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Marin resists call from parents of mentally ill children to implement Laura's Law

Marin Independent Journal (CA) - 8/3/2014

Aug. 03--It has been only a few weeks now since a San Rafael police officer arrived at the door of Suzanne Jensen's home.

Jensen called the police after her 22-year-old son, Todd, who has been diagnosed as bipolar, left their apartment with a knife.

"They surrounded him with squad cars with weapons drawn," Jensen said. "Then they sent an officer to my home to tell me that if it got to the point that they felt threatened that they were going to shoot to kill."

Todd eventually surrendered to police without a struggle and was taken to Marin's psych emergency ward. In 2009, 29-year-old Daniel Frederickson was less fortunate. Frederickson, who had a history of mental illness dating to 2001, was shot and killed by a San Anselmo police officer after he approached the officer with a knife.

Jensen is just one of many parents in Marin County who have children that suffer from mental illness and would like to see Marin County adopt "Laura's Law." The measure, signed into law by Gov. Gray Davis in 2002, gives local judges the authority to order severely mentally ill individuals to undergo outpatient treatment. The Legislature passed the law after a mentally ill man fatally shot Laura Wilcox, a 19-year-old volunteer at a Nevada County mental health clinic.

Laura's Law

Laura's Law targets mentally ill individuals who are too ill to recognize they need treatment and who, as a result, end up being hospitalized or jailed needlessly. To qualify, an individual must have a serious mental illness that resulted in a psychiatric hospitalization or incarceration twice in the previous three years or resulted in violent behavior. While outpatient treatment can be ordered, medication cannot.

The legislation that created Laura's Law, however, allows each county in the state to decide whether to adopt the provision. For years, Nevada County was the only one to do so. Recently, however, after the Legislature authorized use of the Proposition 63 Mental Health Services Act funds for its enforcement, several new counties signed on: San Francisco, Orange and Yolo.

"At least for San Francisco, that change in the law played a huge role," said Jess Montejano, legislative aide to San Francisco Supervisor Mark Farrell, who championed the passage of Laura's Law in San Francisco. "In the early stages of reviewing the facts around Laura's Law, we were concerned about the costs associated with it."

Montejano said the recently passed federal Helping Families in Mental Health Crisis Act, introduced by Rep. Tim Murphy, R-Penn., will also provide $1 million to counties implementing the law.

Montejano said the new funding isn't the only reason that counties are taking a fresh look at Laura's Law. Montejano said mass shootings conducted by severely mentally ill individuals over recent years have also raised awareness about the need for more and better treatment options for the mentally ill.

Rick Roose, vice president of the National Alliance on Mental Illness' Marin affiliate, said, "It's true that most mentally ill people are not violent, and most violent people are not mentally ill."

Roose noted, however, that nearly every mass killing committed in the United States over the last five years has been carried out "by a young male between the age of 17 and 25 who was either schizophrenic or severely bipolar and who wasn't taking any medication."

Four years ago, the NAMI Marin affiliate made a detailed presentation to the Marin County Mental Health Board laying out the argument for adopting Laura's Law. The Mental Health Board advises the county's Board of Supervisors.

The presentation included two case studies of Marin residents who had to be hospitalized and jailed due to mental illness. One cost the county $170,980 over a one-year period; the other required expenditures of $125,866 over a four-month period. At the time, NAMI noted that a Marin County jail bed cost a minimum of $411 per day while a stay in an acute care hospital cost a minimum of $1,000 per day.

Opted not to adopt

The Marin Mental Health Board recommended that the Board of Supervisors implement Laura's Law, but the supervisors chose not to do so.

Suzanne Tavano, the county's director of Mental Health and Substance Use Services, said Laura's Law is unneeded in Marin County; Tavano said the county already has programs to meet the needs of seriously mentally ill patients and, thanks to new state funding, has plans to add programs beginning in September aimed specifically at individuals in crisis.

Currently, teams made up of county employees and employees of the nonprofit Community Action Marin attempt to convince individuals who have resisted treatment in the past to join a program. And in the fall, the county will debut a mobile response team, which will have the capacity to initiate Section 5150 of the California penal code, which authorizes the confinement of people suspected of having a mental disorder that makes them a danger to themselves or others.

"That is where we are putting all of our resources and energies now," Tavano said.

Tavano said she spoke to NAMI'sMarin affiliate in April, presenting an analysis that shows that the county's approach of outreach and engagement has been as effective as Laura's Law in Nevada County. Tavano said advocates of Laura's Law tend to overestimate its powers.

"There are no civil or criminal sanctions if a patient doesn't want to participate or go along with the treatment program," Tavano said.

NAMI disagrees

NAMI, however, notes that a measure similar to Laura's Law in New York, known as Kendra's Law, resulted in a 103 percent increase in medication adherence by participants.

Roose said the data Tavano presented in April showed a decrease in adverse events -- incarceration, hospitalization and homelessness -- for those mental health patients in the county's programs.

"However," Roose said, "you can't compare these to Nevada County because there are no statistics on what has happened to many of the patients who leave the program, refuse to participate or graduate the program.

"The reason these larger counties have gone in for Laura's Law is that they've tried the approach that Marin is using and it hasn't worked that well," Roose said.

Roose said that when Tavano spoke to NAMI in April she said that one of the reasons for not implementing Laura's Law in Marin was that Marin County's judges opposed the idea because they were already spending time authorizing participants in Marin's Sustained Treatment after Release (STAR) program. One of the county's three programs serving the severely mentally ill, the STAR program offers the option of treatment to the mentally ill who have been arrested and face the possibility of jail time.

Tavano said she doesn't recall telling NAMI that. She added, however, "The reality is there would be more demand on the courts."

Parents concerned

Donna Morris of Novato said her son, who has been diagnosed with paranoid schizophrenia, was admitted into the county's STAR program while in prison and his condition improved. Her son, who is now 50, was jailed for several months after he threatened a prominent public official based in Washington, D.C. over the phone.

But Morris said after her son graduated from the STAR program he stopped taking his medications and has since relapsed. Morris filed a missing persons report after her son disappeared for a time. He contacted her six weeks ago seeking help with a bad toothache. She said he is delusional, "telling people he is famous and on TV all the time."

Cynthia Jackson of Larkspur asks, "Why must someone commit a crime first to get treatment?"

Jackson said that several years ago she pleaded with medical professionals to help her son, who is now 35, because he was displaying manic, psychotic behavior.

"I was afraid something bad would happen and it did," Jackson said. "That afternoon he was Tasered by police several times, hog-tied and booked into Marin County Jail. From there he was put into solitary confinement for three weeks."

Jackson said, "The bottom line is if Marin County had implemented Laura's Law this tragedy wouldn't have occurred."

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(c)2014 The Marin Independent Journal (Novato, Calif.)

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