Yolo County supervisors unanimously approved a pilot program Tuesday allowing for court-ordered involuntary outpatient treatment for certain individuals with serious mental illnesses.
The one-year pilot program implements Laura’s Law, a measure passed by the state in 2003 in the wake of a killing spree by a Nevada County man with a long history of mental illness who had resisted treatment.
The law allows a court to order involuntary outpatient treatment (also known as assisted outpatient treatment) for individuals with serious mental illnesses who have a recent history of hospitalization or violent behavior, as well as non-compliance with a voluntary treatment plan indicating a likelihood of becoming dangerous to themselves or others.
In the 10 years since Laura’s Law was passed, only Nevada County has fully implemented the law, but on Tuesday, Yolo County supervisors committed $100,000 to a pilot program that would create four slots for assisted outpatient treatment in the county’s existing community treatment program for seriously mentally ill residents.
The board’s vote followed several months of community outreach and public meetings which managed to bring many of those previously skeptical about Laura’s Law into support. They included Bob Schelen, chair of the Yolo County Mental Health Board, and Yolo County Public Defender Tracie Olson.
Supervisor Don Saylor of Davis, who helped lead efforts to craft a pilot program, noted the absence of any opposition at Tuesday’s board meeting as evidence of how well the program was crafted and presented to community members, including mental health services consumers.
“It’s a small wonder that we don’t have six or seven people who are upset in the board of supervisors’ (chambers),” said Saylor, who added that, “If we had moved more quickly, without the leadership, we’d be in a different place.”
Even those supervisors who originally had reservations about involuntary mental health treatment said they were comfortable with the pilot program as it was structured.
Supervisor Jim Provenza of Davis did request that the Department of Alcohol, Drug and Mental Health provide four reports to the board over the course of the yearlong pilot program.
In order for an individual to be placed in involuntary treatment, a request would have to be made to the county’s mental health director by the person’s spouse, parent, sibling, adult child or roommate, or a treating doctor or peace officer. The county then would investigate and choose whether to file a petition with the court for assisted outpatient treatment.
Nevada County’s program director, Carol Stanchfield, explained to supervisors Tuesday that any subsequent court proceedings are neither punitive nor coercive.
“When we do go to court,” she said, “the judge says, ‘You have done nothing wrong. This is not a criminal court. You are here because people are concerned.’
“And there begins the dialogue,” Stanchfield said. “We discuss the pros and cons of what they are able to do. What they are willing to do to go along with the treatment … There is no violation for not following your treatment plan, for not taking medication, but there is dialogue. What were the barriers? How can we mitigate that for you?”
Without assisted outpatient treatment, she said, these individuals are simply part of a revolving door system, where they decompensate to the point where they are hospitalized or jailed, then are released, stop taking any medication they were on, and decompensate again.
“There are times when folks do not understand their own illness … and do not see how that illness is impacting their behaviors and their stability,” said Kim Suderman, director of alcohol, drug and mental health for Yolo County. “Many times, when someone is encouraged to participate (in treatment), that is enough incentive to give it a shot.”
For others, she said, a court order is enough.
“It is for the health of the individual, the safety of the individual and the safety of the community,” she said in urging supervisors to support the pilot program.
“We don’t very often get to be as proactive as this,” Suderman added.
Schelen, who chairs the county’s mental health board, told supervisors that a number of board members started out skeptical about Laura’s Law, concerned about the idea of involuntary treatment and of people who may not want or even need treatment being forced into it.
“That was a concern of consumers and others represented on the board,” Schelen said Tuesday.
However, he said, they came away from Nevada County’s presentations “impressed that it is not an adversarial relationship.”
“Their efforts are to develop a familiar relationship … an ongoing relationship, and they have been successful,” he said.
Though he ended up voting in favor of the pilot program, Provenza did voice a note of caution going forward.
“It’s a pretty awesome authority to be able to order treatment,” he said. “We have to make sure we do this correctly. I’m going to vote for it but that’s why I’m asking for this to come back (before the board) four times … we have to tread very carefully.”
— Reach Anne Ternus-Bellamy at firstname.lastname@example.org or 530-747-8051. Follow her on Twitter at @ATernusBellamy