Marin debuts two-year Laura's Law pilot after years of resistance
Marin Independent Journal - 9/20/2018
Sept. 19--The Board of Supervisors this week received an update on Laura's Law, the newly implemented two-year pilot program that gives judges the authority to compel severely mentally ill people to seek treatment.
Jei Africa, the county's director of Behavioral Health, reported to the board on the program's rollout, which has had one referral since its launch Sept. 4.
"I really want to thank you for finally putting this program together after 11 long years," said Barbara Alexander of San Rafael, past president of Marin's chapter of the National Alliance of Mental Illness.
For more than a decade, Alexander and many Marin parents with mentally ill children implored the Marin County Board of Supervisors to implement the law.
Signed into law by Gov. Gray Davis in 2002, Assembly Bill 1421, also known as Laura's Law, gives local judges the authority to order severely mentally ill individuals to undergo outpatient treatment. The law was named after Laura Wilcox, a 19-year-old college sophomore who was killed in 2001 by a man who refused to accept psychiatric treatment.
Laura's Law targets those who are too ill to recognize they need treatment. While outpatient treatment can be ordered, medication cannot.
As recently as February 2016, Grant Colfax, director of the Department of Health and Human Services, remained opposed to implementation of the law, saying there was insufficient evidence to prove that programs such as Laura's Law are more effective than non-compulsory treatment approaches in use.
At Colfax's recommendation, supervisors opted instead to put more resources into mental health outreach teams. At the time, only Supervisor Damon Connolly supported implementation.
After that, Alexander and other Laura's Law advocates stepped up their lobbying efforts. They collected 11,000 signatures on a petition calling on supervisors to adopt the law and succeeded in making it an issue in the race for District 4 supervisor. Dennis Rodoni, who supported use of Laura's Law, won that race in November 2017, and Supervisor Judy Arnold, who faced her own race for re-election in June 2018, announced she had changed her position on the issue in January 2018, giving proponents the 3-2 majority they needed.
Alexander said that while she is grateful the county is rolling out a program, she is doubtful about the Department of Health and Human Services' enthusiasm.
In his report to supervisors Tuesday, Africa put the emphasis on how the county could minimize the number of court petitions necessary through use of "assertive engagement" with the mentally ill. Africa said he had consulted with providers of mental health services in San Mateo and San Francisco, which adopted Laura's Law before Marin, and that was the key takeaway.
"We know that assertive engagement can decrease the number of court petitions," Africa told supervisors. "This really is the goal, to get people to voluntarily seek treatment."
After the meeting, Africa explained that under the assertive engagement he was talking about health practitioners would spend much longer, perhaps months, trying to convince mental health sufferers to accept treatment before proceeding with the court process.
Alexander said, "That is definitely a concern of ours. That so much time gets spent on engagement that the person never gets brought into court. There needs to be some policy on how many times you engage with someone before you try the court piece."
Even though the pilot program launched more than two weeks ago, there is no information about it available on the county's website. Africa said so far the county has received one referral.
Referrals may be made by family members over 18, an adult living with a severely mentally ill person, or a mental health caregiver. The phone number to call is 415-473-4321.
Africa told supervisors Tuesday he expects the number of referrals to vastly exceed the number of people who will qualify for the program under the law.
To be eligible, a person must be 18 or older, have serious and persistent mental illness, be unlikely to survive in the community without supervision, and have a history of refusing treatment.
In addition, the person's illness must have resulted in psychiatric hospitalization or incarceration two or more times within the past 36 months or have made threats or committed acts of serious and violent behavior towards themselves or others within the past 48 months.
Africa said the county initially estimated that only five Marin residents would need to go through the entire court process set out by Laura's Law over the two-year trial period, but now he said that number has been revised to 10 to 15.
Supervisor Katie Rice said the county is better prepared to make use of Laura's Law now than it was back in 2016 when she voted along with the board majority who opposed its adoption.
Rice said the county has built up its mental health services so that the people who fail to qualify under Laura's Law will be able to get more help regardless.
(c)2018 The Marin Independent Journal (Novato, Calif.)
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