The problem with Laura’s Law

Pub date April 10, 2012

OPINION Mental health conditions and mental illness are issues that bring passionate people to the table from all sides of the spectrum. Individuals who have lived with the experience of mental-health conditions, clinicians, family members, researchers, and advocates all have a lot to say.

But as a March 11 San Francisco Chronicle piece, “Laura’s Law likely to save lives,” suggests, people can be fueled by pain and emotion, rather than logic and information. It’s in such a hot zone that AB 1421 emerged, after the tragic death of a young woman at the hands of a violent man who also happened to be dealing with mental health conditions.

The so-called Laura’s Law passed the state Legislature in 2002, and counties have a choice whether to implement it locally. If enacted in San Francisco, AB 1421 would mandate outpatient treatment for some people with mental illness — and those out of compliance would get a 72-hour hold under lock and key at the hospital, and would be at risk of being thrown into the revolving door of the criminal justice system.

The public support for AB 1421 and similar involuntary measures outlines the pervasive misunderstanding that comes when emotion rules the fray over common sense and dignity. And more dangerously, it promotes the long-debunked myth that mental illness is related to violence. In fact, individuals with mental illness are one percent less likely to commit violence than other individuals.

Often, the very people whose voices are left out of the decision making process in legislation such as AB 1421, are the ones who are directly affected personally by mental illness and mental-health conditions. That’s due in large part to the lasting impact of stigma, which deprives people of dignity, individual choice, and the empowerment to seek their own goals and paths in life.

What we know is this: voluntary treatment that is accessible in community settings and centered on individual strength is by far the best option for recovery from mental health conditions and the path for a rewarding, enriched life.

San Francisco typically leads the state in the number of involuntary commitments for people in acute psychiatric crisis. That’s proven to be not only a colossal waste of resources but also the wrong approach. Many of those who are involuntarily detained are accessing the mental health system for the first time—in restraints. This leads to further mistrust and trauma for those dealing with mental health challenges.

When it comes to embracing laws such as AB 1421, California voters know better. After the passage of that measure, California voters passed the landmark Mental Health Services Act in 2004. It is the principles of MHSA—voluntary, community-driven treatment, and full inclusion of individuals with mental health conditions as decision-makers—that should guide our efforts in recovery from mental health conditions and eliminating the pervasive stigma and bias that are the true culprits in causing pain and trauma in our society. MHSA provides funding for innovative, alternative approaches to Treatment As Usual.

Michael Gause is deputy director of the Mental Health Association of San Francisco.