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Los Angeles Times
February 14, 2004
Reprinted with permission. All rights
reserved.
EDITORIAL
True help on mental illness
Los Angeles is the only county to implement the
state's 2002 "Laura's law," which allows a judge, under closely monitored
circumstances, to order severely and often violently mentally ill people to accept
treatment.
The other 57 counties, which tend to view the law as controversial and expensive because
it lacks state funding, should look at Los Angeles County. A limited pilot program has
stopped dozens of people from cycling in and out of jails, hospitals and prisons.
Marvin Southard, the director of the county's mental health department, found money to
begin implementing Laura's law (named after a young woman killed by a mentally ill man in
a Northern California clinic) by transferring some seriously mentally ill people out of
guarded psychiatric wards - where they each cost the county about $100,000 a year - and
into supervised, locked board-and-care facilities where they cost from $28,000 to $56,000.
Using savings generated by the transfers, Southard established a program in which mental
health teams closely followed a small number of seriously mentally ill people after their
discharge from jail. Before the passage of Laura's law, such people were typically
released with a sheet of paper referring them to a mental health clinic. Then they were
forgotten. Today, if one of the lucky few in the pilot program fails to comply with his
treatment plan, the team can find him, drive him to a clinic or other prescribed social
service and give him a chance to get back on track.
Critics of Laura's law argue that it, in its coercion, drives the ill away from treatment.
Tell that, however, to Amy Cabonce, who last summer argued to Mateo County mental health
professionals that they ought to compel her 41-year-old son, Jerry, to be treated after he
had stopped taking medications to control his schizophrenia.
The officials told her that because they had not implemented Laura's law, they could not
compel Cabonce to be treated, even though he had stabbed his brother-in-law after stopping
medication a few years earlier.
Just weeks later, Jerry Cabonce stuck a butcher knife into two San Francisco police
officers. Three weeks ago, San Mateo Superior Court Judge Craig Parsons found him too
mentally ill to stand trial. He is expected to be sent to a state psychiatric hospital,
where he will cost state taxpayers about $100,000 a year.
There's no empirical evidence to prove that Laura's law is cost-effective: It is too new
and its implementation too limited to have been academically documented. But had San Mateo
County treated Cabonce, it could have billed the federal government for at least 50% of
the cost of his care through Medicaid. Since Washington doesn't reimburse state
psychiatric hospitals or prisons, the county now shoulders the whole cost.
California counties should implement Laura's law, even partly, because it's the morally
right thing to do. Given the state's current budget crisis, the money-saving potential
should also be better explored.