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‘Laura’s Law’ No Quick Fix for Strained San Francisco Mental Health System

Robin Ngai
San Francisco Public Press
 — Jul 11 2014 - 10:33am

The challenge of preserving civil rights while providing mental health care dominated debate about “Laura’s Law,” a controversial measure adopted this week that gives family members and law enforcement a legal means to compel treatment.

Proponents say the law will help families frustrated by their loved ones’ refusal to seek treatment, but service providers and activists say it is not a panacea for San Francisco’s overstretched mental health system.

The Board of Supervisors had to pick apart many more thorny issues regarding the effects of the law that rarely make it to the front pages including the city’s already overburdened mental health services and the relatively small number of people who would be affected.

Under Laura’s Law, those whose illnesses led them to jail or hospitalization in the previous three years can be forced to stand before judge, who may compel treatment. This also applies to those who have exhibited violent behavior in the previous four years.

“Families feel helpless when patients refuse treatment,” said Mark Farrell, the District 2 supervisor and sponsor of the bill. “Though our mental health services are one of the best in the country, people fall through the cracks.”

About 15 civil rights protesters gathered in the board chambers to oppose the ordinance, donning bright green shirts with the words “Force Is the Opposite of Treatment. Demand Dignity Now!” Despite the political tension, Laura’s Law passed 9-2, with supervisors Eric Mar and John Avalos abstaining.

Other sticking points continue to be raised by those seeking to repeal or amendment the new rules:

TINY BENEFIT: Eric Mar, one of two supervisors to oppose the law, said those who refused treatment were only a fraction of the thousands of mentally ill people in San Francisco. “There are 100 to 130 people who may fall into these guidelines, and it’s a small number of people who will be impacted,” he said. “I feel like it’s going down a road further stigmatizing an already stigmatized population of people.”

LACK OF RESOURCES: Michael Gause, deputy director of the Mental Health Association of San Francisco, said many nonprofit providers, some of which have contracts with city agencies, were already struggling for lack of funding. “There are not enough voluntary mental health services, and that’s an issue we can all agree on.”

MEDICAL ETHICS: “This really undermines the trust and therapeutic relationship between an individual seeking services and a provider,” Gause said.  

DISCRIMINATION: Supervisor Jane Kim cited Duke University research suggesting that Kendra’s Law, a similar law in New York, disproportionately affected African Americans and Latinos. Mar also said language barriers could stand in the way of services offered by the city.

LACK OF DATA: San Francisco is the third county in California to approve of the law, and the only urban center to adopt it. Kim said its impact was in cities with large populations of poor, homeless and mentally ill people interacting daily with police. Farrell noted, however, that 44 states have similar laws, the San Francisco Chronicle reported.

ACCOUNTABILITY: Kim tried to inject an amendment before the ordinance passed to make it a pilot program, running for either three or five years, evaluated yearly. That proposal failed. However, the supervisors accepted her amendment to have an independent source audit the program after three years to look for and prevent abuses.