Laura's Law

Laura's Law, (Assembly Bill 1421, Helen Thomson, Davis), which became effective on January 1, 2003, is a California state statute that allows for court-ordered outpatient commitment of mental health clients who refuse voluntary treatment with psychotropic medications. The law was named after Laura Wilcox, a young woman who was murdered by a mental patient who had refused treatment. It was modeled on Kendra's Law, a similar statute enacted in New York. The measure was passed by the California legislature in 2002, and signed into law by then Governor Gray Davis. The statute can only be enforced in counties that choose to enact outpatient commitment programs based on the measure. As of 2004, only one county had chosen to do so, on a limited basis.

Background

Laura Wilcox, a 19-year old sophomore from Haverford College, was working at Nevada County's public mental health clinic during her winter break from college. On January 10, 2001, she and two other people were shot to death by Scott Harlan Thorpe, a mental patient who resisted his family's attempt to seek treatment. [ [http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2006/03/21/EDGU9GJFMH1.DTL Carry out 'Laura's Law'] , editorial, "San Francisco Chronicle", March 21, 2006.] [ [http://yubanet.com/in_memoriam.shtml In memoriam: Laura Wilcox] , YubaNet.com]

Implementation at county discretion

Because the legislation authorizing Laura's Law did not include state funds for implementation, the decision is entirely up to counties whether or not to implement the bill. Laura's Law allows California counties to decide whether to opt into implementing a community-based, court-monitored outpatient treatment program. A major obstacle, for counties that implement the law is that County Board of Supervisors must make a finding that implementation does not reduce voluntary services. [ [http://lang.sbsun.com/projects/lostamongus/displayarticle.asp?part=6&article=art06_AB1421 Lost Among Us - Part 6 ] ]

By 2004, only Los Angeles County had implemented Laura's Law, on a limited basis. [http://www.psychlaws.org/GeneralResources/article196.htm] Other counties generally cited budgetary concerns for delayed implementation, although the California Network of Mental Health Clients (CNMHC) has suggested that there may be additional obstacles in the bill that make it difficult for counties to implement. [ [http://www.californiaclients.org/main/current%20news/snapshot_of_cnmhc_public_policy_activities2.htm] Dead link|date=March 2008] Since the passage of the MHSA [see below Prop. 63] Nevada County has made plans to implement Laura's Law and several other counties are discussing it.

In those counties that adopt outpatient commitment, an AB 1421 program will ensure medications are administered to certain patients, only those determined to be severely disabled, who have been referred by family members, law enforcement, or other agency, and provided with community treatment, housing, and medication monitoring.

Proposition 63 impact

In November 2004, California voters passed Proposition 63, the Mental Health Services Act (MHSA), to rectify what is generally considered to be a glaring lack of mental health services. The situation is usually traced back to the late 1960s and then-Governor Ronald Reagan's decision to curtail inpatient treatment by closing state-run psychiatric hospitals. Reagan slashed 1,700 hospital staff positions and several state-operated aftercare facilities. [http://www.sfbg.com/News/35/13/13ill.html] Proposition 63 levies a 1% tax on individuals earning more than $1 million per year, and is projected to raise $750 million in the 2005-2006 fiscal year. This new funding is expected by some to result in widespread county implementation of Laura's Law.

Prior to the passage of Proposition 63, and during the statewide stakeholder input process that followed, voters were told that funds from the MHSA would only be used for community-based services. When the California Department of Mental Health (DMH) released its draft plan requirements for county mental health administrators on February 15, 2005, they contained a provision that would allow MHSA funds to be used for 'involuntary services' if certain criteria were met. Opponents throughout the state have spoken out against these provisions at the stakeholder meetings whereas supporters of Laura's Law spoke out in support.

Outpatient commitment eligibility criteria

A person may be placed in an assisted outpatient treatment if, after a hearing, a court finds that the following criteria have been met. The patient must:
* Be eighteen years of age or older
* Be suffering from a mental illness
* Be unlikely to survive safely in the community without supervision, based on a clinical determination
* Have a history of non-compliance with treatment that has either: :# Been a significant factor in his or her being in a hospital, prison or jail at least twice within the last thirty-six months; or :# Resulted in one or more acts, attempts or threats of serious violent behavior toward self or others within the last forty-eight months
* Have been offered an opportunity to voluntarily participate in a treatment plan by the local mental health department but continue to fail to engage in treatment
* Be substantially deteriorating
* Be, in view of his or her treatment history and current behavior, in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would likely result in the person meeting California’s inpatient commitment standard, which is being::# A serious risk of harm to himself or herself or others; or :# Gravely disabled (in immediate physical danger because unable to meet basic needs for food, clothing, or shelter);
* Be likely to benefit from assisted outpatient treatment; and
* Participation in the assisted outpatient program is the least restrictive placement necessary to ensure the person's recovery and stability.

Debate over bill's efficacy and propriety

upporters

Passage of the bill was supported by organizations such as the California Treatment Advocacy Coalition (an affiliate of the Treatment Advocacy Center), the California Psychiatric Association, the Police Chiefs Association, and the National Alliance on Mental Illness (NAMI). In an editorial endorsement of the law, the "Los Angeles Times" touted then Governor Gray Davis's support, while limiting its comments on opponents to mentioning that "a subgroup of the Church of Scientology, which opposes virtually all psychiatric treatments, sponsored a rally at the Capitol against Laura's law." [ [http://www.psychlaws.org/GeneralResources/article100.htm Helping people off the streets: Governor, sign Laura's Law] , "The Los Angeles Times", September 28, 2002]

Opposition

MindFreedom International and the California Network of Mental Health Clients (CNMHC), along with allies in the psychiatric survivors movement, also fought the measure and its earlier versions, accusing such legislation as a regressive and reprehensible scheme to enforce coerced drug treatment regimens against the will of patients. The Church of Scientology also gained attention as an opponent of the new law. [ [http://www.freedominla.org/issue08i1/page12.htm] [http://www.psychlaws.org/GeneralResources/article100.htm] ]

ee also

* 5150 (Involuntary psychiatric hold), California's law for psychiatric emergencies
* involuntary commitment, which is hospital-based
* Involuntary treatment, which is independent of setting
* anti-psychiatry, a movement that opposes any form of involuntary psychiatric treatment

References

External links

Opponent views
* [http://www.mindfreedom.org/mindfreedom/calnet.shtml MindFreedom.org] - 'Bill for More Forced Psychiatry Passed by California Legislature, Goes to Governor', California Network of Mental Health Clients (September 3, 2002)

Proponent views
* [http://www.psychlaws.org/StateActivity/California/Guide-Lauras-Law-AB1421.htm Psychlaws.org] - 'A Guide to Laura’s Law: California's New Law for Assisted Outpatient Treatment', The California Treatment Advocacy Coalition and the Treatment Advocacy Center (January, 2003)
* [http://www.psychlaws.org/PressRoom/stmtCA_passes_AB1421_Lauras_Law.htm PsychLaws.org] - 'Landmark Legislation, Laura's Law, Brings Much-Needed Reform to California: AB 1421 will help those with severe mental illnesses who are too sick to help themselves' (opinion), Mary T. Zdanowicz, Treatment Advocacy Center (September 30 2002)
* [http://www.psychlaws.org/PressRoom/stmtCA_passes_AB1421_Lauras_Law.htm PsychLaws.org] - 'Gov. Davis Signs Laura's Law: AB 1421 will help those with severe mental illnesses who are too sick to help themselves' (November 22 2002)