Santa Maria Sun / Cover Story
The following articles were printed from Santa Maria Sun [santamariasun.com] - Volume 12, Issue 37
Look into Laura's LawA California law would help parents arrange help for their seriously mentally ill adult children who refuse treatment
BY ED CONNOLLY
Imagine circumstances force you to again live with your parents, to return to your childhood home: You lost your job, were evicted; your friendships have unraveled; the world seems hostile. Instead of understanding your plight, your father and even your mother insist your behavior caused these problems, you are to blame, you aren’t thinking clearly, you need mental treatment. The next thing you know, staffers from the Santa Barbara County Department of Alcohol, Drug, and Mental Health Services are at the door gently offering help, which you decline. You turn them away because you know it certainly isn’t you who’s not thinking clearly. Eventually, the injustices become too great to bear.
“He said, ‘I’m not crazy, all of you are crazy,’” Richard Detty recalled about his son Cliff, who, at age 46, died alone last year, unattended while in restraints at the Santa Barbara County Psychiatric Health Facility, where he had been transported from the Marian Medical Center emergency room in Santa Maria. “My son, when he was young, was the son every father wants. Everything he did—sports, academics—he was the best. But from his 20s onward, he never lived a normal life. We suspected drugs for a long time. And we told him we wouldn’t help him if he got in trouble with drugs. He was arrested around age 34.
Detty went on to tell the Sun Cliff was arrested 17 times and was confined in Atascadero State Hospital for a while.
“We tried to get him help, but he refused. ... We went out to both the Santa Barbara County and San Luis Obispo County mental health offices, but they told us they couldn’t talk with us unless we got a signed authorization from him,” Detty recalled.
Cliff never gave permission for his father to intercede, and only by chance during one of the intervals while Cliff lived with him and not on the streets did Richard learn his son had long before been diagnosed with paranoid schizophrenia. A powerful series of articles by Lara Cooper in Noozhawk, an online news magazine based in Santa Barbara, details the tragic circumstances of Cliff Detty’s life and death (see noozhawk.com/local_news/article/083010_cliff_detty ), spurring the Santa Barbara County Mental Health Commission in September 2010 to reconsider Laura’s Law, which would enable immediate family members, provided they are at least 18 years old, of such adults as Cliff to formally request intervention by county mental health professionals.
The California law is named for Laura Wilcox, a 19-year-old sophomore from Haverford College who, while working at the Nevada County public mental health clinic during her winter break, was one of three people fatally shot by a mental patient whose family failed to convince him to continue treatments. Her assailant was found incompetent to stand trial and was remanded to Atascadero State Hospital and later to Napa State Hospital. Neither Amanda nor Nick Wilcox, Laura’s parents, blame her killer for her death because they believe he was entirely unaware of his actions. Cognitive impairment is the signature of schizophrenia.
The measure, which was introduced in the Legislature as Assembly Bill 1421, was passed and signed into law in 2002. It stipulates conditions that justify waiving privacy protections for a family member and authorizes the civil court to order “assisted” outpatient treatment in response to a valid petition from county mental health officials. However, the state leaves the decision whether or not to implement the law to the discretion of county supervisors.
If a person is diagnosed with a serious mental illness that has led to hospitalizations or arrests within three years of the petition, or serious violence toward self or others within two years of the petition, and if she or he has refused treatment and is at grave risk of relapse, cannot safely survive alone, or would likely deteriorate to the point of self harm or harm to others, the court can order the person to accept outpatient therapy. The treatment plan can include antipsychotic drugs, though they can’t be administered involuntarily. Patients can’t be forced to comply—there’s no penalty for contempt of the court order—but if they don’t, the court can order them to be held involuntarily for observation for 72 hours under the state’s 5150 code, and they can be subsequently confined to a hospital if they meet the criteria of that statute—in other words, if they’re deemed a threat to themselves or others.
