Help for those who need it 

Laura’s Law is a state law that was passed in 2002 that allows counties to establish assisted outpatient treatment programs for severely mentally ill persons. AOT offers a lifeline to people with severe mental illness who struggle to comply with prescribed treatment independently. The law allows a family member or mental health official to petition the court for an order directing a severely mentally ill person who meets strict criteria to adhere to a treatment plan developed with a case manager.

Without Laura’s Law, the only available option for treating individuals who lack insight into their mental illness is through San Francisco’s scarce and expensive psychiatric beds or jail. Those with a severe mental illness usually have to end up in the hospital or jail before they get connected to mental health services that can help turn their lives around.

The legislation establishes a procedure for obtaining court orders for certain individuals with mental illness to receive and accept outpatient treatment. A person cannot be placed under AOT unless:

  • The person is at least 18 years old;
  • The person is suffering from a mental illness;
  • The person is unlikely to survive safely in the community without supervision, based on a clinical determination;
  • The person has a history of lack of compliance with treatment for mental illness that revealed serious violent behavior or required hospitalization;
  • The person is unlikely to voluntarily participate in the outpatient treatment;
  • The person is, according to his or her treatment history and current behavior, in need of the treatment to prevent a relapse or deterioration that would likely result in serious harm to the person or others; 
  • The person is likely to benefit from AOT.

“Laura’s Law” was modeled after a New York measure that has resulted in 77 percent fewer psychiatric hospitalizations, a 74 percent reduction in homelessness, a 55 percent drop in suicide attempts, an 83 percent reduction in arrests and incarceration by 87 percent.

Los Angeles County has implemented Laura’s Law through a limited pilot program that stopped dozens of people from cycling in and out of jails, hospitals and prisons. The money Los Angeles County saved from keeping people out of guarded psychiatric wards was more than enough to establish a program in which mental health teams closely monitored a small number of seriously mentally ill people after their discharge from jail. Before Laura’s Law, these individuals would have been released from jail with a sheet of paper referring them to a mental health clinic. They were then forgotten until they ended up in the system again.

What is great about San Francisco is that we have an array of mental health services that are already in place. We also have the model for an AOT program in our Behavioral Health Court. The mission of the Behavioral Court is to enhance public safety and reduce recidivism of criminal defendants who suffer from serious mental illness by connecting these defendants with community treatment services.

The problem with our system now is that people are usually connected to these community treatment services because they end up in jail or in psychiatric emergency services at SF General Hospital because they are a danger to themselves or others.  
Laura’s Law is about providing another avenue to those services short of a jail cell or hospital visit. It is a compassionate law that will help the most severely mentally ill when they are not able to help themselves.

The Board of Supervisors will have an opportunity to vote for Laura’s Law on Tuesday, July 20. We must begin to reform a system that places mentally ill persons in jails rather than in treatment. Laura’s Law will save money but most importantly it will save lives.

Michela Alioto-Pier is a San Francisco Supervisor.

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Staff Report

Staff Report

A daily newspaper covering San Francisco, San Mateo County and serving Alameda, Marin and Santa Clara counties.
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