Why doesn't Oregon have Laura's Law?

A blogger in Oregon recently posed the question – why doesn’t Oregon have Laura’s Law?

I wonder why we don't have something like Laura's Law (see previous entry) in Oregon. Is it because we don't have the resources? When you think of all the damage that happens without Laura's Law, doesn't it make sense that we find the resources? In the end, I believe it would be cost-effective, since it could keep people out of the hospital and/or jail and could help them to function better through counseling and meds. Doesn't this seem like a humane way to deal with people who are deteriorating, by keeping them from getting worse? Families would have some sort of recourse when their loved one starts going out of control. It just seems a shame we aren't looking at this law as being one of our solutions.

Laura’s Law or assisted outpatient treatment (AOT) is an effective and humane way of helping people with severe mental illnesses who need treatment.

Oregon does have AOT, but it’s rarely used, and a person must be a danger to themselves or others before it’s ordered.

The question posed by the blogger is an excellent one for Oregon legislators – Why does Oregon make it so difficult for its citizens with severe mental illnesses to get outpatient treatment?

Using Laura's Law in California

Too many times we are reminded that having laws on the books providing for Assisted Outpatient Treatment (AOT) does not necessarily translate into the actual use of the treatment mechanism.

In California, Laura’s Law was passed in 2002, offering every county the opportunity to adopt an AOT program. In Los Angeles, a small pilot program was implemented soon after the law was enacted and has been helping a few dozens of people with severe mental illnesses each year. California’s first county-wide program will soon start in Nevada County. However, so far, Laura’s Law has not yet been implemented anywhere else in the state.

This is largely because the initial bill was saddled with limitations by opponents during the legislative process. Laura’s Law now provides that it is up to each county to decide whether or not to implement the law and to establish a program for it. Among other cumbersome restrictions, the law also requires a finding at the county level that no voluntary mental health program will be reduced as a result of adopting an AOT program, that AOT can only be used in conjunction with an extremely costly and often unnecessary outpatient service program and that counties must have very high thresholds of general services, most of which are unrelated to the use of AOT.

Thankfully, Senator Leland Yee from San Francisco has recently introduced SB 1606 that aims to remove many of the limitations included in the initial law. If passed, this law will make the treatment tool available in all counties throughout California.

California needs Laura's Law

Columnist, C.W. Nevius wrote about treating severe mental illnesses and outpatient committment in a recent column in the San Francisco Chronicle.

While the issue of the beds at S.F. General is important, there is a much larger issue. Across the country, and particularly in California, we need to take an honest look at the consequences of letting mentally ill people decide whether they want to accept treatment. Remember, in these cases their own parents are begging to have them confined to a safe, secure facility where they will have to take their medication and hopefully begin to find themselves. Leaving the choice up to them, as a consequence of patient rights movement, is a recipe for failure.

As Nevius explains, the current system isn't working:

Officer Martin, who walks a beat in downtown San Francisco, estimates that "six to seven out of 10 of our contacts have mental health issues." The police have limited recourse, even in the most extreme cases. One thing they can do is file a 5150 under the California welfare and institution penal code, which is a "72-hour psychiatric hold." But Martin says even that confinement is often "a pipe dream."

"There's been times when I've 5150'd somebody," he says, "and they'd be walking out when I was getting back into my patrol car."

And yet, most counties in California still haven't implemented Laura's Law. What are we waiting for?

Interested in getting Laura's Law implemented in your county? Visit the California Treatment Advocacy Coalition (CTAC) website for resources on implementation.

Severe mental illness: a mother's perspective

On today’s San Francisco Chronicle blog two mothers each tell heart-breaking stories of their grown sons’ struggles with severe mental illnesses. As the Chronicle writes in the introduction to the video clips:

California is a state that has a strong belief in patient rights. It sounds like a good and reasonable theory until you talk to the mothers of severely mentally ill children.

A sad weekend in California

Families and police officers are two of the groups most at risk for being on the receiving end of violence by those with untreated mental illnesses

In Salinas, John Vierra, a 44-year-old man with schizophrenia fatally stabbed his mother, Maria James. Vierra had stopped taking his medication last spring.

In San Diego, Alan Kosakoff is in critical condition after he was shot by two police officers. Kosakoff, who has been diagnosed with schizoaffective disorder, attempted to run over the two officers when they tried to arrest him for driving 114 mph. Kasakoff had not been taking his psychiatric medication.

Today, one California man faces time in prison; the other, if he survives, will also likely face the criminal justice system. Both men were not taking their prescribed medications for severe mental illnesses.

Yet most California counties still haven’t implemented Laura’s Law – a way to get court-ordered outpatient treatment for people with severe mental illnesses. Access to treatment, and to programs such as Assistant Outpatient Treatment, maintain treatment compliance, an important step in helping prevent such tragedies from occurring in the future

Perhaps it’s time to help people in California with severe mental illnesses get treatment, because without it, there are certain to be more sad weekends.

Bloody Monday in CA

Not a good week in California if you need treatment but instead encounter police.

In Santa Rosa, officers responded to a 911 call from a woman who claimed her husband was firing shots into the ceiling of their home because he believed there was an intruder in the attic. The woman also told authorities her husband was bipolar and needed his medication. Officers opened fire on Richard DeSantis, who was killed in his driveway. His wife and 2 young children were home at the time.

