-old was accepted into San Luis Obispo County’s Mental Health Diversion Program to address criminal charges he received in the midst of mental health crises.
“I can breathe,” Lisa Kania, Perez’s mother, texted The Tribune immediately after San Luis Obispo Superior Court Judge Barry LaBarbara ruled Perez could take part in the program.
Kania has been trying to get her son treatment ever since her family moved to Atascadero 10 years ago. The process to receive this much needed treatment wasn’t easy, and it’s taken a toll on everyone involved.
“We’re very, very tired. Emotionally and physically — it has exhausted our entire family,” Kania said. “It’s been going on forever and it’s just like, we just want Joseph to get treatment.”
Entrance into the program is hard to come by — only 21% of applicants were accepted between March 2019 and April 2022 — and it’s contingent on opinions from the county Behavioral Health Department, the district attorney and ultimately, a judge.
Perez petitioned the court to divert him into treatment for his mental illness instead of forcing him to face a criminal trial after he was arrested twice last year for crimes allegedly committed during manic episodes.
He was first arrested on June 22, 2021, while experiencing a severe mental health crisis and on a 5150 hold at Twin Cities Community Hospital in Templeton.
According to a police report obtained by The Tribune, Perez yelled at Atascadero police officer Zachary Yeaman-Sanchez to leave him alone. The officer pushed a cart into him and Perez punched the officer with his arm, which was wrapped in a soft cast. The cast was deemed a deadly weapon, according to both the police report and the charges filed by the San Luis Obispo District Attorney’s Office.
Perez experienced another mental health crisis while out on bail in August 2021.
During this incident, Perez tossed a rock in the direction of his mother. Atascadero officers said they could only arrest him on suspicious of assault despite his mother’s wishes to have him put in treatment instead of jail. He was arrested and charged with assault with a deadly weapon, according to court documents.
“None of the court dates have been pleasant,” Kania said. “It was very, very stressful wondering what was going to happen.”
Perez had five court dates to evaluate whether he could be accepted into mental health diversion. Four of the hearings pushed the decision back for procedural legal steps, like being seen by another county psychiatrist or needing time to file or read a report.
And while acceptance into mental health diversion is welcome news for the family, it’s by no means a cure-all for Perez, who struggles with his condition every day and suffers crises and suicidal thoughts that continue to require acute care and even mental health holds.
Perez’s story is just one of many in San Luis Obispo County that shows what happens when mental health crises are handled by the legal system.
Mentally ill man not given medication in SLO County Jail for months, court documents show
A key motivation for Perez’s family to enter mental health diversion, they say, was the lack of treatment he received in San Luis Obispo County Jail last year.
After his second arrest in August 2021, Perez was held at the jail because he was deemed incompetent to stand trial.
According to court documents, Perez did not receive any psychiatric medication for his illness for nearly three months, despite being found incompetent. On Nov. 8, 2021, a judge ordered the jail to give Perez proper medication and for him to be committed to a state hospital.
In the order, the judge wrote Perez would likely “suffer serious harm” to his physical and mental health without his medication. The judge also noted that Perez lacked capacity to make decisions about medication and should be medicated involuntarily if needed.
But a month later, Perez still was not receiving medication.
In a hearing on Dec. 22, 2021, a judge ordered the jail to give Perez medication to manage his illness — again — and set a hearing a week later ordering jail representatives to explain why Perez was not being properly medicated.
Court documents show Jenna Morton, a lawyer for the county; Jeremiah Mayes from the San Luis Obispo County Jail; and Joyce Smiley from the California Department of State Hospitals appeared to explain to the court Dec. 28, 2021, but it is unclear what that explanation was. The judge also ordered the jail psychologist to evaluate Perez to figure out what type of medication would work best for him.
Despite these orders, court documents show Perez was never transferred to an inpatient facility. He told his family he was in “solitary confinement” nearly the entire time he was in jail awaiting competency, Kania said.
