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STATEMENT

of TAC Executive Director Mary T. Zdanowicz, Esq.

LAURA’S LAW EXTENDED TO 2013
California legislators overwhelmingly support mandating treatment to the sickest – counties have green light to help those with the most severe mental illnesses

Arlington, VA – Via an overwhelming bipartisan majority, California legislators sent a clear message to counties: California should help people with severe mental illnesses who are too sick to help themselves, and counties will be given more time to use a nationally proven program to do just that.

California’s extension of Laura’s Law (AB 2357) through January 2013 ensures that assisted outpatient treatment remains an option. Signed on Friday by Governor Arnold Schwarzenegger, the extension bill had vast legislative support (30-4 in the Senate and 65-5 in the Assembly).

Assisted outpatient treatment (AOT) allows a court to order community-based mental health treatment for someone with a severe mental illness, like schizophrenia or bipolar disorder, who meets a strict set of criteria. Laura’s Law has nine eligibility requirements, including that someone is unlikely to survive safely in the community without supervision and has a history of noncompliance with treatment that has either been a significant factor in 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. The criteria are strict to ensure the law affects only the sickest of the sick – those who most need help but are least able to make informed treatment decisions.

It is a population we all know too well. They are in our jails and prisons at an ever-increasing rate – the Los Angeles County jail is by default the nation’s largest psychiatric hospital. They live on our streets but refuse help, because their diseased brains convince them that outreach workers are aliens or CIA operatives. They are the most difficult to help in part because they do not believe they are ill – a condition that affects approximately 50 percent of individuals with schizophrenia and 40 percent of those with bipolar disorder. This lack of awareness of illness has been shown to be the primary reason for medication refusal.

California is in a crisis, and Laura’s Law is a critical piece of the puzzle – the only real way to help the small group who refuse it otherwise. Yet in the three years since Laura’s Law was originally passed, California’s counties have broadly failed to implement it.

This time around, California’s legislators expressed a clear mandate for counties to perform the intent of this law. Counties should immediately begin work to implement it or be prepared to justify their inaction to the legislature, which has called for stricter reporting requirements.

In places where AOT laws are used, they truly reach those who are in extreme distress caused by lack of treatment. People in the program in New York have experienced dramatic reductions of 74% or more in homelessness, psychiatric hospitalizations, arrests, and incarcerations. Patients enrolled in the program have self reported significant benefits in quality of life: 75% of recipients interviewed said they valued assisted outpatient treatment for helping them regain control over their lives and 81% said that AOT helped them to get and stay well.

California could learn a lesson from New York, not just implementing a strong and important law, but in constantly working to make it more usable. New York is continually assessing ways to improve access to Kendra’s Law, and legislators and providers alike take responsibility for making sure this hardest-to-serve population doesn’t fall through the cracks.

Counties now have a fair chance to establish AOT. There are strong indicators that some are ready to bring this law to their constituents – Nevada County and Sacramento County have expressed interest, Los Angeles County stands ready to expand its AOT pilot program, and San Francisco’s Mayor Gavin Newsom has “ . . . vowed to make [Laura’s Law] implementation a City Hall priority.” The legislature has given him the chance to do so. We applaud all those who are fighting to make court-ordered outpatient treatment a priority.

Assisted outpatient treatment is not a panacea. But it is an important and critical piece of the treatment puzzle, one that Californians can – and should – now begin to use.

CTAC homepage | Guide to implementing Laura's Law

San Francisco Chronicle says "Carry Out Laura's Law" | Laura's parents testify (in PDF)

The Treatment Advocacy Center (www.treatmentadvocacycenter.org) is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illnesses. TAC promotes laws, policies, and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.

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