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Laura’s Law Takes Effect in San Francisco
In 2003, California passed a law that allowed California counties to enact forced treatment programs for the severely mentally ill. The law is known as Laura’s Law, after 19-year-old Laura Wilcox, who was shot in Nevada County by a mental health patient who had stopped complying with treatment.
In the first 10 years since the law was passed, only one county—Nevada County—put coercive treatment programs into effect. However, 2014 has seen several other counties begin to adopt the programs, including Yolo County in January and Orange County in May. On July 9, the San Francisco County Board of Supervisors voted to make their county the latest in California to enact these programs.
When Forced Treatment May Be Employed
Under the outlines of Laura’s Law, certain criteria have to be met before people with mental illnesses may be ordered to receive treatment. First, individuals suffering from mental illness must have been hospitalized or jailed for reasons connected with their mental illness two times in the space of three years. The only other scenario in which treatment may be ordered is if people have harmed themselves or others, or seriously threatened to harm themselves or others in the last four years.
Patients in these situations must first be offered voluntary treatment. If they refuse, and their condition is considered to be deteriorating, a court order may be issued requiring them to follow a course of outpatient treatment. In the event that people pose an immediate danger to themselves or others, law enforcement can be called in to help transport them to a hospital.
San Francisco’s Laura’s Law program will require the county health supervisor to designate a “care team” for each patient that includes a forensic psychiatrist, a family member and another individual with mental illness.
Family Members and Law Enforcement Support Law
Several groups in San Francisco County strongly advocated for the adoption of Laura’s Law, including family members of people with mental illness. These people often face the responsibility of caring for ill family members but many feel that they are put in an impossible position when the sick individual refuses to stay in counseling, take medication or otherwise remain compliant with treatment.
Law enforcement and emergency services, including firefighters, also expressed strong support for a Laura’s Law program. Spokespersons for these groups report seeing the same people in an out of prison and in and out of hospitals because they continually resist receiving treatment. They believe that these programs can help to reduce the number of mentally ill people who put themselves and others at risk and and/or end up incarcerated, often worsening their mental health condition.
Many Patients Say Programs Are Ineffective
In contrast, many people who are suffering from mental illness have opposed Laura’s Law programs. They contend that forcing people into treatment causes them additional mental trauma rather than helping them to become healthy and stable. Furthermore, they say than forced treatment ultimately drives people with mental illness away from treatment and discourages them from continuing treatment or going back into treatment once the coercive program is over.
The Mental Health Association of San Francisco has been the leading voice for patient advocacy and opposition to forced treatment. In addition to being ineffective, those who oppose Laura’s Law say that people have the right to choose what happens to their own bodies and what medications go into them.
Nevada County Believes in Program’s Success
As the only county with a long-standing Laura’s Law program, Nevada County is currently the only source of information about the effectiveness of these programs. Overall, Nevada County believes its program has been a success for both patients and the larger community. Hospitalizations in the county have gone down by 64 percent since 2008, homelessness has gone down by 33 percent and incarceration has gone down by 27 percent.
Reporting the Board of Supervisor’s decision, San Francisco County Supervisor Mark Farrell said that academic and government studies have consistently shown that programs for court-ordered treatment reduce hospitalizations and incarceration among people with mental illnesses.