In Van Nuys that same evening, John Eric Goudeaux ignored orders by police to drop his weapon, a 3-foot-metal bar, when they responded to a call that Goudeaux was holding his ex-wife hostage.

Goudeaux’ mother asked: "Why didn't they shoot him in the leg and take him to a mental hospital?" That is the same question posed by the family of Jason Paul Yule, killed by police in Sacramento the previous Saturday.

What could police do differently? We ask again … what could the mental health community have done differently? Why are people who are so ill allowed to keep deteriorating until the only action their family can take is to call 911?

If you live in one of these counties, consider putting pressure on your county supervisors to actually implement Laura’s Law – designed to get people help before they deteriorate.

The Shock, Grief, Panic and Guilt from the Other Side of a Tragedy

Severe mental illnesses can agonize in so many ways. The most direct manner is the impact on those who have them, but the scope can range far wider – to the families, others, and numerous critical components of our society.

Among the most heart-wrenching of anguish is that of families whose loved ones fall victim to the acute psychiatric disorder of another. We have painfully watched as families, such as those of Kendra Webdale, Laura Wilcox, and Gregory Katsnelson, bravely withstand the devastation of needless and unexpected loss. We have also been awed as members of these families have nobly turned their grief, not into revenge, but to bringing treatment to people incapacitated by illnesses like the one that ripped away their child, sibling or parent.

There is a flip side of these tragedies that rarely gets attention – the grievous turmoil of the families of the person who caused the harm, and did so only because of the symptoms of an illness that were neither asked for nor susceptible to self-control.

Imagine the turbulent mixture of shock, grief, panic and guilt experienced by the parents of Anthony Capozzi when their son, who has schizophrenia, was charged with two rapes in 1985 and later convicted of them. Was it the illness? Could his parents have prevented his actions? Something else? According to Albert Copozzi, Anthony’s father, "It is with you every moment …We don't go to bed at night without thinking about our son."

To put a twist on the Capozzis' distress that is hopeful yet also utterly confounding, imagine that – after 23 years of weekly eight-hour roundtrips to visit him in prison – Anthony Capozzi might not have done anything after all.

Laura's Law extended - now lets get it implemented

California's Laura's Law was extended to 2013 with a stroke of the Governor's pen on Friday. The bill (AB 2357) was overwhelmingly supported by California legislators (30-4 in the Senate and 65-5 in the Assembly).

California legislators sent a clear message about the county-determined program: California counties must help people with severe mental illnesses who are too sick to help themselves, and counties will be given more time to use a nationally proven program to do just that.

Nick and Amanda Wilcox - Laura's parents - are to be commended for their advocacy, as are the determined advocates at California Psychiatric Association, NAMI California, the California Medical Association, and a variety of supporters, from police chiefs to judges to editorial boards from the Los Angeles Times to the San Francisco Chronicle.

The California Treatment Advocacy Coalition and The Treatment Advocacy Center together produced "A Guide to Laura's Law" to help counties with implementation. We hope now that there is more time, people will get moving to bring this important treatment tool to those who need it most.

* * *

MORE: Statement by TAC Executive Director Mary Zdanowicz: LAURA’S LAW EXTENDED TO 2013: California legislators overwhelmingly support mandating treatment to the sickest – counties have green light to help those with the most severe mental illnesses

California bill passes with overwhelming majority

An extension of California's Laura's Law has now passed the full Senate 30-4, after passing the Assembly 65-5 earlier this summer. Follow the action via the California Treatment Advocacy Coalition's website at www.lauraslaw.net.

CA especially bad for homeless people

What will it take for California to start implementing Laura’s Law?

Homeless man suspected in fatal torching

"He has been diagnosed as paranoid schizophrenic,'' he said. "He refused to take his medication. He went off the wall. That was two years ago.'' He said his son had been arrested for bizarre behavior before but had never been charged with a crime. "I have no idea where he goes, what he's up to,'' the elder Kinney said. He said he had tried to have his son institutionalized but had failed to persuade a court to have him committed. – San Francisco Chronicle, Nov. 2

Who failed Lashaun Harris?

More news on the sad case of Lashaun Harris, the mother in California who threw her three young children to their death from the pier. [Photo is from the Harris family via AP, from happier days.]

- She had a history of schizophrenia and multiple hospitalizations
- She had been hearing voices – that told her to throw her kids in the bay
- She had been off her medication for 4-5 months ("She's been going crazy for a while," her half sister told reporters.)
- On Wednesday, she told her family that “she was going to feed the kids to the sharks.”

People need to start asking why California isn't implementing and using Laura's Law - there is no excuse not to use a law that is saving lives in places like New York,where 74% fewer participants experienced homelessness, 77% fewer experienced psychiatric hospitalization, 55% fewer recipients engaged in suicide attempts or physical harm to self and 47% fewer physically harmed others.

Arguments against implementation ring pretty hollow when you see how many people are being helped in New York (people who, incidentally, are already costing the state quitea bit through emergency rooms and repeated hospitalizations) - and how many people are suffering in California.