Contra Costa County supervisors face a milestone decision in the weeks ahead. In late May or early June, they will weigh the merits of a mental health program made possible by Laura's Law, which allows for court-ordered, assisted outpatient treatment for persons with serious mental illness.
The state statute was named for health care worker Laura Wilcox. who was killed by a patient in 2001. It has been on the books for 11 years, but implementation has been slow because it's been left up to individual counties -- and because the law has stirred controversy.
Detractors say mandated treatment tramples an individual's civil liberties and exposes the county to added expense. Advocates say it will be more humane and less expensive than current practices.
Count Karen Cohen of Walnut Creek and Antioch residents Doug and Linda Dunn among the supporters.
Cohen was introduced to the devastating effects of mental and emotional instability 25 years ago when her daughter, then 15, was diagnosed with mental illness and a chromosome anomaly. The Dunns were thrust into turmoil in 2006 when their 21-year-old son fell victim to bipolar mania and psychotic behavior later identified as schi zoaffective disorder.
The problem, both families say, is not that help is unavailable. Rather, the problem is that many who need treatment refuse to accept it.
"The term for that is anosognosia," Doug Dunn said. "It means they don't understand that they're ill, and because of that they don't take their medication or do what they need to do to stay mentally stable."
What often follows is a spiral into erratic behavior, apprehension by authorities and forced stays in the county hospital's psychiatric ward or secure mental health facilities. Dunn, who has studied the issue as a member of the county's Assisted Outpatient Treatment work group, said his son was hospitalized three times in 2012, at a cost to the county of $160,000. He said being proactive is better than reactive, and it's far less expensive.
Linda Dunn likens it to putting a guard rail near the edge of a sheer cliff. Instead of waiting at the bottom with ambulances, the county should keep people from falling off.
"Laura's Law is very humane and benign," Cohen said. "It confuses me why some people see it as punitive."
Before the law's provisions can be enacted, a person must be seriously mentally ill, have a record of treatment noncompliance or failed hospitalizations and show signs of deterioration that could pose a risk to himself or herself or others.
The program proposed for Contra Costa would assign participants to 24-hour Assertive Community Treatment teams -- psychiatrists, case managers and service coordinators -- responsible for seeing that patients undergo treatment and receive their prescribed medications.
Doug Dunn said the program makes sense medically and fiscally. Using skills learned in a 25-year financial operations career, he showed how a $2 million outpatient program that effectively treats 45 people could save the county $4.4 million in fees that otherwise would be incurred for lockup and rehabilitative facilities.
The challenge is persuading supervisors to enact an option that has been available since 2003. An internal county memo proposes a 10-person pilot program. The Dunns and Cohen say the need is larger than that.
Serious mental illness demands serious attention. Just ask them.
Contact Tom Barnidge at firstname.lastname@example.org.