The Orange County Board of Supervisors is slated to vote Tuesday on whether to adopt Laura’s Law, which would allow the county to force certain people with severe mental illness to receive treatment. The supervisors have some real-life examples they can study as they try to make their decision: Nevada County has fully implemented the law, and Los Angeles and Yolo Counties have pilot programs.
Laura’s Law is intended for a narrow segment of the population: mentally ill people who have landed in jail or hospitals because of their condition. It only applies to those who might be a danger to themselves or others, because they don’t recognize they need treatment.
The state law gives counties the option of adopting Laura’s Law. While L.A. and Yolo are running pilot programs, tiny Nevada County in Northern California, has fully implemented it.
"It doesn’t always work, but boy, sometimes it really works," says John Buck, CEO of Turning Point Community Programs, which provides the treatment services in Nevada County.
Buck says he knows the involuntary nature of Laura’s Law is controversial, but he says it works.
"All we’re asking them to do is actually engage with us," he explains. "So a person looks at our menu, and they say, 'I don’t want to take medication, but I’m willing to see the psychiatrist.'"
Buck says the program offers a variety of services, including psychotherapy, crisis intervention, nursing, substance abuse counseling, housing support, benefits and medication.
Nevada County’s program is small – it has served about 80 people over six years, and never more than eight at a time.
Buck’s group does not have comprehensive data on the pilot’s effectiveness. It tracks people just for the year before they entered the program, and the year after. But Buck says it has had successes, saying some have gotten jobs, and found housing.
"We’ve seen such incredible recoveries in some people that their families have said, 'I’ve got my son back, and he’s not in trouble,'" Buck says.
In 2012 a Nevada County grand jury praised the program, saying it was saving the county money.
Nearby Yolo County started a pilot program last fall, but it’s too early to see results. Los Angeles County also has a pilot program - with one difference: While it provides treatment to people who would qualify under Laura’s Law, L.A.’s program is voluntary.
"These intensive services that we provide appear to be very helpful for people who accept them," says Dr. Roderick Shaner, the medical director for the county Department of Mental Health.
L.A.’s pilot program has treated 50 people over the last three years. Nearly half improved their situation or are still enrolled in the program. Dr. Shaner says what he doesn’t know yet is how beneficial the services would be for people who are forced into treatment.
The involuntary nature of Laura's Law also raises ethical questions, say the law's critics.
Forced treatment doesn’t work, says Leslie Morrison, director of the investigations unit at Disability Rights California.
"Research has shown that people buy into treatment when they go in voluntarily, and voluntary treatment works," she says.
Officials in L.A. will be watching how Orange County’s supervisors vote on Laura’s Law. L.A.’s supervisors may be taking up the same question in the months to come.