Your son or daughter is now 18 or older. They are mentally ill. They refuse to continue with treatment and take their medication. They are saying and doing things that make you scared for your safety, the safety of your loved ones, and the people in the community. You are at a loss. You have removed any guns or weapons from your home. You have conferred with mental health providers familiar with your loved one’s case and they cannot help. You call the police and describe the situation to them. You hope they do not just come out to your home and arrest your loved one on criminal charges of making a terrorist threat, California Penal Code section 422, a strike for adults if a felony. You tell the police you want your son or daughter taken into custody on a Welfare & Institutions section 5150 hold and placed in an Emergency Psychiatric Facility on a 72-hour hold. The police come to your home and investigate. They agree your son or daughter has mental health issues that qualify them to be placed in an emergency psychiatric facility on a 72-hour hold. This same scenario occurs several times. You are back to square one in trying to get help for your loved one who refuses to get treatment and continues to act out. You cannot understand why your loved one is not referred for a mental health conservatorship and be involuntarily committed.
California has adopted Laura’s Law in California Welfare and Institutions Code sections 5345-5349. It is a California state law that allows for court-ordered assisted outpatient treatment (AOT). It is patterned after a similar law in New York called Kendra’s Law. The following counties in California have approved its implementation in their jurisdictions: Los Angeles County, Nevada County, Orange County, Placer County, San Diego County (effective January, 2016), Yolo County, Contra Costa County, and the City and County of San Francisco. To qualify for the program, the person must have a serious mental illness plus a recent history of psychiatric hospitalizations, jailings or acts, threats, or attempts of serious violent behavior towards themselves or others.
How does Laura’s Law help families? To obtain an evaluation of your loved one for Laura’s Law, a request can be made to the Behavioral Health Services Director or his designee in your county for the initial AOT examination by:
-Anyone at least 18 years of age living with the person;
-Any parent, spouse, sibling, or child at least 18 years of age;
-A director of a public or private agency, treatment facility, charitable organization, or licensed residential care facility providing Mental Health services to the person ;
-A director of the hospital where the person is hospitalized;
-The Licensed MH treatment provider supervising treatment of or treating the individual;
-A peace officer, parole officer, or probation officer assigned to supervise the individual.
Upon receiving a request, the BH Director or his designee must conduct an investigation into the appropriateness of the filing of the petition. Substance abuse alone does not meet the criteria for AOT services. Aggressive or violent behavior as a result of substance use solely does not meet eligibility for AOT services. Homeless status with substance use solely does not meet eligibility requirements.
What must a court find to order AOT services? A person may be placed in assisted outpatient treatment (AOT) if, after a hearing, a court finds that the following 10 criteria have been met. The patient must:
-Be eighteen years of age or older;
-Be suffering from a mental illness;
-Be unlikely to survive safely in the community without supervision, based on a clinical determination;
-Have a history of non-compliance with treatment that has either:;
-Been a significant factor in his or her being in a hospital, prison or jail at least twice within the last thirty-six months or resulted in one or more acts, attempts, or threats of serious violent behavior toward self or others within the last forty-eight months;
-Have been offered an opportunity to voluntarily participate in a treatment plan by the local mental health department but continue to fail to engage in treatment;
-Be substantially deteriorating;
-Be, in the view of his or her treatment history and current behavior, in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would likely result in the person meeting California’s inpatient commitment standard, which is being a serious risk of harm to himself or herself or others; or gravely disabled (in immediate physical danger due to being unable to meet basic needs for food, clothing, or shelter);
-Be likely to benefit from assisted outpatient treatment; and
-Participation in the assisted outpatient program is the least restrictive placement necessary to ensure the person’s recovery and stability.
If the court finds that the individual meets the statutory criteria, the recipient will be provided intensive community treatment services and supervision by multi-disciplinary teams of highly trained mental health professionals with staff-to-client ratios of not more than 1 to 10 and specified additional services for persons with the most persistent and severe mental illness. The law specifies various rights of the person who is the subject of a Laura’s Law petition as well as due process hearing rights. The bill also provides for voluntary settlement agreements as an alternative to the hearing process.