LA County Board of Supes to Vote on Laura’s Law… as Sheriff Candidate McDonnell Commits Strong Support for Mental Health Diversion

EXPANDING LAURA’S LAW IN LA COUNTY

On Tuesday, the LA County Board of Supervisors will consider the issue of how best to help LA County’s mentally ill from two different perspectives.

First of all the supervisors are expected to vote to expand and fund something called the Assisted Outpatient Treatment (AOT) Demonstration Project Act of 2002—more commonly known as Laura’s Law.

Although Laura’s Law was passed by the California legislature in 2002, the statute was controversial, thus the state gave counties the option of adopting it or not.

In brief, Laura’s Law allows a family member, roommate, mental health provider, police officer or probation officer to ask the court to order a seriously mentally ill person into outpatient treatment. The law only applies to a narrow subset of people—namely the mentally ill who have landed in jail or in hospitals, or who appear to be a danger to themselves or others, but who don’t qualify for a “5150,” which mandates a psych hold. Moreover, the court can issue such an order for treatment only after an extensive and multi-layered review process.

Los Angeles and Yolo Counties already have pilot programs. Orange County has adopted the whole thing, as has Nevada County, which was where the law originated.

San Francisco approved the provision last Tuesday.

If the LA supervisors approve the expansion of the Laura’s Law pilot,—as they are expected to do—the county is expected to do approximately 500 evaluations for the program per year (up from around 50 evaluations per year during the pilot period). The expanded program would allow for around 300 people to be enrolled in outpatient treatment any given time (up from 20), plus 60 crisis residential beds.

Some mental health advocates have been adamantly opposed to Laura’s Law maintaining that it not only violates the rights of the mentally ill, it also compromises any therapeutic relationship by forcing people into treatment.

However, a similar law enacted in New York in 1999, called Kendra’s law, featured few of the feared problems and showed a range of improved outcomes for the mentally ill involved.

Some of the main supporters of Laura’s Law have been family members who say they need better tools to keep their loved ones out of jail, and off the street when they are too ill to realize they need treatment.

Supervisor Supervisor Michael Antonovich has been the board’s lead supporter for Laura’s Law.

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NOW WHAT ABOUT MENTAL HEALTH DIVERSION?

The second important discussion at Tuesday’s meeting regarding mental health will be centered on a board-requested status report from District Attorney Jackie Lacey, in which she is expected to present recommendations for “the next interim steps to be taken for mental health diversion in Los Angeles County.”

Although most of the board members seem to be, at least in general theory, for the notion of diverting some of LA County’s non-violent mentally ill away from the jails and into community treatment, the supes have been short on action on the matter. A couple of months ago, however, after voting to go ahead with a giant jail expansion plan, the board did pass a motion by Supervisor Mark Ridley-Thomas to ask DA Lacey to produce a 60-day progress report about what might be done with this whole diversion matter—hence Tuesday’s presentation. Yet, since the board has since showed no interest in factoring diversion into their calculations when ordering up a new jail, it was hard to view their commitment to the matter as full-throated.

Thus it was heartening when, on Monday, Long Beach Chief of Police and candidate for LA County Sheriff, Jim McDonnell, put out a strong policy statement supporting Lacey’s work and calling in no-nonsense terms for LA County to “fund and promote an effective network of treatment programs for the mentally ill which will provide them with the support, compassion and services they need to avoid our justice system.”

In other words, it’s time for a firm commitment by the county.

“Our Sheriff’s Department currently runs what amounts to the largest mental health institution in the nation,” wrote McDonnell, “yet our jails are not a place for those who are suffering from mental illness and who would be better served by community-based treatment options that can address the underlying problems, while still maintaining community safety. I applaud District Attorney Jackie Lacey for her leadership and her vision in developing a comprehensive plan for mental health diversion in Los Angeles County.

McDonnell also praised the recent report released by the ACLU and the Bazelon Center for Mental Health,—which provided research showing why diversion works far better for non-violent inmates, and outlined the success of diversion programs in Miami-Dade and San Francisco. (Note: The ACLU report has already drawn support from organizations and individuals such as Chairman of the LA Police Commission, Steve Soboroff.)

