Laura’s Law languishes

Mental-illness law hasn’t been implemented in most California counties

Continued police shootings of people with untreated mental illnesses. Repeated rampage shootings committed by individuals with no awareness that they are ill. Days spent distraught in locked psychiatric facilities, or incarcerated, or homeless.

Nine years after the passage of Laura’s Law, this remains the reality for too many Californians with untreated mental illness. In fact, only two counties—Nevada and Los Angeles counties—have implemented it.

Why the law remains unimplemented in most counties is due to both a lack of political will to fund it and its still-controversial nature in some circles. This, despite the fact that in places like New York, and elsewhere in the 44 states that now have similar laws, it’s demonstrated across-the-board reductions in psychiatric inpatient stays, homelessness, officer-involved shootings and incarcerations.

“There’s no doubt that … Laura’s Law has saved lives,” says Nick Wilcox, father of the slain teen, Laura Wilcox, for whom the law was named.

Through specialized mental-health courts, Laura’s Law provides a way for judges to mandate outpatient treatment for persons who, though not meeting the current standard for involuntary inpatient commitment, are at serious risk of continued decline if treatment is not accepted. Such an order could be imposed only if, during a formal hearing, a litany of criteria were found to be true.

The process, known as assisted outpatient treatment, is outpatient in its design, and does not take place in a locked facility. Individual agreements are reviewed every six months to assess continuing viability.

“The fact that the California mental-health system has not aggressively implemented Laura’s Law … is perhaps the most prominent sign of the lengths the California system will go to avoid helping the seriously ill,” said DJ Jaffee, attorney and policy analyst for Mental Illness Policy Org., a national pro-treatment organization based in New York City.

Jaffee, along with colleague Mary Ann Bernard, argue that the Legislature—with the monies earmarked in the Mental Health Services Act for prevention/intervention programs—should make Laura’s Law mandatory to fulfill MHSA’s promise to treat the most seriously mentally ill.

But others, like Sen. President Pro Tem Darrell Steinberg, believe “fully funding involuntary treatment” is not “consistent” with the intent of Proposition 63, asserting that Laura’s Law requires counties to have functioning “voluntary” systems of care in place before funding involuntary treatment programs. But with budget cuts, no one is arguing that’s occurred.

In Nevada County, where MHSA funding has been used successfully, along with Medicare and Medi-Cal reimbursements, to fund Laura’s Law, behavioral-health director Michael Heggarty says he thinks people are misinterpreting the law.

First, he notes that the section of law Steinberg was referring to has to do with not “reducing voluntary treatment programs to pay for it. It doesn’t say you can’t have both if you can pay for both.”

Secondly, he points to two sentences in a policy letter written by then-state mental-health director Stephen Mayberg in May 2005. The first sentence reads: “Programs funded must be voluntary in nature.” But the second sentence says: “Individuals accessing services funded by MHSA may have voluntary or involuntary legal status, which shall not affect their ability to access the expanded services under this act.”

Heggarty believes the first part guards against MHSA funds being used for locked inpatient treatment—something which does not apply to Laura’s Law. His argument with the next part is that his department treats “a lot” of court-ordered people, whether from probation or conservatorship, “and we use MHSA funds to treat them. Excluding people in the Laura’s Law group wouldn’t be fair.”

The Sacramento County Mental Health Board last month voted to form an ad hoc committee to “review the feasibility” of implementing Laura’s Law, said behavioral-health director Mary Ann Bennett. The Board will also be looking at other types of programs to address the same issues that Laura’s Law is intended to address.