The San Luis Obispo County Sheriff’s Office said it does not use solitary confinement for inmates and when asked about Perez’s claims, department spokesman Tony Cipolla said the office does not release specifics about inmate housing.
“The County Jail does not have solitary confinement cells where inmates basically have no contact with the outside world,” Cipolla said in a May 6 email.
Cipolla said the jail does have “administrative separation housing” for inmates, which is described as single- or double–person cells where inmates have interactions with correction staff and visits from medical and mental health staff.
The jail also uses “safety cells,” which are single-person cells for inmates deemed at acute risk of suicide, Cipolla said.
“Inmates are separated due to violent behavior or because they pose a risk to other inmates or may be at risk themselves,” he said.
Although the Sheriff’s Office said placement in safety cells does not exceed 48 hours, Perez and his family said he spent nearly all of his five months at the jail in isolation, without much interaction with medical or mental health staff.
Perez made bail in March 2022, when he was deemed competent and stable enough to stand trial.
Fear of returning to jail drives Atascadero man to suicidal thoughts
Perez’s time in isolation at the SLO County Jail has plagued him since his release in March 2022.
Kania said in the months since his release, Perez likes to walk around the neighborhood in the open air and prefers to sleep with his bedroom and patio door open.
“He has the door to the outside — he has his own little deck and he sleeps with that door open a lot,” Kania said. “He says he just can’t handle it being closed, that closed-in feeling.”
Perez’s petition for mental health diversion required five court hearings over the past three months.
The cycle of hearings, continuances and other procedural court matters was a trigger for Perez, who told his mother numerous times he would rather die than risk returning to jail, Kania said.
He’s acted on those suicidal thoughts twice, his mother said: Once just before a court hearing where the decision regarding his acceptance was postponed and once shortly after a hearing where the decision was postponed again.
Perez attempted suicide May 20, less than a week before a May 26 court hearing. Kania said her son experienced a manic episode in which he was deemed gravely disabled by Atascadero police officers — meaning he could not make decisions for himself.
Later that day, Kania said she watched her son overdose on medication. She called 911 immediately, and Atascadero police officers responded along with EMTs and paramedics.
She said responding officers did not believe that her son had been deemed gravely disabled earlier in the day and unable to make decisions for himself. Even after the officers confirmed with dispatch, they still did not believe Kania when she said her son overdosed, because Perez denied taking any medication, she said.
Atascadero officers turned away EMTs, she said, and Kania had to manage her son’s overdose on her own, waking him up each hour to ensure he was OK. Perez survived, but it took a toll on both him and his family.
“I was freaking out, I’m not going to lie,” Kania said when she recounted managing her son’s overdose. “I was freaking out, trying to remain calm at the same time. And it was almost impossible for me.”
Atascadero city officials as well as the Atascadero Police Department declined to answer Tribune questions or comment on the May 20 incident.
The Kanias requested a meeting with Atascadero officials to discuss the incident, and it was scheduled for June 6.
Before the meeting could happen, and days after a court hearing was rescheduled, Perez attempted suicide a second time on June 3.
The complications from this overdose left Joseph with dangerously low blood pressure and a slow heart rate.
“Because of the most recent events with the Atascadero Police Department, not getting to a hospital with the most recent overdose, I knew calling 911 here was not an option,” Kania said. “I didn’t have time to argue with the police officer.”
Instead, she drove him to French Hospital Medical Center in San Luis Obispo.
Kania held his hand at French Hospital, day and night. Once he was stable, Perez was transferred to Canyon Hills Psychiatric Hospital in Chino.
Kania family demands accountability from Atascadero officials in community meeting
While Perez was in the hospital after his second suicide attempt, the Kania family and two relatives met with Atascadero officials.
Kania called the meeting because she wanted answers as to why Perez’s overdose May 20 was treated as a police matter rather than a medical emergency.
