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An Rx Against Violence

April 14, 2002

Imagine a train wreck that scatters passengers across the landscape. Paramedics arrive and begin loading the injured onto stretchers. But when anyone screams out in pain, "No! Don't touch me!" the medics nod compassionately and leave that person sprawled amid the rocks and cactuses.

A similar scene has been unfolding on the urban landscape for the last 40 years. People with severe mental illness, tossed from state hospitals, have landed on public sidewalks and in wretched urban encampments. And no one helps them because they say they don't want help.

It's time for society to reevaluate this perverse arrangement.

Senate Health and Human Services Committee Chairwoman Deborah Ortiz, a Sacramento Democrat, is presently deciding when, or whether, to schedule a vote on a bill by Assemblywoman Helen Thomson (D-Davis) that would give authorities more power to impose treatment.

AB 1421, or "Laura's law," would let judges compel some severely mentally ill people to accept supervised outpatient care. A person whose voices were telling him to hurt himself or someone else, for example, could be forced to attend counseling sessions with a psychologist or psychiatrist and to take prescribed stabilizing medications.

The bill is named after Laura Wilcox, a 19-year-old high school valedictorian killed along with two other people in Northern California last year by a man whose mental illness went untreated. Existing laws had left his family, the police and mental health professionals impotent to intervene.

Civil libertarians have defeated the bill twice now, by persuading legislators--notably Senate President Pro Tem John Burton (D-San Francisco)--that no one should be forced to take medications against his or her will. Thomson's bill, however, has been amended numerous times to provide comprehensive civil rights protections. It would let judges order treatment only after mental health professionals, social workers and family members had carefully deliberated and decided that without intervention a severely mentally ill person would be at ''high risk'' of injury to himself or others.

Of course, society must guarantee that no patient is ever again subjected to the sort of abuse that was rampant in the psychiatric "snake pits" of the late 1950s and early '60s. But those who focus solely on worries about mistreatment need to understand something that the families of people with severe mental illness and other activists pushing for Laura's law know all too well: that lack of treatment can be just as bad.

Couple this shared compassion for a vulnerable population with the fear among people whose children or spouses have been attacked by individuals who needed medical care and it becomes very clear why California needs to restore a balance between rights and responsibilities. This was lost when civil libertarians passed laws that not only liberated mistreated patients but granted some the new freedom to harm themselves and others in a never-ending cycle.

Only a small percentage of people with serious mental illness are the least bit violent. But since Laura Wilcox's death in January 2001 the state's failure to give assertive treatment to those who need it has led to many other tragedies.

Just days after a man suffering from severe paranoia shot Wilcox, a trucker known to become erratic when he wasn't on medications rammed his 18-wheeler into the state Capitol and died in the crash. In San Bernardino, a man with paranoid schizophrenia killed his mother on Mother's Day. And last month San Diego police killed a man who had been released that morning by a psychiatric hospital without mandatory follow-up treatment.

Los Angeles County Sheriff Lee Baca and the California Peace Officers Assn. recently threw their important support behind Laura's law. Ortiz, her colleagues in the Legislature and Gov. Gray Davis should do the same.

Term limits will push Assemblywoman Thomson out of state office this fall. It may be a while before another politician has the courage to pick up this cause--one that is all too easy for so-called leaders to ignore. The time to pass this important, long-delayed bill is now.

To Take Action: Call or write state Sen. Deborah Ortiz, (916) 445-7807, the chairwoman of the Senate Health and Human Services Committee, where the bill will face its biggest challenge. Or write to your own senator, whose address you can find on the Web at www.sen.

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