Opening a Safety Net for the Mentally Ill

Orange County families will soon have a new recourse to help mentally ill loved ones from spiraling downward and potentially endangering their lives.

The county Board of Supervisors unanimously voted last week to implement Laura’s Law, which allows families and professionals involved with the care or supervision of the severely mentally ill over the age of 18 to petition for court-ordered assisted outpatient treatment.

Laura’s Law has the potential to make a positive difference as another tool in aiding the mentally ill if used properly by the courts, said Corporal Jason Farris, Laguna Beach police department’s community outreach officer who works with the homeless. At least once a week, a family calls saying they “don’t know what else to do” to help a loved one who is either living with them or homeless, Farris said.

The law is meant to address “a small but very troubled minority of mentally ill individuals, including some who are homeless,” said Dawn Price, executive director of Laguna’s Friendship Shelter, which helps homeless adults achieve self-sufficiency in its own facilities and also runs the city’s temporary shelter in the canyon. The small pool of people affected by the law meant it would probably not have a major impact on Friendship Shelter’s work, she said.

Only about 120 people county-wide will be treated annually through the program, which should be implemented by October, Mary Hale, mental health director of the county’s Health Care Agency’s, told the supervisors last week.

The program’s cost could be as much as $6.1 million a year, with $4.4 million in available funding from the state Mental Health Services Act, said Hale.

Though the state law passed in 2002, it requires that each county opt-in separately to take advantage of the law’s provisions. Orange County is the first large county in the state and the second county overall to do so, after tiny Nevada County, near Lake Tahoe.

At least 45 states have enacted similar laws, according to mental health advocates.

The California law’s namesake, Laura Wilcox, worked at the Nevada County Behavioral Health Clinic, where she was shot and killed by a client of the clinic in 2001. The tragic event galvanized support for the law.

Nevada County adopted the law as part of a settlement with the Wilcox family. No other counties followed suit until now. Advocates for the law in Orange County mobilized in 2011 after the death of homeless schizophrenic Kelly Thomas. He sustained fatal injuries in a beating by Fullerton police.

Even so, an earlier county effort to pass Laura’s Law in 2011 failed. The measure was revived after a change in the law in 2013, allowing the county to use funds from the Mental Health Services Act, which were previously excluded.

At the hearing last week, Ron Thomas said his son Kelly might have avoided such a confrontation had he gotten proper treatment.

Of 17 others who spoke, some described watching loved ones rapidly deteriorating due to mental illness, but refusing treatment. Health officials and mentally ill patients alike said the law would save lives. “It civilizes, it doesn’t criminalize,” said Laura Torres, a patient who had experienced forced stays in state hospitals before being sent back to live on the streets, and advocated for assisted outpatient treatment as much more humane and effective.

Opponents say the proposed law breaches privacy and civil rights, has unproven outcomes and incurs huge costs to help a few people. Richard Krzyzanowski of the California Assn. of Mental Health Peer Run Organizations, a patient’s rights advocate, termed the law: “an expensive intervention into the private lives of citizens.”

The criteria for adults eligible for court-ordered assisted outpatient treatment include severe mental illness, a lack of compliance with treatment and a substantially deteriorating condition, said Hale in her report. Mental health officials must also establish that mental illness has caused two psychiatric hospitalizations or incarcerations in the last three years; or attempts or threats of violent behavior within the last four years.

In any event, the assisted outpatient treatment must be the least restrictive tool available.

“The law is very specific about who can request assisted outpatient treatment,” insisted Hale. There is a set group of people who can petition for that treatment. This includes immediate family members, adults residing with the individual, medical professionals and police, probation and parole personnel who supervise the individual.

“Involuntary medications are not allowed” as part of the treatment services, Hale emphatically pointed out.

Kendra’s Law in New York, a law very similar to Laura’s Law that was enacted in 1999, has a track record to show that it has reduced the severest consequences from lack of treatment and has also reduced costs for the most expensive services, according to two studies.

The county will monitor participants in the program and evaluate its effectiveness, especially regarding homelessness, hospitalization and incarceration, Hale said.

If the law can intercept the downward spiral of the severely mentally ill, “I think we are morally obligated to help,” said Supervisor Pat Bates, who represents the Fifth District, which includes Laguna Beach.