San Mateo County ready to move forward with Laura’s Law

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The San Mateo County Board of Supervisors has voted unanimously to enact Laura’s Law, enabling courts to mandate outpatient treatment for individuals who may be a danger to themselves or others.

Laura’s Law was passed in California in 2002, but is only implemented in those counties that choose to ratify it. The law is named for Laura Wilcox, an employee of a Nevada County mental health clinic who, along with a co-worker, was shot to death by a client suffering from psychiatric problems.

Stephen Kaplan, director of Behavioral Health and Recovery Services for the San Mateo County Health System, said his organization recommended adopting Laura’s Law after studying its successful implementation in Orange County. Kaplan noted that Nevada County was the first to ratify Laura’s Law, and the counties of San Francisco, Los Angeles and Contra Costa are also rolling out new services under the law.

Laura’s Law enables courts to order treatment for adults who suffer from serious mental illness, are unable to live without supervision and meet at least one other criteria, which can include deteriorating health, violent behavior, previous hospitalization due to mental illness or refusing voluntary treatment.

Some activists fought Laura’s Law when it was introduced, citing concerns about civil liberties and potentially harmful therapies. But while the law allows judges to order treatment, it provides no enforcement mechanism, meaning individuals who refuse court-ordered treatment face few legal consequences.

Kaplan said most potential clients are likely to accept voluntary treatment before a court action becomes necessary. This is partly because staff who communicate well with clients and their families are often able to earn their trust and cooperation, Kaplan noted.

And based on Orange County’s experiences and his own organization’s observations, Kaplan said even though Laura’s Law contains no enforcement provision, some people will agree to voluntary treatment just to avoid going to court.

Annette Mugrditchian, director of adult behavioral health for Orange County’s Health Care Agency, agreed that even without enforcement the mere involvement of a judge often compels people to accept and comply with the treatment they’re offered.

“It’s the black robe effect,” Mugrditchian noted.

While Kaplan said it might take about six months to ramp up the expanded services in San Mateo County, Orange County ratified the law in March 2014 and its program began in October 2014.

Of the 322 referrals her organization has received, Mugrditchian said 73 individuals accepted voluntary mental health services and only six cases led to court settlements.

Kaplan noted that such court cases are not criminal matters. Nonetheless, individuals going through the court process are assigned public defenders who make sure their clients are aware of their rights, Mugrditchian said.

It’s too soon to tell how successful Orange County’s efforts have been, Mugrditchian said, but she noted that the program has been well-received by those it serves.

“We’ve had nothing but support from our clients and their families,” Mugrditchian said.
Although Laura’s Law was named for the victim of a homicide committed by a person with mental illness, Kaplan agreed that the mentally ill are “far more likely” to be victims of violent crimes rather than perpetrators.

Mental health professionals sometimes uncover stories of domestic violence and other forms of abuse while working with their clients, Kaplan said, and such traumas can exacerbate mental illness.

“The hidden part of the story is the victimization of the mentally ill,” Kaplan said, “We know that trauma experiences are very common for this population.”

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