Orange County could be an early adopter of a law governing the involuntary treatment of severely mentally ill adults, once Gov. Jerry Brown signs a bill prompted in part by the beating death of mentally ill transient Kelly Thomas in Fullerton.
The measure was authored by Senate President Pro Tem Darrell Steinberg, D–Sacramento, and backed by the Orange County Board of Supervisors. It specifies that counties may use money from Proposition 63, passed in 2004 and known as Laura’s Law, to treat adults who either are unaware they are severely mentally ill or simply refuse medication.
“Fortunately, the prodding from Orange County has borne fruit,” said Supervisor John Moorlach in a newsletter emailed last week to his constituents. Senate Bill 585 “is now on the Governor’s desk for signature. Consequently, the OC truly is poised to consider adoption of this opportunity to assist families who are dealing with (an adult) child that has a mental illness.”
Moorlach and Health Care Agency Director Mark Refowitz traveled to Sacramento while the bill was pending in the Legislature to help round up support.
Parents now can obtain treatment for their mentally ill children only until they turn 18. Once they become adults, there is little that families can do to require them to take medications. Patients often refuse to take medications because either they don’t believe they are ill or to avoid the sometimes strong side effects.
Serious adult mental illness is a major contributor to homelessness, with estimates as high as 40 percent of the street population suffering from untreated mental problems. As a result, police rather than trained mental health professionals are often left to deal with mentally ill adults.
Thomas, 37, had been in and out of treatment for severe schizophrenia before being confronted by Fullerton police on July 5, 2011, in the parking lot of the city’s bus station. Video shows Thomas being beaten by officers, and three of them were charged with second-degree murder or involuntary manslaughter.
Two years ago the U.S. Supreme Court ordered California to dramatically reduce its prison overcrowding, partly because mentally ill prisoners were being denied treatment.
But the Orange County counsel’s office advised the supervisors they couldn’t use money from Proposition 63, known as the Mental Health Services Act, to implement Laura’s Law. Without that funding, the county couldn’t afford to go ahead.
Laura’s Law is intended to provide outpatient medical treatment — mandatory treatment if necessary — for the most severely mentally ill adults in the state. In the most severe cases, untreated patients are homeless and potentially violent.
The law was named for Laura Wilcox, a college student and vacation worker who was murdered by a Nevada County mental patient during the years the bill was making its way through the Legislature. The law gives the courts authority in the most severe cases to order an individual to accept specific outpatient treatment.
The Legislature left to each county the decision to implement the law.
Since its passage in 2003, Laura’s Law has been fully implemented only by Nevada County, and that was to settle a lawsuit after three workers — including 19-year-old Wilcox — were shot and killed in 2001 in a Nevada County public mental health clinic by a patient, Scott Thorpe.
Los Angeles County has a pilot program.
Until the late 1960s, California, like many states, operated a series of large mental hospitals for long-term care of adults with serious mental disabilities.
In 1967, the Legislature passed and Gov. Ronald Reagan signed the Lanterman-Petris-Short Act, ending involuntary, indefinite commitment of mental patients to institutions in California. The state was leading a national trend away from locking up for years people with mental illnesses.
The idea, said the late Assemblyman Frank Lanterman, R-La Canada, at the time, was to have community clinics treat the long-term patients. But local treatment centers statewide never materialized.
To protect adults from being wrongly forced into treatment, Laura’s Law requires county health officials to work with the patient to seek voluntary treatment. Only if that fails would the adult be brought before a judge, who could order the person to participate as an outpatient in medical treatment. During the court proceedings, a public defender would be assigned to protect the rights of the adult.
Those court costs, estimated at about $1 million a year, wouldn’t be covered under Laura’s Law, but other county health expenses would. Nevada County officials said that in their experience, few patients go all the way to the court before agreeing to treatment. The propects of facing a judge — known as the “black robe effect” — causes patients to cooperate, officials said.