Supes Spike Laura’s Law

“Laura’s Law has always been a non-starter in Mendo. We can’t afford it,” said one County official involved in the preparation for last week’s two-and-a-half-hour presentation on the “court assisted outpatient treatment” program.

Advocates think implementation of Laura's Law would help Mendo’s diminished mental health services head off the volatile mentally ill before they hurt themselves or someone else. The murders of Matthew Coleman and Fort Bragg City Councilman Jere Melo last August by Aaron Bassler mobilized Laura's Law proponents who immediately regarded Bassler as a person who, if Laura's Law had been in effect, might have been helped before he became lethal.

(Laura Wilcox, 19 and a college sophomore, was working as a mental health intern in Nevada County when she was murdered by a man who had refused psychiatric treatment. On January 10, 2001, she and two other people were shot to death by Scott Harlan Thorpe, a 41-year old man who had resisted his family's attempt to compel him to seek psychiatric treatment. Thorpe was found incompetent to stand trial and was sent to Atascadero State Hospital and was later transferred to California's Napa State Hospital. After the incident Laura’s parents chose to advocate for compulsory treatment of individuals considered to have mental illness. Scott Harlan Thorpe tried on several occasions to get help from Nevada County Mental Health by going in-person and pleading with the staff for psychiatric treatment. He was denied assistance.

The difference between Thorpe and Bassler is that Bassler, so far as is known, never sought help. In fact, he did well when he was held for prior run-ins with law enforcement at the Mendocino County Jail, indicating that his psychotic state may have been induced by methamphetamine.)

Bassler was shot and killed by a Sacramento SWAT team in the woods northeast of Fort Bragg after a 35-day intense manhunt. He was presumed to be mentally ill based on reports of family members and judged from episodes of bizarre behavior, but he was not undergoing therapy although he'd once been court-ordered to do so, attending the mandated sessions only sporadically.

The double murders prompted a number of Mendocino residents to assert that if Laura’s Law was instituted in Mendocino County, seriously mentally ill people would get the help and treatment they need and Bassler-like tragedies might be averted.

But, as former Mental Health Department staffer Roanne Withers wrote for this newspaper last October, “In reality, the chances of anyone being murdered by someone with schizophrenia are about one in 14 million. You have a much better chance of being killed in a car accident or struck by lightning. And the murder rate is actually the same for someone with or without a psychotic disorder."

As passed by the California legislature, Laura’s Law allows individual counties to opt into the Laura’s Law program, but it also requires that a variety of mental health services be in place first, and that “patients” must first decline the in-place services before they can even begin to be considered for “court-assisted, voluntary” treatment.

The assumption here is that the dangerously mentally ill can rationally negotiate existing services much less even refuse them.

Since such comprehensive services are simply not in place in most California counties, only Nevada County has set up a Laura’s Law program — under court order, not because their Board of Supervisors voted to implement it. And Nevada County was the site of the shocking murder of Laura and her two associates. And the killer had been refused existing mental health services.

No other counties have taken the plunge.

Supervisor Dan Hamburg introduced the subject last Tuesday with some history and a summary of the strict provisions of Laura’s Law, noting that there is “no funding — that’s a very important consideration here,” he added.

According to Hamburg’s background info, in the first two and a half years Laura’s Law had been in effect in Nevada County after its launch in 2008, there have been 37 people considered for the program. Twenty-two of them agreed to enter the program “under court settlement” (i.e., court pressure with threats of jail or in-patient treatment) and 11 were court-ordered into the program involuntarily. Four declined treatment and went to court to argue against it being applied to them and won.

Laura’s Law explicitly prohibits any corresponding reduction in other mental health services.

“Hundreds of people in Mendocino suffer from mental illness and lack of awareness of mental illness,” said Hamburg, noting that "many times the mentally ill don’t know they’re mentally ill. But families do."

“It’s better than jail,” according to a San Mateo psychiatrist Hamburg cited. And it “ensures care before tragedies.”

But, Hamburg said, it’s expensive, it threatens civil rights of patients, and there is the possibility of a mental health court alternative.

“As a father of a mentally ill child who looked to County mental health services for assistance five years ago and came up empty, I think we do need to do better,” Hamburg said, explaining why he favored giving Laura’s Law full consideration. “If not Laura’s Law, then something.”

