My name is Dave Pilon and I am the CEO for Mental Health America of Los Angeles, a chapter of the nation’s oldest mental health advocacy organization. I am here today to express my concerns about the County’s proposed adoption of AB 1421, otherwise known as Laura’s Law.

 

I believe that there are well-meaning and well-intentioned people on both sides of this debate.  I have nothing but sympathy and concern for family members whose loved ones have not chosen to accept mental health services and are suffering in the community.  I think that in large part the system has failed these families because we have been unable to make our voluntary services relevant or welcoming or desirable to their loved ones.

 

However, MHA is on record as being against the implementation of Assisted Outpatient Treatment.  We have taken this stand because we believe that services offered without coercion will ultimately be much more effective.  We also believe that the existing scientific evidence is at best unclear as to whether adding a court order to enforce treatment, what is sometimes referred to as the “black robe effect,” actually makes it more likely that people will accept and participate in treatment.

 

It is our belief that what is helpful, and what is currently missing, is intensive outreach and engagement, services that meet people where they are and build a relationship that makes people want to accept them.  In this respect, we are encouraged by the approach that the County Department of Mental Health intends to take if the Board adopts this proposal – What Doctor Southard has referred to as “engagement on steroids.”  No one should mistake my opposition to court-ordered treatment as opposition to this type of enhanced outreach and engagement.  We are in complete agreement that this is exactly what these people need.  What we don’t believe is that it is necessary couple these services with a court order.

 

However, should you go forward with this proposal, in the spirit of collaboration and cooperation, MHA proposes that you direct the Department of Mental Health to work with MHA and the Treatment Advocacy Center to develop an evaluation component for this program that is specifically designed to answer the question: Is a court order necessary and does it actually increase the likelihood that people will accept services and improve their outcomes?  While an evaluation of this nature would add slightly to the upfront costs, it has the potential for saving money in the long run if the results suggest that the resources needed to support the involuntary component of the program do not substantially improve patient outcomes.

 

But more importantly, the United States has always been a country in which we take civil liberties, and the occasional need to limit them, very seriously. The people whose liberty may be limited by this law deserve to know that we are making every effort to keep those limits to a minimum. By providing for an evaluation of the necessity of a court order, you will be taking an important step that will serve to protect their civil liberties.