Santa Clara County Supervisors Consider Mandatory Mental Health Treatment for Critically Ill People | New
Santa Clara County Oversight Board set to decide whether or not to use court-ordered treatment to help people with severe mental illness, opening the door to forced care for those who refuse help .
On Tuesday, the board is due to address the controversial issue of assisted outpatient treatment, better known as Laura’s Law, and has until the end of June to make a final decision. If implemented, court judges would be empowered to compel residents to undergo mental health treatment if they failed to follow voluntary programs and ended up in prison or hospital multiple times due to of disease.
Supporters say Laura’s Law would greatly help those with mental illness who have not received treatment – many of whom end up homeless on the streets – and who are too mentally ill to even recognize their own condition. County supervisors Joe Simitian and Otto Lee previously recommended the implementation of Laura’s Law at a committee meeting in March, with Simitian calling it one more tool to help those in need.
“These are people who continue to suffer from untreated illnesses,” Simitian said in a May 17 statement. “These are people whose families have been told time and time again that there is nothing we can do to help them if their loved ones are not willing to accept care. They have a right to mental health care, and now we have the chance to finally get help for them. “
Laura’s law has been in place since 2002, but most counties – including Santa Clara – have refused to implement the program. Along with fears that compulsory treatment violates civil liberties, county health officials insist time and money would be better spent strengthening voluntary programs and questioning the value of court-ordered care as a means of treating sick patients. The Silicon Valley Law Foundation has also been skeptical and says Laura’s Law reinforces the misconception that people with mental disorders are violent and cannot make decisions about their treatment.
Although the law is nearly two decades old, Laura’s Law is back in the spotlight. A new state law, Assembly bill 1976, requires all counties to adhere to Laura’s Law by default, and those who opt out must do so by the end of June with a clear rationale for refusing. According to Santa Clara County officials, San Bernardino County will disengage, at least in part over fears that mandatory treatment disproportionately affects communities of color.
A letter of support for Laura’s law, signed by 40 people, including leaders from environmental, business and mental health groups, urged county supervisors to adhere to it. The letter says that assisted outpatient treatment is narrowly focused on some of the more difficult cases. Those eligible for court-ordered treatment must be adults with severe mental health problems and have “little chance of surviving” in the community without supervision. The illness must also have led them to be incarcerated or hospitalized twice in the past 36 months, or to have caused violent behavior or attempts to harm themselves or others.
Santa Clara County’s estimates, while broad, suggest that between 39 and 236 residents would meet Laura’s Law criteria each year, of which 20 to 50 could be subject to judicial warrant.
“AOT (Assisted Outpatient Treatment) would benefit the most vulnerable members of our society: seriously mentally ill people who refuse to receive the care they need,” the letter said. “It is not compassionate, fair, or fiscally responsible to allow the revolving door between emergency rooms, prisons and the streets to continue.”
Some Bay Area counties, including San Francisco and San Mateo, have implemented Laura’s Law in recent years and have found success, with massive reductions in incarceration and hospital admissions psychiatric patients among the participants. Proponents of the program say that stable housing is an important factor in the success of assisted outpatient treatment, and that it should come alongside treatment.
Although county behavioral health staff are seeking to reject assisted outpatient treatment, Simitian said it is increasingly difficult to justify the withdrawal when so many counties are able to implement Laura’s Law with positive results. He said he had struggled with civil liberties and due process concerns in the past, but had since changed his mind.
“I am now convinced that the law is worded restrictively enough, and that it contains enough protections, that these concerns have been alleviated,” said Simitian.
Early estimates show Laura’s law would cost nearly $ 4 million, which would not be paid for by the state and must come from county coffers. Simitian said the costs were justified.