Laura’s Law

Laura’s Law: point...

Kelly Davis’ Oct. 19 article about Laura’s Law, “‘The black-robe effect,’” overlooks the effectiveness of voluntary alternatives to forced treatment. In addition, key voices were missing from the article—that of persons labeled mentally ill. These are the people who are most likely to be detained by police and hospitalized against their will under Laura’s Law and who are overwhelmingly opposed to implementation.

Laura’s Law deprives persons who have a history of hospitalizations or suicide attempts but who are not presently a danger to themselves or others of their fundamental right to make medical decisions. But there’s no need for such extreme measures when voluntary services have a proven track record and the so-called “black-robe effect” remains unsubstantiated.

For example, a three-year controlled study in New York City, comparing the efficacy of enhanced community mental health services with and without court ordered treatment, found no difference in outcomes. Likewise, in California, fully voluntary programs such that offer “whatever it takes” 24-7 services have been highly successful—decreasing hospitalization by 56 percent, jail time by 72 percent and homelessness by 67 percent.

Moreover, research shows that forced treatment is ultimately counterproductive—renewing trauma, undermining trust, and steering people away from the mental-health system altogether.

Thus, San Diego County’s decision to reject forced treatment and instead fund an intensive program of voluntary services for those diagnosed with serious mental illness is commendable.

Scarce public dollars are better spent expanding voluntary-treatment programs that provide the surest path to recovery.

Ann Menasche, Disability Rights California

... and counterpoint

Thanks for your story on Laura’s Law [“‘The black-robe effect,’” Oct. 19]. In home outpatient treatment is no subsitute for Laura’s Law. It’s only for those who voluntarily accept services. Laura’s Law is for those who don’t. Mental-health authorities always oppose implementing assisted-outpatient treatment because it allows courts to compel them to treat seriously ill people. That’s what is key. The mental-health system loses some ability to cherry pick the easiest to treat for admission and send the others to the streets, jails or the morgue.

Parents should not be forced to watch their mentally ill children deteriorate. Laws should not require their children to become a “danger to self or others.” Laws should prevent it. Families of people with serious mental illness have been begging California counties to implement Laura’s Law as a way to help get care to their mentally ill loved ones.

Laura’s Law works: A major independent study published in the May 2011 issue of Psychiatric Services found the odds of arrest for a violent offense were 8.61 times greater before participants entered New York’s version of Laura’s Law than after. Versions of Laura’s Law implemented in other states show it helps the seriously mentally ill by reducing homelessness (74 percent), suicide attempts (55 percent) and substance abuse (48 percent).

It also keeps the public safer by reducing physical harm to others (47 percent) and property destruction (43 percent). And it saves money by reducing hospitalization (77 percent), arrests (83 percent) and incarceration (87 percent). Nevada County, which reluctantly implemented a law to settle a lawsuit, believes it saved that county $500,000 annually In California, money is not the issue.

Mental Health Services Act money is intended to fund services for the most severely ill. But California mental-health authorities are wasting it on the worried-well and failing to do what voters wanted: provide treatment to the truly needy.

DJ Jaffe, Mental Illness Policy Org