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Forced Mental Care Possible Under Law

By Jim Sanders -- Bee Capitol Bureau
Published 2:15 a.m. PDT Sunday, September 29, 2002

AB 1421 was hailed by Gov. Gray Davis as landmark legislation allowing courts to mandate outpatient treatment for severely mentally ill people who reject voluntary programs.

Proponents say the current system tends to wait too long to treat mentally ill people, then incarcerates or hospitalizes them for brief periods before releasing them to begin the cycle again.

Davis called AB 1421 -- by Democratic Assemblywoman Helen Thomson of Davis -- a critical step in mental health treatment that "plugs a huge hole in California's safety net, offering safety, support and compassion."

"This legislation will help end the cycle of hospitalization, quitting treatment and relapse," Davis said.

But opponents claim the measure violates civil rights by allowing courts to order treatment for mentally ill people who didn't seek it, don't want it, and are not necessarily a threat to society.

"It's going to make a dysfunctional mental health delivery system even more dysfunctional," said Virginia Knowlton of Protection and Advocacy, a private, nonprofit law firm focusing on the civil rights of disabled people.

AB 1421 authorizes -- but does not require -- counties to launch programs leading to court-ordered treatment of the mentally ill. The legislation does not provide any new funding.

Saturday's signing ended months of bitter fighting over the bill, named "Laura's Law" in honor of Wilcox, 19, a Nevada County Mental Health Office employee who died from shots allegedly fired by a mental health patient, Scott Harlan Thorpe.

Thorpe was arrested on charges that he killed two people and injured two others at the mental health office, then traveled to a Grass Valley restaurant, where he allegedly killed the manager and injured a cook.

Thorpe told his brother that he shot people at the mental health facility "because he felt his doctor there was working with the FBI to harm him" and he went to the restaurant because he believed "management was poisoning his food," according to court documents.

Thorpe ultimately was found incompetent to stand trial and ordered to obtain treatment, first at Atascadero and then Napa state hospital.

Shortly after Davis signed AB 1421, Nick and Amanda Wilcox, Laura's parents, said such legislation might have prevented their daughter's death if it had been in effect prior to the January 2001 shooting spree.

"While we have nothing personally to gain by this bill, our hope is that it will save lives and help spare terrible tragedies," Nick Wilcox said.

Thomson said her bill, patterned after "Kendra's Law" in New York, is designed to promote thorough, compassionate treatment without infringing on civil rights.

"It's protective of patient rights and has been so from the beginning," she said.

Current law permits the arrest and forced treatment of mentally ill people deemed a danger to themselves or others, or who can't provide for their food, clothing, shelter or other basic needs.

But Thomson and others claim the system has huge holes, often leading to brief, inadequate treatment of some while ignoring the needs of many others who are severely disabled but don't meet the legal threshold for arrest.

AB 1421 would allow courts to order up to six months of outpatient treatment for a seriously mentally ill person whose history suggests he or she could become dangerous or gravely disabled without such care.

The goal is to provide such disabled residents with individualized care that could include physical health care, psychological treatment, medication, housing and other services.

Anyone who is the subject of a court hearing to consider mandated treatment has the right under AB 1421 to legal representation and can call or cross-examine witnesses.

While judges can mandate treatment under the new state law, they cannot order someone jailed solely for violating their order. Earlier drafts of the measure allowed enforcement of a judge's order by police, but that provision was stripped in the Senate. Advocates said experience in other states shows most patients comply with such orders.

Statewide, costs stemming from AB 1421 are unknown but could total tens of millions of dollars, depending on how many counties launch such programs, a legislative report said.

Critics say the bill will increase distrust of mental health programs.

"When people experience coercion, they run," said Sally Zinman, executive director of the California Network of Mental Health Clients. "It's going to hurt (existing) programs tremendously."

Zinman said AB 1421 won't end the fight over mandated treatment. "All it's done is transfer the battlefield to the counties," she said. "This same conflict will now be played out in whatever county attempts to do this."

AB 1421 will become state law Jan. 1 and will expire in 2008 unless extended by lawmakers.