By Jeff Adachi

Special to the SF Examiner

Mental illness is not a crime. Assisted outpatient treatment, also known as Laura’s Law can stop us treating it like one. But the plan’s success rides entirely on its proper implementation.

As the public defender, my office represents more than 3,500 people with serious mental illnesses each year. We are mandated under city and state law to defend the interests of our clients and advocate on their behalf.

I support assisted outpatient treatment as long as its implementation is done legally, responsibly and thoughtfully.

Criminalization of people with organic brain diseases like schizophrenia is our national shame. Recent studies show approximately 1 in 5 people behind bars suffers from a severe mental illness.

I have seen it daily in my 30 years working in the justice system, people in desperate need of help shuffled from jail to prison to shelters to emergency rooms. And with each cycle, they lose their tenuous hold on health care and housing.

Laura’s Law holds the potential to strengthen San Francisco’s psychiatric health system while healing the lives of families struggling with mental health challenges.

I recently had the opportunity to learn firsthand about the practical aspects of Laura’s Law from Judge Thomas Anderson, the former Nevada County public defender.

Nevada County remains the only county in the state that has implemented the plan. Judge Anderson, who was placed in charge of the county’s assisted outpatient treatment court in 2008, reports that in more than 75 percent of their cases, the intervention of their outreach team resulted in a person in crisis receiving treatment. Most importantly, the outreach provided that person with the stability to remain free of forced commitment in the hospital or jail.

As a result, the incarceration rate of mentally ill people in Nevada County was reduced by 65 percent. The law also resulted in fewer criminal cases filed against the mentally ill in favor of civil proceedings and outcomes that took patients out of the criminal justice system.

The statistics are impressive. However, Laura’s Law is not a panacea for proper mental health care or a cure for homelessness.

According to Judge Anderson, it will likely only serve a small population of those who are most severely mentally ill.

In Nevada County, which has a population of 90,000, only 37 people were referred to assisted outpatient treatment in the first two years following implementation of Laura’s Law. Currently, more than 23,000 San Franciscans receive mental health treatment through The City’s Department of Public Health.

If the percentages of clients served in Nevada County hold true for San Francisco, only 1 percent of this group would be referred to treatment under Laura’s Law each year.

I believe it is absolutely necessary to form a strong oversight committee to ensure Laura’s Law is not abused and that only cases that meet the legal criteria are allowed.

Supervisor Mark Farrell, who has introduced the Laura’s Law legislation, has committed to work with my office and other agencies to enact additional legislation to ensure fair and responsible implementation of the law.

With these protections, and if all the participating agencies work together through the court process, we can begin making real change by addressing citizens’ mental health needs before a crisis occurs. We have experienced this success through our city’s Behavioral Health Court.

The collaborative court has become a national model in stabilizing the lives of people with mental illness through coordinated treatment and services, coupled with court supervision.

The criminal justice system has been described as society’s emergency room. But severe psychiatric disorders require a commitment to ongoing care.

Laura’s Law holds the promise of decriminalizing mental illness, but only if we do it right. The lives of vulnerable San Franciscans depend on it.

Jeff Adachi is the public defender for San Francisco.


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