Public Comment

Response to "Laura's Law in A Nutshell"

By Jack Bragen
Sunday September 25, 2011 - 11:05:00 AM

Court-ordered, intensive, outpatient treatment. What would this look like in practice? Well, a couple of beefy guys would restrain a psychiatric patient, and a nurse would shoot antipsychotic medication into the person’s ass. It would not be a pretty sight. The side effects of the medication come later. Will the workers have the time to remain on site for the next twelve hours to monitor side effects? Doubtful. If the person is having muscle spasms or rigidity, or perhaps neuroleptic malignant syndrome, who do they call for help? Who will answer when they call? 

What would it look like if we tried to “help” the homeless people that way? Well, a group of enforcers would have to go out on the streets to find homeless people, or maybe they would be found at the soup kitchens, these people would be pinned down, and they would be shot in the ass with a big dose of antipsychotic medication. By the way, the person might not also be given food, shelter and medical attention, urgently needed by homeless people. Instead they can go hungry and cold while the antipsychotic medication is going to work on them. Side effects won’t bother them, will they? Is the term; “rational decisions” defined in this law? Who decides if someone is making “rational decisions”? Is it a “rational decision” to join the Army and fight for your country? Is it a “rational decision” to marry your high school sweetheart? Maybe those people should get treatment. Is the only possible “rational decision” under this law: “Yes I need medication and I will submit to any treatment passively that you want to give me”? That’s a fairly limited definition of rational decision making. 

180 days isn’t a very long time, is it? Well, that works out to six months. That’s a half a year of being physically restrained and shot up with medication, which will likely be on a weekly basis. What legal offenses are there that provide six months in jail? Or maybe six months of house arrest? Such a sentence is usually reserved for significant crimes. What “crime” is this person guilty of? Not taking their medication?  

What about us mentally ill people who are behaving well? Is there any guarantee that we will be left alone by the medication enforcers? Or will we be required to pass a “wellness check” every week? What if we have some type of ambitions in life, and don’t have time to do the wellness check every week? What if we are not complying exactly to all prescriptions because one of them is creating undue discomfort, and we haven’t yet met with our doctor to get it changed? What if us “well” mentally ill people don’t need a mental health social worker on our backs on a constant basis? Sometimes we like to forget that we are a mental patient. Just for a day maybe. 

How else will the people be found to shoot up with medications, other than with such a monitoring system? And what about Laura Wilcox? My heart goes out to her family. Restraining the lives of all mentally ill persons will not bring her back. Far more people get shot in Oakland or Richmond, or New York City on a constant basis by criminals who are not mentally ill. Mentally ill people are responsible for relatively few deaths, and the lives that are taken are often our own. When hope is taken away by Laura’s Law, there may be more suicides. 

Before Laura’s Law, laws were already in place to help mentally ill people who have deteriorated. These laws protected our civil rights while allowing timely intervention. In fact, when someone is in crisis and wants to go to the hospital, often there is not sufficient bed space or the person may not have adequate health coverage. Implementation of this law would take essential money away from programs that empower mentally ill people who are doing well, such as help with getting jobs or with meeting our daily needs, or perhaps a drop in center that gives people hope that there is something more than being medicated for us on the horizon. 

A correspondent of my column says the following: 

“The legal ability to force medical treatment exists. When that medical treatment involves physical health, it is rarely employed, and highly protected from misuse. When it involves mental health treatment force has evolved to almost the prevailing model, and few if any protections exist against it. 

“When the two models coincide, are equal in every legal aspect, I will support them, so long as they are not, I cannot. 

…“The greatest fear I have is the absence of protections against force in the area of mental health. The offer to "choose" voluntary over involuntary is itself an act of force: "You choose voluntary, or I force involuntary" is force.” 

--Harold A. Maio, retired Mental Health Editor