State Program Unused Locally for Mentally Ill

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A state law that could treat severely mentally ill patients before they turn violent is not being used in San Diego County.

Right now in San Diego, if a mentally ill person over the age of 18 refuses treatment there is virtually nothing family members or doctors can do to help.

A California state law called “Laura's Law” empowers the courts to require treatment for the severely mentally ill.

Laura's Law was passed statewide in 2002, but only one county in California enforces it, and it's not San Diego.

"We would treat someone with a stroke and couldn't talk as appropriately medically, if someone has schizophrenia and can't think clearly, then I also think it's on us to treat them appropriately,” said Dr. Brian Miller, the clinical director and chief psychiatrist at Grossmont Hospital. “There will be a team of people who are going to follow up with you, assist you in getting an appointment, getting medications, getting the treatment and making sure you know what's available."

The San Diego Psychiatric Society and the Mental Health Board said it’s wrong San Diego doesn’t utilize it.

"In 44 states, Laura's Law has been held up in every court of the land,” said Theresa Bish, former Chairperson, Health Services Advisory Board. ”Including the highest court. Furthermore our Attorney General says Laura's Law reduces crime.”

But not all agree with Bish and Miller.

Alfredo Aguirre is the Behavioral Health Director for the County and said Laura's Law is flawed and expensive.

“It offers a cookie cutter approach to the recommended treatment which we already offer anyway from a voluntary perspective, so it doesn't provide flexibility; it also sets up the county to basically fund all these referrals that require a very expensive level of care,” he said.

Instead of Laura's Law, the county set up a three-year pilot program called In Home Outreach Teams, or IHOT.

Critics say IHOT is a good program, but not a substitute for Laura's Law because outreach teams are not allowed to treat the mentally ill who refuse it.

"It's a real policy question, does the county have the responsibility,” said Aguirre. “It's really big government if you think about it that way... to be responsible for all the population that doesn't seem to connect with the private practitioner.”

There is available money from the state to help pay for Laura's Law that comes from the Mental Health Services Act, which raises hundreds of millions of dollars a year through a special tax on millionaires.

"I think we’ve hit our pain threshold where family members are saying with all due respect to our Board of Supervisors, we can no longer take it on good faith that Laura's Law is not appropriate for our county. We must see substantiated proof,” said Bish.

New County Supervisor Dave Roberts says he wants to see the data too. He's working with Supervisor Dianne Jacob to review Laura's Law and the county's alternative IHOT program, at the March 19th board meeting.

"We're really excited to bring it to our colleagues and get the county to look at what we're doing versus what we could be doing - are there improvements that we can make,” said County Supervisor Dave Roberts.

Nevada County is the only county in California to implement Laura's Law. During a 2.5 year period, they had a 46 percent reduction in psychiatric hospital days, a 65 percent reduction rate in incarceration days, a 61-percent reduction rate in homeless days and a 44 percent reduction in emergency interventions.

The net savings for the county was just more than $500,000.

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