Sunday, September 29, 2002

Robert Salladay, Chronicle Sacramento Bureau

Sacramento -- Mentally ill Californians who consistently refuse psychiatric help could face court-ordered, involuntary treatment for up to six months under a measure signed Saturday by Gov. Gray Davis.

The bill, dubbed "Laura's Law" after a 19-year-old Nevada County woman killed by a mentally ill man, is a significant revision to the landmark 1967 Lanterman-Petris-Short Act and a source of division for years among advocates for the mentally ill and homeless.

The measure, AB1421, would target a class of mentally ill people who consistently avoid treatment because they do not recognize the need for it. Counties that agree to participate would set up special mental-health teams to monitor the patients during in-home treatment ordered by a judge.

Under current law, only people who pose a significant and immediate threat to themselves or others can be forced into hospitalized treatment for up to six months, although many patients are released in less than 72 hours.

"This legislation will help end the cycle of hospitalization, quitting treatment and relapse," Davis said. "It plugs a huge hole in California's safety net, offering safety, support and compassion."

But some advocates for the mentally ill believe California will return to a system of coercive treatment at the same time it is cutting back on other voluntary services for the mentally ill.

The governor's own Department of Finance opposes the measure because it would cost the state an estimated $15 million in extra court costs. Counties also would have to determine how they want to pay for the new mental health monitors that the law requires.

"People end up in crisis because the system is dysfunctional and adding a coercive measure just makes the system more dysfunctional," said Virginia Knowlton, acting legislative director for Protection and Advocacy Inc. "It's going to be costly, and it's not going to do anything to protect society from violence, and it's certainly not going to promote recovery."

Nevertheless, some advocates for the mentally ill believe the threat of a court order itself would be enough to prompt patients into voluntary treatment,

even before a judge is asked to step in.

Assemblywoman Helen Thomson, D-Davis, author of the measure, said the law protects patients by granting them legal representation, evaluation by a mental health professional and intensive follow-up treatment during their court-ordered supervision.

Thomson acknowledged, however, that nothing in the new law requires forced hospitalization or lockdown for a nonviolent patient. If a mentally ill patient lapses and simply refuses treatment, even under the court order and supervision, only a maximum of 72 hours' hospitalization can be ordered.

The law, which takes effect Jan. 1, would work county-by-county, with each board of supervisors required to authorize -- and pay -- for the program. San Francisco Mayor Willie Brown already has written a letter supporting the measure.