Laura’s Law essentially provides a way for families to arrange voluntary intensive outpatient treatment under court authority for a seriously ill member, to prevent a violent outburst and police response. It’s the last avenue before confinement to a mental institution, jail, or worse.
Bad day at Black Road Auto
Lee Isaac Bedwell Leeds murdered four people in March 2008 at Black Road Auto in Santa Maria, including his father, who owned the business, a wrecking yard. He suffers from paranoid schizophrenia. Leeds was arrested, confined to a state hospital for treatment, and was shuttled to court multiple times for hearings to review his mental condition until May this year, when he was finally found competent to stand trial. Leeds admitted committing the quadruple deadly shootings but has pleaded not guilty by reason of insanity. A trial to determine whether he was insane is scheduled for January. Had his father or other family members contacted county mental health services to arrange therapy, the answer would have been like the replies Richard Detty got. In 2003, the last time the county considered implementing Laura’s Law before Cliff Detty’s case moved the Mental Health Commission to re-examine the issue, the county decided against putting it into effect.
Then there’s the case of Kerry Flood, whom a sheriff’s deputy shot dead during a struggle inside his mother’s mobile home in Orcutt in April while she was present. The home is in a retirement park where deputies were summoned by a complaint about a man who was acting irrationally and not wearing clothes in the community hot tub. The two deputies traced him to her home and entered after talking with her, intending to question him about the complaint. According to the district attorney’s report of the incident, Flood instantly attacked them with a concrete paving block, giving the officer who fired in self defense a concussion. The officer described Flood as the most aggressive individual he had dealt with during his 14-year career in law enforcement. Flood’s mother told investigators he had been diagnosed with paranoid schizophrenia when he was 19 years old and was discharged from the Navy at that time. She, too, had no legal ability to arrange treatment for her son.
The predicament police and sheriff’s deputies face when confronting psychotic individuals is well known by the county Department of Alcohol, Drug, and Mental Health Services. Officers from law-enforcement agencies throughout the county attend annual crisis intervention training seminars to help them respond to people in psychiatric distress.
What did the Mental Health Commission, the department’s advisory board, decide when they reconsidered the law last year? “There was a decision that no, [Laura’s Law will not be implemented] but let’s make a more concerted effort than maybe we had been doing, in a more concentrated way, to make it known to individuals in the community that there is a way they can contact our department when they’re worried about someone and that we will make a focused effort to respond,” Ann Detrick, director of the Santa Barbara County Department of Alcohol, Drug, and Mental Health Services, told the Sun.
The idea is to make sure families with members who have serious mental illness know the department wants to provide treatment and will approach the individual several times to offer help, which she or he is under no obligation to accept. Asked whether that amounts to more of the same approach the department already has taken, Detrick answered, “Yes, I think you’re probably right about that.”
Detrick pointed to the cost of court proceedings as a factor in the decision not to implement the law.
Ann Eldridge, a mental health commissioner who advocates that the county implement Laura’s Law, said on behalf of the department, “What we are doing is a little more than what has been done. This is assertive outreach and engagement.
“In the pilot program that just started in March, the workers are instructed to keep on being engaged,” she continued. “We’ve had a couple of people for whom it seems to be having effect. It boils down to the power of persuasion. I am a proponent of Laura’s Law because it takes the onus off the mental health worker from being the bad guy, especially when it comes to 5150 holds. And people do seem inclined to respect the authority of the court.”
Carla Jacobs, a director of the Treatment Advocacy Center, a national organization that lobbies for the reform of treatment laws to better serve people who have the most severe and debilitating brain disorders, is skeptical of the outreach program the county put in place instead of Laura’s Law.
“It’s the same old, same old I’ve heard for 20 years that mental health departments will increase their outreach. I wish it were the case that if they are very, very nice people will come to them, but that is not the case,” she said. “Yes, we should have a very robust voluntary system, but we, in fact, have a system in which the most severely impaired individuals are left to suffer their delusions by themselves.
