The citizens of Stanislaus County who overwhelmingly support the adoption of Laura’s Law received a regrettable lesson in cynical politics last week.
Ignoring decades of peer-reviewed studies, support from nearly every major national organization impacted by severe mental illness and the actual experiences of counties across California, consultants argued those many experts were mistaken and the program is actually of little use. (“No proof that Laura’s Law is helping the severely mentally ill, study say,” Page 1A, July 31)
This finding no doubt comes as a surprise to San Francisco Mayor Ed Lee, who singled out his county’s program in his 2017 state-of-the-city speech saying, “Laura’s Law works.”
Or the San Diego Board of Supervisors, who voted to adopt Laura’s Law after years of attempting a strategy of expanding voluntary-only programs as recommended by these consultants.
Or to Orange County, whose Laura’s Law program reported participants experienced a 70 percent decrease in days of inpatient hospitalization, a 75 percent decrease in number of days incarcerated and a 76 percent decrease in homeless days after admission to the county’s Laura’s Law program.
Or to Resource Development Associates, the independent research group that evaluated Alameda County’s pilot program and recommended in March that it expand the number of slots available based on its results.
The Results Group’s unsupported conclusions show a fundamental lack of understanding of Laura’s Law and its goals.
For example, the group discounts comprehensive peer-reviewed data from U.S. research in favor of data from other countries studying entirely dissimilar programs. The consultants rely on data of a community treatment program in Great Britain that fails to include a court order, a component that U.S. research shows is key to the success of programs like Laura’s Law. Such a mistake is akin to comparing Interstate 5 to a farm lane in Wales – both are roads, but very few would mistake one for the other.
Throughout the report, the consultants attempt to pit Laura’s Law against Assertive Community Treatment, In-Home Outreach Team and other intensive services. Laura’s Law is not an alternative to such programs, but a means of ensuring the most severely ill are able to engage in such services more effectively. It is all of those services, plus a court order to engage individuals who are too sick to seek treatment voluntarily.
This misstatement by Results Group demonstrates a frightening lack of understanding as to what they were actually evaluating.
Laura’s Law, far from competing with voluntary services, statutorily requires the participant have first been offered the opportunity to participate in high intensity services but has refused to do so.
Attempting to restrict all programs to solely voluntary participants ignores the wealth of scientific research showing that for a small but significant percentage of those with the most severe mental illness, the inability to engage voluntarily is a direct result of their illness. Such lack of insight, referred to as anosognosia, is different than denial and ensures there will be no “rock bottom” moment in which the person sets aside their delusions. Their illness makes them physically unable to do so.
Laura’s Law programs across the country have consistently shown large net decreases in costs specifically because they are able to ensure consistent participation in treatment. Without such care, those in need still receive services, but only when in crisis or after arrest – the most expensive possible options.
For the people of Stanislaus County with serious mental illness and their families, wasting time rehashing old arguments and unnecessarily reinventing the wheel only delays care and guarantees further tragedy. The time for adoption of Laura’s Law is now – in fact, it is far overdue. We know what works, now families must hope their county supervisors recognize that reality.
John Snook is the executive director of the Treatment Advocacy Center, based in Arlington, Va. He wrote this for The Modesto Bee.