Laura's Law

Laura's Law, (Assembly Bill 1421, DavisWiki.org|Helen Thomson, Davis), was passed by the California legislature and signed into law by then Governor Grey Davis in 2002, allows for court ordered outpatient treatment of mental health clients who refuse medication in counties that enact outpatient commitment programs based on the measure. Laura's Law, which became effective on January 1, 2003, was named after Laura Wilcox and was modeled on Kendra's Law, a similar statute enacted in New York.

Implementation at county discretion

Laura's Law allows counties to decide whether or not to opt into implementing an involuntary mental health treatment program. To date, only Los Angeles County has implemented Laura's Law on a limited scale. Other counties have cited budgetary concerns - the bill had no new money attached for services - for delayed implementation, and there are additional obstacles in the bill that make it difficult for counties to implement.[1]

In those counties that adopt outpatient commitment, an AB 1421 program will ensure medications are administered to certain patients referred by family members, law enforcement, or other agency.

Outpatient commitment eligibility criteria

A person may be placed in an assisted outpatient treatment if, after a hearing, a court finds that the following criteria have been met. The patient must:

• Be eighteen years of age or older
• Be suffering from a mental illness
• Be unlikely to survive safely in the community without supervision, based on a clinical determination
• Have a history of non-compliance with treatment that has either:

1. Been a significant factor in his or her being in a hospital, prison or jail at least twice within the last thirty-six months; or
2. Resulted in one or more acts, attempts or threats of serious violent behavior toward self or others within the last forty-eight months

• Have been offered an opportunity to voluntarily participate in a treatment plan by the local mental health department but continue to fail to engage in treatment
• Be substantially deteriorating
• Be, in view of his or her treatment history and current behavior, in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would likely result in the person meeting California’s inpatient commitment standard, which is being:

1. A serious risk of harm to himself or herself or others; or
2. Gravely disabled (in immediate physical danger because unable to meet basic needs for food, clothing, or shelter);

• Be likely to benefit from assisted outpatient treatment; and
• Participation in the assisted outpatient program is the least restrictive placement necessary to ensure the person's recovery and stability.

Debate over bill's efficacy and propriety

Backers of Laura's Law have cast the measure in a humanitarian light, asserting everyone "has the right to live in a world free of psychotic delusion."

Advocacy groups, including MindFreedom International, the California Network of Mental Health Clients (CNMHC), and their allies in the psychiatric survivors movement fought the measure, and its earlier versions, casting the legislation as a regressive and reprehensible scheme to enforce coerced drug treatment regimens. The CNMHC plans to be the plaintiff in a suit against Los Angeles County for its implementation of AB 1421.

According to CNMHC, outpatpatient commitment allowed by the statute means that patients can be rehospitalized for very minor infractions, such as not taking medication, or a patient being judged by a lay person to be vulnerable to further deterioration. The group warns that implementation of Laura's Law would mean forced drugging in the sanctity of one's home, and the possibility that clients could more easily be place into a psychiatric hospital against their will. Opponents are also critical of the potential for using the law for purposes of intimidation and for fostering the further erosion of civil rights. Furthermore, critics contend, coerced treatment:

• Precludes recovery and permanent remission
• Destroys trust between clients and health care providers (Jean Campbell and Ron Schraiber's study)
• Creates fear and dependency
• Violates human and civil rights
• Is costly and diverts money from recovery-oriented services

Outpatient commitment and Program for Assertive Community Treatment (PACT) are often linked. PACT was developed in Wisconsin, as was the National Alliance for the Mentally Ill (NAMI), a group sometimes criticized for having excessive ties to the [[pharmaceutical] industry. In PACT, patient compliance with drug treatment is rendered through financial and housing incentives to take drugs. PACT, according to critics, is very much based on a coercive biological psychiatry model.

Reference

• OceanPark.com - Text of AB 1421, "Laura's Law"

External links

Opponent views

• MindFreedom.org - 'Bill for More Forced Psychiatry Passed by California Legislature, Goes to Governor', California Network of Mental Health Clients (September 3, 2002)
• NAMISCC.org - 'California Battles Forced Psyciatry...Again', National Alliance for the Mentally Ill Santa Cruz County (April 12, 2001)

Proponent views

• Psychlaws.org - 'A Guide to Laura’s Law: California's New Law for Assisted Outpatient Treatment', The California Treatment Advocacy Coalition and The Treatment Advocacy Center (January, 2003)
• PsychLaws.org - 'Landmark Legislation, Laura's Law, Brings Much-Needed Reform to California: AB 1421 will help those with severe mental illnesses who are too sick to help themselves' (opinion), Mary T. Zdanowicz, Treatment Advocacy Center (September 30, 2002)
• PsychLaws.org - 'Gov. Davis Signs Laura's Law: AB 1421 will help those with severe mental illnesses who are too sick to help themselves' (November 22, 2002)