Viewpoint: Fractured minds need Laura’s Law
By Jan Loomis
College basketball player Kevin Ware recently fractured his leg spectacularly on national TV. He was immediately surrounded by coaches, his team, doctors, and other health care professionals. He received immediate hospital care and is now well on his way to recovery. That is what we expect when someone is injured and needs medical help. So it seems impossible that we routinely leave people with badly fractured minds to fend for themselves, but we do, every day.
As a result, our cities are full of homeless men and women who can no longer function. Often self-medicated on alcohol and drugs and tormented by voices and delusions as their only reality, they cannot hold a job or take care of their own basic needs. Prey to crime, injury, and hopelessness, they wander untreated and uncared for along the streets and beg on the corners. Since 1955, we have eliminated over 95 percent of the public hospital beds for the mentally ill. There is no place left to care for them except the jails.
As a result, our prisons are full of the mentally ill. Riker’s Island in New York and the Cook County jail in Chicago are now the biggest mental treatment facilities in the world. Over 50 percent of their inmates suffer from some sort of mental illness and the guards, untrained in how to treat psychiatric illnesses, are their caregivers. Bedlam, pun intended, is the obvious result. Committing a crime is the only way these very ill people get any treatment at all.
Even worse, we watch horrified as a young man, untreated for his problems, turns a gun on his mother, and a room full of school children and teachers, another shoots up a theater full of movie goers, and yet another opens fire on a meet and greet held in a grocery store parking lot. We shed tears, construct memorials, form foundations, pray, pass gun control measures, but know that there will be another horrifying event all too soon.
Caregivers face a person who often denies there is something wrong — lack of insight into the disease is primary symptom of mental illness. In many states the only way a person can be treated who refuses treatment (and many do) is if they are deemed a danger to themselves or others. If the person refuses treatment after 72 hours, they are released no matter how ill or dangerous. Parents, siblings, and friends often simply give up trying to help, watching helplessly while their loved one joins the homeless, ends up in jail for a petty offense, kills someone while in the grip of a delusion, or commits suicide.
Surely we can do better than this. We need to change our approach to those with mental illness. We need to try to prevent violence not require it for treatment.
Caregivers need tools such as California’s Laura’s Law. This law allows the courts to authorize assisted outpatient treatment and inpatient commitment before someone becomes dangerous to themselves or others. Laura’s Law also allows forced administration of anti-psychotic drugs. Studies show that where these laws have been implemented, the participants are far less likely to become homeless or violent. They are also less likely to be arrested. Overwhelmingly, according to the studies, those who have been part of these programs support them and credit them with helping them regain control of their lives. The law includes many safeguards for participant’s safety and their civil rights.
These laws work, and they have been passed in 44 states, but unfortunately they are often not available because implementation is voluntary and left up to the individual counties. California passed Laura’s Law in 2002, but it has only been fully implemented in one county (Nevada County where it is very successful) and as a pilot program in Los Angeles County.
To their credit, the San Diego County supervisors recently commissioned a 90-day staff review of Laura’s Law to determine if it should be implemented in San Diego County. Costs and privacy issues will be considered as well as how to integrate the law into the current mental health programs.
We need to implement this law. We owe it to those who can no longer rescue themselves from their own fractured minds.
Loomis is a Poway resident. She is a published author and was a caregiver for someone with mental illness.
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