As for the nuts and bolts of how he would aid in getting a comprehensive diversion program funded if he is elected to head the sheriff’s department, McDonnell said that the position of sheriff offers the “influence and the ability” to help “create priorities in the county.” He also stressed that all funding need not come from the county alone, that he’d seek out other sources—noting that once those sources saw that formerly siloed groups like the sheriff’s department, the DA’s office and the board of supervisors were able to “talk to each other” and work “collaboratively and strategically” on the issue, funds were far more likely to be forthcoming.

“I think what we do here will be watched carefully by other jurisdictions across the state, and really across the country,” said McDonnell.

We think so too.

All the more reason to get going sooner rather than later.

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PS: IF WE NEED ONE MORE REASON TO PUSH HARD AND SOON for a robust mental health diversion program, let us not forget that, in June, the U.S. Department of Justice found that Los Angeles County violates the constitutional rights of inmates by failing to provide adequate mental health care and appropriate suicide prevention policies in its jails. The DOJ also encouraged the county’s efforts to expand diversion programs for those inmates with mental illness.

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AND WHILE WE’RE ON THE TOPIC: BRUTAL ATTACKS BY STAFF ON MENTALLY ILL INMATES IN NY’S RIKER’S ISLAND “COMMON OCCURRENCES”

As the LA County Board of Supervisors considers the above issues pertaining to LA County’s mentally ill, the results of a 4-month investigation into violence by staff against the mentally ill of Riker’s Island (the nation’s second largest jail) seemed perfectly—and painfully—timed to demonstrate the problem with using jails as default mental health facilities.

Here’s a clip from the opening of the alarming NY Times report, written by Michael Winerip and Michael Schwirtz:

After being arrested on a misdemeanor charge following a family dispute last year, Jose Bautista was unable to post $250 bail and ended up in a jail cell on Rikers Island.

A few days later, he tore his underwear, looped it around his neck and tried to hang himself from the cell’s highest bar. Four correction officers rushed in and cut him down. But instead of notifying medical personnel, they handcuffed Mr. Bautista, forced him to lie face down on the cell floor and began punching him with such force, according to New York City investigators, that he suffered a perforated bowel and needed emergency surgery.

Just a few weeks earlier, Andre Lane was locked in solitary confinement in a Rikers cellblock reserved for inmates with mental illnesses when he became angry at the guards for not giving him his dinner and splashed them with either water or urine. Correction officers handcuffed him to a gurney and transported him to a clinic examination room beyond the range of video cameras where, witnesses say, several guards beat him as members of the medical staff begged for them to stop. The next morning, the walls and cabinets of the examination room were still stained with Mr. Lane’s blood.

The assaults on Mr. Bautista and Mr. Lane were not isolated episodes. Brutal attacks by correction officers on inmates — particularly those with mental health issues — are common occurrences inside Rikers, the country’s second-largest jail, a four-month investigation by The New York Times found.

Reports of such abuses have seldom reached the outside world, even as alarm has grown this year over conditions at the sprawling jail complex. A dearth of whistle-blowers, coupled with the reluctance of the city’s Department of Correction to acknowledge the problem and the fact that guards are rarely punished, has kept the full extent of the violence hidden from public view.

But The Times uncovered details on scores of assaults through interviews with current and former inmates, correction officers and mental health clinicians at the jail, and by reviewing hundreds of pages of legal, investigative and jail records. Among the documents obtained by The Times was a secret internal study completed this year by the city’s Department of Health and Mental Hygiene, which handles medical care at Rikers, on violence by officers. The report helps lay bare the culture of brutality on the island and makes clear that it is inmates with mental illnesses who absorb the overwhelming brunt of the violence.

The study, which the health department refused to release under the state’s Freedom of Information Law, found that over an 11-month period last year, 129 inmates suffered “serious injuries” — ones beyond the capacity of doctors at the jail’s clinics to treat — in altercations with correction department staff members.

The report cataloged in exacting detail the severity of injuries suffered by inmates: fractures, wounds requiring stitches, head injuries and the like. But it also explored who the victims were. Most significantly, 77 percent of the seriously injured inmates had received a mental illness diagnosis….