Laura’s Law can help mentally ill, keep peace in San Francisco

On Jan. 10, 2001, Scott Thorpe pulled out a gun and murdered Laura Wilcox at a community mental health clinic in Nevada City. Wilcox was a 19-year-old college student working as a receptionist there. Thorpe was an untreated schizophrenic.

Thorpe’s father and grandfather killed themselves. Thorpe’s own mental deterioration started around 1993; by the time he was ready to kill, he had begun hoarding guns, gas masks and night-vision goggles in case the FBI raided his house. His family members repeatedly begged local mental health officials to institutionalize him, to compel him to take anti-psychotic drugs and undergo therapy. But Nevada County’s mental health system was desperately underfunded. And since the 1960s, a patient’s rights movement has restructured mental health services from top to bottom, giving patients more autonomy and control over their treatment, but often preventing doctors from forcing treatment upon the severely mentally ill.

Nowhere are the consequences of these developments more transparent than in San Francisco, where some 23,000 mentally ill people walk The City’s streets. In the Tenderloin, the image of schizophrenic people sleeping in doorways and babbling to themselves is all too familiar.

After Wilcox was murdered, the state Legislature passed Laura’s Law in 2002, a decidedly controversial measure that would allow counties to force mentally ill  people to undergo a variety of outpatient treatments, from regular therapy sessions and meetings with caseworkers to compulsory anti-psychotic medications.

The patients must be diagnosed as severely mentally ill and have a history of frequent arrests and violent behavior before county health officials can coerce them into treatment. Nonetheless, state and county officials are extremely uncomfortable with the prospect of forcing citizens who have not committed extremely violent offenses to be forcibly medicated. To this day, only Nevada County has agreed to assume the power to coerce the mentally ill into such treatment.

Last year, as The San Francisco Chronicle reported, the Department of Public Health decided to try out a voluntary version of Laura’s Law. Severely mentally ill patients, who have been hospitalized after a long history of arrests, are strongly encouraged to take part in a pilot program of regular therapy, close supervision and social service programs.

So far, only eight of The City’s most distressed residents have been referred to the program. And of these, the results are not exactly conclusive; data on two patients are unavailable, two others refused treatment or had the referral withdrawn, and one patient was incarcerated. So far, the remaining three have not been hospitalized since entering the program.

This isn’t nearly enough to judge the efficacy of San Francisco’s variation of Laura’s Law. But the concept of identifying The City’s most severely mentally ill, and concentrating resources in order to keep them from wandering the streets and cycling in and out of San Francisco’s jails and hospitals, is sound.

When Gavin Newsom was mayor, he strongly urged the Board of Supervisors to implement the full version of Laura’s Law, and Mayor Ed Lee is considering doing the same. Trying out this voluntary version is an important first step toward helping the people in San Francisco who may not be of sound enough mind to help themselves.

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