Atascadero Police Chief Robert Masterson, Atascadero Mayor Heather Moreno and Atascadero Deputy City Manager Terrie Banish all attended the meeting, Kania said. Kania’s husband, Chuck Kania, also attended the meeting, while her sister and brother-in-law, Christina and Marshall Runkles, joined remotely.
Kania said she asked them to attend because Marshall Runkles has been a paramedic in Florida for more than 20 years.
When Kania asked if she could record the meeting to prevent any future confusion, she said her request was denied by all Atascadero officials in attendance.
Both Kania and Christina Runkles told The Tribune that Masterson seemed agitated during the meeting and raised his voice in frustration; they said Banish had to “calm him down.” Masterson said in the meeting that he had not read the police reports regarding the May 20 incident, despite the meeting being set up specifically to address it, Kania said.
“We have been through a lot, and I said, ‘Now my son fights for his life because of them,’ ” Kania said regarding the May 20 incident, “because they didn’t want to do their job, or they were annoyed or whatever it is they were feeling that day.”
Atascadero city officials and the Atascadero Police Department also declined to answer questions or comment on the June 6 meeting.
Because Perez is an adult, police reports documenting these incidents can only be requested by and released to him or his attorney. Perez has not been able to file a formal request given his recent challenges with mania and suicidal ideation, Kania said.
Son’s mental illness impacts the entire family, SLO County mother says
When caring for an adult with a severe mental illness, the entire family is impacted.
“You know, when my phone rings in the wee hours of the night, I don’t know if it’s (Kania) calling me about (Perez) or her husband calling me about her,” Christina Runkles said.
Kania said she has been under “a tremendous amount of stress.” She said she has trouble sleeping and takes medication to keep her blood pressure in check.
“It’s hard to have a son who has schizophrenia and there not be any resources,” she said. “Then you’re too afraid to call (911) because you’re afraid of jail for him. You’re afraid of people not caring.”
And when it comes to getting her son the help he needs, she feels helpless.
“It’s kind of like if your child needed CPR, but you’re paralyzed and you can’t give him CPR and you’re watching him trying to breathe,” Kania said. “There isn’t a heart monitor thing to get his heart pumping again. I can’t reach it. There isn’t anything around.”
Acceptance into the county’s mental health diversion program is not a cure-all for Perez’s mental health struggles, nor is it the end of the family’s journey.
On June 12, Perez was discharged from the Chino psychiatric hospital where he stayed about a week. His 5150 hold, which can last a maximum of 72 hours, was extended to a 5152 hold, which can last up to 14 days, Kania said.
On Thursday night, Joseph’s escalating paranoia and delusions reached a breaking point, and he was placed on a 5150 hold for the second time in two weeks.
There was a marked difference between police response this time and during the previous incidents, Kania said.
“I must say, APD came out and within minutes put him on a 5150 hold and were completely professional and empathetic,” Kania said Friday. “I was impressed and grateful as I was concerned because of past issues. The difference was amazing.”
Perez is currently in the emergency room at Sierra Vista Regional Medical Center in San Luis Obispo, where he is waiting for a bed at a psychiatric hospital.
It’s unclear how this may impact his admittance to the Mental Health Diversion Program — something that worries his mother.
If Perez no longer qualifies for mental health diversion because his diagnosis has become too severe, the only other option to address the charges he received during his mental health crises is through the criminal court system.
“I’m not sure if this will affect his diversion and neither are (SLO County Behavioral Health officials). I pray it doesn’t,” Kania said. “In my opinion, it wouldn’t be very fair if it did. I mean it is ‘mental health’ diversion. This shouldn’t be used against him — he’s in a mental health crisis.”
If you or someone you know is having thoughts of suicide, the National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 1-800-273-8255. You can also call the Central Coast Hotline at 800-783-0607 for 24-7 assistance. To learn the warning signs of suicide, visit suicidepreventionlifeline.org.
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