“My sister-in-law was mentally ill, on the streets with her small son. My husband and I tried to get help for her for two years but because she was not yet considered a danger to herself or others, she did not qualify for treatment. She took a cab 70 miles, shot and stabbed her mother to death, and was found not guilty by reason of insanity. She bought the gun at a yard sale.”
Eldridge said, “We’ll look closely at what our outcomes are compared with Nevada County.”
Nevada County received a 2010 Challenge Award from the California State Association of Counties for the assisted outpatient treatment program it conducts under Laura’s Law. Beyond commending the county for improving life for severely ill patients, the award announcement lauded the program for saving money: “Program costs of $80,000 were offset by savings estimated at $203,000, based on decreased hospitalization costs and reduced incarcerations.”
Two other counties in particular are looking closely at Laura’s Law to avoid another potential tragedy. Mendocino County supervisors will take up the issue of whether to implement the measure in the wake of two homicides allegedly committed by Aaron Bassler, who was severely mentally ill.
After the murders (one of the victims was a former mayor and at the time a councilman of Fort Bragg), the 35-year-old Bassler fled deep into the dense woods beyond the city, eluding dozens of law enforcement officers for weeks until he was tracked down by bloodhounds, cornered, and shot by SWAT sharpshooters. Months before the crimes, Bassler’s father pleaded with the county mental health department and the court system to provide help for his son because of his increasingly bizarre and menacing behavior, to no avail.
Bassler’s arrests stretched back to the early ’90s. He was unable to hold a job. In 2009, he was arrested for throwing what appeared to be explosives into the Chinese consulate in San Francisco. But the items weren’t bombs; they were drawings of Martians, Chinese weapon designs, and a black jumpsuit with red stars. As a result of that episode, the court recognized he suffered from a mental illness, and he was enrolled in a pre-trial diversion program that included regular appointments with a doctor. According to his father, he reluctantly complied. But that program was not intensive enough to quell his symptoms. In February, he crashed his truck into a school tennis court and was jailed. His father begged jail personnel, the court, and staff at the mental health department to arrange treatment, but was turned away.
Bassler’s father is convinced Laura’s Law would have prevented the tragedies and is campaigning for its implementation by the supervisors.
Orange County supervisors will vote on whether to implement Laura’s Law following the death of Kelly Thomas, a schizophrenic transient man who died after an alleged beating by two Fullerton police officers outside a bus station. One of those policemen is charged with second-degree murder in the death; the other is charged with involuntary manslaughter. County health officials have issued a report discouraging implementation of the law by the supervisors, citing costs. Thomas’ father is a staunch advocate for the measure.
Randall Hagar, the government affairs director for the California Psychiatric Association, which represents more than 3,300 psychiatrists statewide, said, “Psychiatrists often pick up the pieces when patients go to jail or end up in the hospital. They see the results of tragedy. We not only support the law, I helped draft the bill. It is counterintuitive and defies common sense why people would oppose this opportunity for treatment. We see Laura’s Law as an early intervention, not a panacea, to enable treatment for people who do not realize they are sick.”
His son was diagnosed with schizophrenia.
“The ability to intervene in a predictable series of events is what sets Laura’s Law apart from other legal avenues, which are available only after violence occurs,” Hagar concluded.
Santa Barbara County Supervisor Steve Lavagnino, whose district includes Santa Maria, joined the Mental Health Commission after the decision last year not to implement Laura’s Law. He told the Sun, “I’m open to hear both sides of the argument. I have an autistic son, who will soon be an adult, who is the opposite of violent, introverted. But I can appreciate what limitations parents face who seek help for adult children. My insurance agent is Rich Detty, and I know his situation very well.”
Where does Detty stand?
“The main problem I had was the front-line people who were involved were police, and they don’t seem to have the training to deal with situations like Cliff’s,” he said. “If Laura’s Law was available, any family member could have called to have him evaluated before he got into trouble. Parents should have the right to intervene for their children if they are ill, no matter what age they are.”
Ed Connolly is the Sun’s opinion editor. Contact him at firstname.lastname@example.org.
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