Carla Jacobs

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January 3, 2012
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Extend Laura's Law in 2012

Jan. 10, 2001, Nevada County and California reeled in horror as a mentally ill and delusional Scott Thorpe started his rampage at the county's behavioral health clinic in Nevada City, first killing Laura Wilcox and Perlie Mae Feldman before moving on to Lyon's Restaurant in Grass Valley to murder Michael Markle. Three others were injured or shot before Scott went home to take a nap.

Scott's crime did not come without warning. His mental illness was long spiraling out of control. In June, 2000, the Nevada County Department of Behavioral Health evaluated him to determine if he met criteria under California's Lanterman, Petris, Short Act (LPS Act) for involuntary hospitalization. They determined he was not an imminent danger.

By December 2000, Scott's family was desperate. He hated his psychiatrist, believed the FBI was spying on him and that the manager of Lyon's Restaurant poisoned his coffee. He had turned his home into an arsenal. His brother, Mark, a Sacramento Deputy Sheriff, called Scott's psychiatrist, Dr. George Heitzman, who was the then medical director for the county's behavioral health agency. But, Dr. Heitzman never called back.

Nevada County's mental health system was a tragedy waiting to happen.

Warnings by family members, treatment providers and law enforcement officers no longer go unheeded in Nevada County. In 2002, largely due to advocacy by Laura Wilcox's parents and Nevada County community members, California passed an amendment to the LPS Act.

The amendment allows a county to institute a program known as Assisted Outpatient Treatment (AOT). That treatment combines intensive and mobile community treatment with a court order so severely mentally ill people are quickly reached when their condition is seriously deteriorating, but before they meet the standards for immediate inpatient hospitalization. Waiting for danger is too late. In California, it's known as Laura's Law.

Laura's Law did not pass lightly. Then Senate President Pro Temp John Burton (D-San Francisco) fiercely opposed it as an infringement of a person's autonomy. Some said it would stigmatize mentally ill people by bearing the name of a murdered girl. Money always becomes an issue. A group from the Church of Scientology, which opposes virtually all psychiatric treatment, rallied against it on the Capitol steps.

Upon its passage, the San Francisco Chronicle declared, "Carefully crafted, {Laura's Law} ... strikes a delicate balance between an individual's right to complete freedom and society's responsibility to protect its members from violence or death."

In 2008, Nevada County became the first - and so far only county - in California to fully integrate Assisted Outpatient Treatment into its mental health system. It's now a model throughout the United States as to a component of what a good mental health system should deliver. Other counties are considering implementing Laura's Law and supporters hope they will soon follow Nevada County's lead.

Laura's Law recipients are people with severe mental illness, such as schizophrenia and bipolar disorder. Generally, they have refused or been unable to accept or consistently engage in community mental health treatment because they are just too sick to know they have an illness from which they can recover. Delusional, paranoid, sometimes hostile, without Assisted Outpatient Treatment, they threaten harm to themselves or others or revolve through psychiatric hospitalizations and jails.

Laura's Law is a combination of accountability, services and therapeutic jurisprudence. For acceptance of that responsibility and its application, I point to the now Behavioral Health Director Michael Heggarty, Program Director Carol Stanchfield and Presiding Judge Thomas Anderson. These individuals have designed an exemplary program that has won awards for its innovation from both the National Association of Counties and the County Supervisors Association of California and will soon be featured in a "best practices" implementation guide for AOT programs around the country.

Moreover, Nevada County has found that for every $1 of its mental health funding that it spends on Assisted Outpatient Treatment, $1.81 has been saved in reduced hospitalizations and jailings. That savings represents not only additional services for other mentally ill individuals, but potential violence averted.

Laura's Law's is set to sunset out of legislation in 2012. Assemblymember Mike Allen (Santa Rosa) has committed to introduce a bill to extend the law. Hopefully, it will pass, but the same philosophical arguments used against it in 2002 are expected to rise again. Nevada County came together to help pass and then implement this life saving law. We now have to ensure it is reauthorized. We can't let the Legislature take it away from us.

Carla Jacobs is a veteran mental health advocate. She co-chairs the California Treatment Advocacy Coalition, a sponsor of AB 1421, also known as Laura's Law, and the LPS Reform Task Force. She is also a founding board member of the Treatment Advocacy Center.

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The Union Updated Jan 3, 2012 06:35PM Published Jan 3, 2012 06:33PM Copyright 2012 The Union. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.