County to weigh Laura’s Law against current mental health strategy

Tuesday, March 19—County supervisors  voted today to study Laura’s Law as they look for additional ways to help the severely mentally ill.

The Board of Supervisors unanimously agreed to weigh the law, which allows for involuntary outpatient treatment for the mentally ill who resist help, against the county’s current voluntary approach.

The county’s In Home Outreach Team program, or IHOT, provides voluntary home outreach to adults who have previously refused services. Other county-run behavioral programs include a psychiatric response team and a public awareness campaign aimed at reducing the stigma tied to the mentally ill.

“San Diego County has a lot to be proud of when it comes to addressing mental illness,” said Supervisor Dianne Jacob, board vice chairwoman. “But we need to always ask ourselves: Are we doing enough? Do we need to modify our approach to make sure we are reaching as many of the mentally ill as we can?”

“It is important that the county examine our care options to make certain we are doing all that we can for the mentally ill, their families, and for the protection of the public,” Supervisor Dave Roberts said. ”We must have the ability to keep someone from harming themselves or others.”

Laura’s Law, approved by state lawmakers in 2002, allows for court-ordered outpatient treatment for the mentally ill who refuse medication and are unable to make rational decisions.

Nevada County is the only county in California that has implemented Laura’s Law. San Diego County is among those that have created voluntary programs in recent years.

IHOT was started as a three-year pilot program early last year in the hopes of reaching a larger pool of high-risk individuals than served under Laura’s Law, due to the narrow eligibility criteria under the law.

The supervisors on Tuesday asked county staff to analyze the two programs and return to the board within 90 days with recommendations.

The county’s Psychiatric Emergency Response Team, or PERT, assesses the mentally ill who find themselves in situations involving law enforcement. Last year, the county launched “It’s Up To Us,” a public awareness campaign designed to shed light on mental illness and to reduce the stigma behind it.

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Posted by Maureen Robertson on Mar 19 2013. Filed under Backcountry, Government, News, Ramona. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.

6 Comments for “County to weigh Laura’s Law against current mental health strategy”

  1. Jane Tanaka MD

    First question that comes to mind :
    How would you enforce this?
    Even when a person is on LPS conservatorship and his or her conservator would like to have him/her hospitalized due to impending decompensation, and to prevent him/her from reaching the point of attempting to harm himself or others, often times police cannot place him or her on a 5150, and hospital cannot admit him because 5150 criteria are not met and the insurance will not cover the hospitalization because he/she isnt legally a "danger to himself or others or gravely disabled.>'

  2. Jane Tanaka MD

    2nd question that comes to mind,
    Again, how do you enforce this? Say someone is court ordered to come to my outpatient psychiatric office for his/her appt, and refuses to come for their appt or to take their meds, then does the family call the sheriffs dept, and then, does he/her get taken to jail or to a psychiatric hospital for non-compliance? Are the sheriffs able to do this every single time he/she is non-compliant with meds/appts?

  3. Jane Tanaka MD

    And in additon to asking County Staff to take a look at the feasibility of implementing Laura's Law, shouldnt the local chapter of NAMI ( National Alliance for Mental Illness),
    and San Diego Psychiatric Society/ Medical Society be consulted too. I assume Sheriffs Dept is already being consulted.

  4. Jane Tanaka MD

    To me, in order to implement Laura's Law effectively, and to treat severely mentally ill persons on an outpatient basis involuntarily, you still need IHOT going to pts homes at the beginning. Getting someone who is severe anxious , depressed or paranoid out ofthe house and into a psychiatric office is major obstacle. Without IHOT , you will have the sheriffs dept being greatly burdened .

  5. JOB

    Laura's Law is synonymous to Assisted Outpatient Treatment. There will be a team of people that are connected to the individual. They will monitor the individual and their needs. There will be a relationship built with the team. The black robe effect seems to be the "teeth" that makes the people comply. If they do not, and they feel the individual is decompensating, they can take the person to the hospital for an evaluation. Medication will NEVER be forced unless there is a Reese hearing. The main element is that the team will be monitoring the individual for six months so if the person becomes very ill, they are in place to get the person help . Better to help them before they commit a crime or hurt themselves or others. They should not have to get so sick that they get hospitalized for long periods of time or criminalized and then get the help.

    • Jane Tanaka MD

      Thank you JOB, for the clarification that there will be a team involved in monitoring the individual and his/her needs. Agree with you that earlier intervention/help is very much needed prior to decompensation . But we are back to whether a hospital will admit such a person who is not holdable because symptoms are not yet to that point of a 5150. Will a different set of criteria and funding be in place to make such inpatient evaluations of 72 hours possible for perons on Assisted Outpatient Treatment? ( Many times, I have tried to get pts voluntarily admitted and they are refused admission, even though they are psychotic and having great difficulty functioning, because they are not suicidal, homicidal and family still willing to care for them to provide food, shelter, clothing) . And the Riese hearing can only approve of medicating the person without their consent on an inpatient basis…. or is that going to change to also outpatient medication administration somehow with implementation of Laura's Law? Again, thank you, JOB.

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