WOODLAND — Laura Wilcox was working as a temporary receptionist at the Nevada County Behavioral Health Department in January 2001 when Scott Thorpe, a mentally ill patient who had resisted treatment, entered the building and asked to see his psychiatrist. When he was unable to see the doctor, he shot and killed Wilcox and ultimately two other people.
In the wake of their daughter’s death, Nick and Amanda Wilcox joined forces with then-Assemblywoman Helen Thomson of Davis to push for passage of AB 1421, also known as Laura’s Law.
The bill would allow counties to provide court-ordered involuntary outpatient treatment (also known as assisted outpatient treatment) to 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 that indicates the individual is likely to become dangerous or gravely disabled.
AB 1421 ultimately was passed by the Legislature and signed into law in January 2003, but only one county — Nevada County — has fully implemented Laura’s Law in the years since. A lack of funding and concerns about forcing the mentally ill into treatment have kept other counties from following suit.
But on Tuesday, Thomson urged Yolo County supervisors to follow Nevada County’s lead and pass a resolution allowing for the implementation of Laura’s Law locally.
“I think it is time to take care of those who need it so much,” said Thomson, herself a former Yolo County supervisor. “I think it’s really important that the mentally ill get the most appropriate care in the least restrictive setting.”
According to the mental health experts who spoke before the board on Tuesday, a number of individuals suffering from severe mental illnesses, including one-third of those with schizophrenia, resist treatment because they don’t believe they need it. However, many end up hospitalized or incarcerated because of that lack of treatment.
Kim Suderman, director of alcohol, drug and mental health for Yolo County, said the number of county residents who might fall in that category would be small.
“Definitely no more than 20, probably less,” she told supervisors. “Is it more than 10? It’s hard to say.”
And while treatment could be involuntary under Laura’s Law, Suderman said, medication would not be.
“This does not allow for literally strapping someone down and doing an injection against their will,” she said. “Forced medication is rarely done in any outpatient setting because it … is a civil rights issue.”
Cost is also an issue, because AB 1421 did not provide additional funding for assisted outpatient treatment.
However, Nevada County has shown an overall cost savings since implementing Laura’s Law.
According to the Nevada County Grand Jury, 17 individuals entered that county’s assisted outpatient treatment program for an extended period of time between April 2008 and December 2010. The total cost to the county for their treatment during that time was $482,443.
But in the one year preceding their entry into treatment, those 17 individuals had incurred a combined $425,100 in hospitalizations and incarcerations, the grand jury said. Had they not spent that time in assisted outpatient treatment, the projected cost of hospitalizations and incarcerations over that 2 1/2-year period would have topped $1 million, the grand jury reported.
“Just on the basis of the fiscal aspect, this makes sense,” said Supervisor Don Saylor of Davis. “And that doesn’t account for the potential harm to the individuals or the community they live in or the heartbreak that happens.”
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.
Sometimes the initial action is all that’s required, said Randall Hagar of the California Psychiatric Association, because just knowing they are being investigated often leads individuals to seek treatment.
“I think the voluntary nature of this program is under-appreciated,” Hagar told supervisors. “The investigation … really has a beneficial effect by itself.”
Though several supervisors expressed concerns about costs and other aspects of Laura’s Law, most said they likely would support a resolution implementing the law here.
By a 5-0 vote, they agreed to a resolution coming back to the board in June, when they also may take a position on two bills related to Laura’s Law currently being considered in the Legislature. One, co-authored by Sen. Lois Wolk, D-Davis, actually would eliminate the need for county supervisors to OK the implementation of Laura’s Law, while another would clarify that funding for treatment under Laura’s Law could come from Proposition 63, the Mental Health Services Act of 2004.
— Reach Anne Ternus-Bellamy at firstname.lastname@example.org or 530-747-8051. Follow her on Twitter at @ATernusBellamy