Published Date: 2012-03-29
From SF Gate by Dan Brzovic, March 26, 2012
Laura's Law has been on the books since 2002, promoting expensive, involuntary treatment of people with mental health disabilities on the basis that they might become dangerous to themselves or others. Although The Chronicle editorializes that it would be a crime for Laura's Law to sunset, the real crime is that as a result of California's bad economic climate, the state and counties too often have made drastic cuts to mental-health and other social-services funding, depriving individuals of the community-based services they need to avoid hospitalization.
In the last decade, only Nevada County has implemented this unproven program. California's other 57 counties are using funding under the Mental Health Services Act (also known as Proposition 63) to support voluntary programs, such as Full Service Partnerships, which in many cases have reduced hospitalizations by 50 percent, homelessness by 70 percent and incarcerations by 88 percent.
Californians got it right when they voted in 2004 by a substantial majority for the Mental Health Services Act (San Francisco had the highest majority - 74.4 percent voted in favor). The act raises $1 billion a year for mental health services.
Authored by the Legislature's mental health champion, Senate President Pro Tem Darrell Steinberg, the act has funded an innovative set of programs based on voluntary compliance that have saved lives and money. These programs include housing, community-based recovery services, 24/7 emergency response, and family and peer support services. As Sen. Steinberg noted in a recent article, the new system is "premised on a very different and better philosophy, which is recovery - doing whatever it takes, which is not just having people cycle in and out of clinics or in and out of institutional care and hospitals."
The Laura's Law program, as Eduardo Vega, executive director of the Mental Health Association of San Francisco has commented, "has failed its test for California."
My organization, Disability Rights California, agrees. An extension of Laura's Law will not achieve the results suggested by The Chronicle's March 11 editorial, because the program is:
-- Costly, requiring the use of expensive judicial resources.
-- Duplicative, because existing laws enable 72-hour, 14-day or 180-day holds for individuals who are a danger to themselves or others or gravely disabled (unable to meet basic needs for food, clothing and shelter).
-- Ineffective, because outcomes have taught us that forced treatment of people with mental health disabilities is counterproductive, often driving people away from services.
-- Bad policy, because it relies on an unproven assumption that it is possible to predict violent behavior.
-- Rejected by the vast majority of mental health clients because coerced treatment breaks the bond of trust between people with mental health disabilities and their service providers.
-- Rejected by disability rights advocates because it fails to protect the rights and autonomy of individuals with a significant mental health history without any clear gain to them or society.
The Chronicle editorial board appears to be under the mistaken impression that a vast body of research demonstrates that violence of people with mental disabilities constitutes a significant public danger, and that court-ordered treatment programs in other states, particularly New York, have achieved great success. Neither is true.
Universally recognized research clearly shows that people with disabilities are much more likely to be victims than perpetrators of violence. A new study indicates that individuals with mental health disabilities are approximately four times more likely to be victims of violence than those without disabilities. ("Prevalence and risk of violence against adults with disabilities," the Lancet, Feb. 28, 2012, a meta-analysis of 21 studies).
The few incidents perpetrated by people with mental health conditions tend to receive headline coverage, distorting our perceptions. As researcher Heather Stuart summarized: "Public perceptions of the link between mental illness and violence are central to stigma and discrimination, as people are more likely to condone legal action and forced treatment when violence is at issue" ("Violence and Mental Illness: an overview" World Psychiatry, June 2003).
We know there is work to be done to reduce stigma and discrimination toward people with mental health disabilities. We are confident that, with persistence in public education and support from media leaders, perceptions can change. One such precedent was noted on St. Patrick's Day in the New York Times by Peter Behrens, citing early prejudice toward Irish immigrants to the United States. He said one slur among many that created barriers was that the Irish "were particularly prone to violence."
Allowing Laura's Law to sunset this year and become part of the past, would allow California to focus on a future based on the more innovative, effective and voluntary services offered by the Mental Health Services Act and to engage people with mental health disabilities as part of their communities.
Daniel Brzovic is the associate managing attorney for the Oakland office of Disability Rights California. www.disabilityrightsca.org