“Fortunately for me, my son is doing a lot better, but that’s because my wife and I went outside and used very unconventional means to get help for our son. I know a lot of people in our County have to do the same thing. The Basslers unfortunately were not so fortunate. They apparently tried to get the attention of mental health workers and law enforcement officials but finally they resorted to some very dire situations, very difficult situations within their family and finally had to watch in horror as two men were killed and Aaron Bassler was shot dead. No parent or other loving relation of a severely mentally ill and violent person should have to go through what some of the families in this county have gone through. I’m not saying Laura’s Law is a panacea, but I do think it’s a potentially useful tool that we should have in our toolbox. Again, if not Laura’s Law, something modeled after it just to assuage the pain and suffering that people are going through in this county.”

Health and Human Services Director Stacey Cryer and recently appointed Mental Health Department Manager Tom Pinizzoto ran through a formal presentation on Laura’s Law summarizing the pros and cons.

Predictably the cons substantially outweighed the pros.

“Some provisions are already in place and available,” said Cryer, citing other laws that mandate mental health services —conservatorships, forced medication, etc. “But medications have side effects and the voluntary programs have not proven better than involuntary — although some disagree."

“Forced medication is not a provision of Laura’s Law,” noted Hamburg with agreement from Pinizzotto.

When people are nominated by family members for enrollment in the Laura’s Law program they get a court hearing with a public defender and a mental health staffer who, with County Counsel, represent the County and its intent to push the patient into treatment.

In addition, counties have to prove that they have a variety of voluntary programs in place that have been turned down by the patient before they can pressure someone into court-pressured voluntary, much less involuntary, treatment.

Public Defender Linda Thompson described the burdensome legal process and strict criteria that must be met to even go to court for a given candidate.

“Very few of my clients would be within the criteria of Laura’s Law,” said Thompson, adding that the cost of Public Defender services would be high.

“We’d be going to court every day,” Thompson said with what sounded like exaggeration. Then there would be the usual time delays and follow-up hearings to continue the patient in the program.

On further consideration, Thompson estimated that there would probably be “three or four clients every couple of months. Many of them just don’t understand what’s going on. Competency questions arise.”

Aaron Bassler’s father, Jim Bassler, told the Board that mental health court is like Laura’s Law and requires similar collaboration between various offices. “But it’s not as comprehensive," he continued. “Nevada County proves that Laura’s Law works. Yes, the services are not provided here now. But Laura’s Law is what makes mental health providers really take mental health seriously. If you do, you will want Laura’s Law.”

Laura’s Law advocate Sonya Nesch described how seven people on the Mendocino Coast now demand a variety of (mostly police) services which could be reduced if they were enrolled in a Laura’s Law program.

“Laura’s Law is not just for criminals. It gives you an opportunity to intervene before danger,” she said.

District Attorney David Eyster was clearly opposed to the idea.

“The idea that Mental Health Court is just for criminals is not strictly true,” said Eyster. “There are criminals and law-breakers. When mentally ill people violate the law they are not necessarily criminals. We are compassionate and give them a break when we can. … I have completed my investigation on the officer involved shooting [of Aaron Bassler] and I’ll have a written result coming out to the Fort Bragg City Council in early August. But I’ve found that if we had applied Laura’s Law criteria, I don’t believe Mr. [Aaron] Bassler would have been in the system. I don’t think he’d have qualified. He would not have been in the Laura’s Law structure. I say that not as an opinion or philosophy but on the facts and looking at past jail records and Sheriff’s reports and all sorts of things for me in reviewing the officer involved shooting. If we are doing things because we think it would have brought back Mr. Coleman or Mr. Melo or would have stopped that tragedy, that is no reason to do it because I don’t think Laura’s Law would have stopped that. We also have the distinction between those who are mentally ill and those who abuse drugs. We have to make sure we differentiate those. Some folks are self-imposed mentally ill [i.e., from substance abuse], others are just that way. Some just need structure and help. If I had to take one of these options, I would say please invite one of the judges down here, perhaps Judge Henderson, presiding judge, because I will make sure that one of my attorneys goes to a mental health/homeless court as we did before and we would work with Ms. Cryer and Ms. Thompson and I think that’s what we need to do because I don’t see how Laura’s Law will work effectively in Mendocino County. Nevada County put in a lot of mental health infrastructure for a relatively few people because of the strict criteria. But we have to decide what’s good for the whole, not just a few.”

Supervisor Hamburg pressed staff for advice on what a family would do now if they had a mentally ill family member. “What do people do when they need services? Who would Jim Bassler go to? I’ve been hearing lately that the letters that they sent never arrived at the offices they were sent to, which is kind of amazing.”

Unfortunately, Hamburg didn’t explain this provocative remark which suggests, well, it suggests the letters might not exist.

“But who would they go to now?” Hamburg continued. “Where would I start? What I like about Laura’s Law is that it has that efficient process to get you in the door. I couldn’t find a way to get in the door.”

