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Expert says mental health law successful, so far

April 15, 2015 | Patricia Harriman

Orange County became the state’s largest to adopt Laura’s Law in October 2014. The law authorizes court-ordered outpatient treatment for people with severe mental illness.

So far, the program is a “huge success,” according Dr. Jody M. Rawles, a clinical psychiatrist at the UCI Health Department of Psychiatry & Human Behavior. A supporter of the law, Rawles provided expert testimony when the Orange County Board of Supervisors was considering the measure.

The goal: Improve access to mental health services

“Laura’s Law helps mentally ill people who do not recognize they need treatment because they are too ill,” he said.

“This is an aid in deploying mental health resources. Without it, there is no way to engage them into treatment. You have to wait until something bad happens, which means they wind up being hospitalized or jailed. The goal is to improve access to mental health services and avoid relapse, repeated hospitalizations, arrests, incarceration and violent behavior.” 

The program is formally known as Assisted Outpatient Treatment, and enables an immediate family member or adult residing with the individual, a medical professional, or a law enforcement officer to ask a judge to direct that person to receive outpatient mental health treatment.

Qualifying for the program

To qualify, an individual must have a serious mental illness that has resulted in a psychiatric hospitalization or incarceration twice in the previous three years or violent behavior toward themselves or another person. 

While a judge can order outpatient treatment, a person cannot be compelled to take medication. There are no civil or criminal penalties incurred for refusing to participate. The law’s power lies in the “black robe” effect of the judge being strong enough to convince the mentally ill person to accept treatment. 

No force is used

Critics contend that it forces people into treatment and taking medication.

Rawles strongly disagrees. 

“Laura’s Law does not force mentally ill people into treatment, nor does it coerce them into taking medication,” he said.

“If that’s what you think, you are missing a huge part of the program. It helps people at risk who are ambivalent about getting treatment to go ahead and do it.” 

Statistics show success so far

In the first four months, according to county statistics, there were:

  • 500 inquiries made to the Orange County Health Care Agency’s Behavioral Health Services, of which 310 were information-only calls
  • 169 treatment referrals with face-to-face follow-ups
  • 144 resolutions without going to court - 18 referred to substance abuse and other community programs, with 19 already enrolled in mental health programs.
  • 34 people voluntarily entered treatment
  • 24 outstanding cases – the Assisted Outpatient Treatment Team is conducting outreach activities designed to engage the referred candidates into the appropriate voluntary treatment programs

“These statistics show a great success,” Rawles said. “The information-only calls are important, because we don’t know the number of people who went ahead and got treatment on their own. The 144 cases resolved without going to court saved the expense of legal fees. As for the 24 outstanding cases, just because you’ve not taken the final step – going to court - doesn’t mean the law isn’t effective. Compare it to a speed trap. Just because you don’t write any tickets doesn’t mean that people aren’t driving slower. It’s a deterrent that is successfully modifying behavior.”

Laura’s Law is named for Laura Wilcox, a 19-year-old volunteer who was one of three people shot and killed by a mentally ill person who had refused treatment at a behavioral health clinic in Nevada County, Calif. in 2001.

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