San Francisco Set to Implement Laura's Law, Compels Treatment for Mentally Ill

Starting next week, San Francisco will be the fifth county in the state to implement Laura's Law, the measure that allows judges to force severely mentally ill people to get treatment.

The measure is targeted toward people who are resisting care and have a history of hospitalization, incarceration or violence. Family members, mental health providers or police officers can petition the court to compel patients into outpatient treatment, though patients cannot be forced to take medication.

“Living with a mental illness is a constant struggle,” says Cedric Fotso, a peer specialist with San Francisco’s program who has resisted treatment for his own mental health diagnosis. “Stigma is one of the many obstacles to overcome when seeking care.”

Other people are in total denial of their illness, or believe they are cured if symptoms lessen after a hospital stay, says David Fariello, a clinical social worker at UCSF and director of Citywide Case Management Programs, which will treat patients referred through Laura’s Law.

“A lot of these folks also have a very strong distrust of institutions and police, so we get thrown into all that, because we’re an agency,” he says. “Particularly people who’ve lived on the streets, in order to survive, they’ve developed this distrust of others. So it’s very hard to engage folks like that.”

Laura’s Law was named for 19-year-old Laura Wilcox, who was killed in 2001 by a  psychiatric client at a clinic in Nevada City.

The state passed Laura's Law in 2002, but left it up to counties to choose to implement it. For a while, only Nevada County did. In 2013, the state made more money available for the program, by allowing counties to use funds from Proposition 63, a state law that taxes millionaires to expand mental health services. Since then, more counties have been adopting Laura’s Law, most recently, San Diego, Kern and Contra Costa counties.

Public health officials estimate only about 100 people in San Francisco will meet the strict eligibility requirements of the program every year, though they hope more people will be guided toward treatment voluntarily. They estimate that treatment costs will be $40,000 per person, per year.

Opponents of Laura's Law say it infringes on people's civil rights. They worry that people of color will be disproportionately targeted for court-ordered treatment.

San Francisco's Laura's Law program, called the Assisted Outpatient Treatment program, will begin serving patients Nov. 2. Referrals can be made at www.cdph.org/aot or by calling 844-255-4097.