First to attempt a reply was Supervisor John McCowen.

“One of the problematic issues is that Laura’s Law, even for people who, apparently, even for people with serious problems, may also not be the way to get in the door.”

“It’s not a panacea, I know,” replied Hamburg.

Mr. Pinizotto then launched into a buzzword-laced non-answer soliloquy that shed zero light:

“What’s different now is we’re more focused on outreach and engagement. Our culture within the mental health department is changing as we have gone through the last couple of years of reorganization and restructuring. Aggressive outreach engagement. We’re enhancing these programs as we speak. Just on the coast, most recently, we have awarded several service contracts. Hospitality House won a federal grant which gives additional dollars on the coast for outreach and engagement of homeless folks and people in need. Also we’ve enhanced services as we speak. What’s different now is we have increased psychiatric medication support services on the coast from 16 hours a week to 36 hours a week. … This is a timeline as well. In the past six months we’ve met with our stakeholders and have increased and expanded mental health services act programs throughout the coast. Working closely with our community partners we have funded additional children’s services. We are finding economies of scale and efficiencies and integrating and talking more. In terms of access we are now in the process of moving forward with monitoring the amount of time from when someone is first seen and our goal is to have that in five days or less.”

Next time, Mr. P., please provide subtitles for us English speakers.

Hamburg diplomatically replied, “You’re talking about people who are looking to get some help. But I’m talking about people who are not looking to get some help because they think they’re fine. But they’re scaring the bejesus out of everybody who comes in contact with them. Those are the people who I’m concerned about, frightened about, frightened for their families.”

It fell to Health and Human Services Director Stacey Cryer to state the obvious:

“It’s not a popular option, but one thing you can do today is you can always call law enforcement. They will make a determination on whether or not they should go to the emergency room, and if they need to be evaluated further.”

Cops as therapists and mental health evaluators, given the Blue Meanie mindset of Mendolib, is not what Mendolib ever wants to hear, but most cops are not only experienced in dealing with 5150s, they're better at it than many "helping professionals."

Hamburg laughed at Cryer’s bluntness. “That’s what I was always told. If I wanted to get help for my son I should put him out on the street and let him get arrested. Then he’d go to jail!"

Cryer tried to soften the point: “You don’t have to let them get arrested, you just call law enforcement.”

Sheriff Allman estimates that at any one time at least 20% of his jail inmates are mentally ill.)

Hamburg (sarcastically): “And he’d get his treatment.”

Cryer repeated, “They don’t have to necessarily get arrested.”

Hamburg: “They have to do something wrong to get stopped.”

The cop treatment option having been set-aside, Supervisor McCowen said he was “happy to see the mental health/homeless court option up there. Two sergeants with the Ukiah Police Department, Eric Baarts and Sean Kaeser, approached me probably six to eight months ago with the idea of a homeless court. They do exist in other jurisdictions. They’re effective. We currently don’t have a good system of dealing with what I would call the low level social offenses that homeless people are prone to commit. A lot of times it’s kind of a crossover. Is it mental illness? Is it homelessness? Is it substance abuse? All of the above? But the information that I read says that homeless court was an effective means of causing the people who are committing the offense to have to address their behavior and the intent was to get them to address their behavior, not to inflict punishment. But if they were not willing to change their behavior or take the steps that would be consistent with making the effort to change their behavior then there would be some consequences that would ensure that. Instead of just going to court, get a fine, go to jail, it would be get a citation, change your behavior, go to court, don’t go to jail, don’t get a fine, maybe start developing the skills that would get you out of the situation you were in. That did show a lot of promise. I had a very brief preliminary discussion with Public Defender Thompson and District Attorney Eyster. They were both favorable to the concept. I was getting pulled in other directions so I didn’t pursue it, so I’m happy to see that on the list.”

Hamburg: “If the judges are willing to participate in this we have to pull a cast of characters together and we need to do something like this because I do believe that when people go to court it’s kind of a wake up call, particularly when that judge has some power over people’s lives. I really welcome getting the judges involved.”

Public Defender Thompson then launched into a windy recitation about how hard it would be to get the judges — much less those unruly crazy people — to show up, much less participate, concluding, however, that she’d talk to the judges about it and if she had to she’d put in her own time to do whatever they end up doing.

Along the way Thompson declared that the courts are about to take a 35% budget cut themselves, a number we’ve not heard and are unable to verify.

The Board finally voted to ask staff to come back with “a plan” in late September incorporating some of the options that were discussed — not including Laura's Law.

If history is any guide, “the plan” will be that Mendocino County will continue to muddle along with what few mental health options the County offers.