Laura’s Law Aims to Make Assisted Outpatient Treatment a Family Affair

Under Laura’s Law in San Francisco, high-risk severely mentally ill people won’t be forced to take medications and they won’t be forced to comply with a court order for assisted outpatient treatment, but their families will be able to seek out mental health care for their loved ones like never before, according to city officials.

Laura’s Law, which was passed in the state legislature in 2002, is named after Laura Wilcox, a 19-year-old college student who was working at a mental health clinic in Nevada County in 2001 when she was fatally shot by a psychiatric patient who had resisted his family’s efforts to get care.

Only four California counties have implemented Laura’s Law so far and on Nov. 2, San Francisco will become the fifth to do so.

Under Laura’s Law, the city’s new assisted outpatient treatment program will start serving the community and “will add another option for family members seeking to help a severely mentally ill relative,” San Francisco Mayor Ed Lee said today.

The mayor said that with medical professionals working with the family, instead of just the individual patient, they have a chance to find a more sustainable approach for the patient’s treatment.

Lee said he hopes the city’s program will result in “a more compassionate approach to dealing with mental illness.”

Laura’s Law is designed to assist adults who have a documented severe mental illness, who are not actively engaged in care, are in deteriorating condition and have a history of failing to comply with treatment.

The hope, said Dr. Angelica Almeida, a psychologist with the Department of Public Health and the director of the Assisted Outpatient Treatment program, is to get mental health services to individuals with a documented history of mental illness before they enter a state of crisis.

She said the program is founded in the principle that recovery and wellness is possible.

When an individual is referred to the program, a team of specialists will first try to engage the individual on a voluntary basis.

If voluntary engagement proves unsuccessful, a judge can order outpatient care and that care will be provided through the University of California at San Francisco and the San Francisco General Hospital’s Division of Citywide Case Management, housed at 982 Mission St.

Even once a court order has been issued, however, the city cannot require an individual to receive treatment if they choose to decline it.

The program relies heavily on the symbolic weight of the court.

Cedric Fotso, a peer specialist with the program, said that living with a mental illness is a constant struggle and that stigma around mental illness still exists.

“Trauma is very real,” Fotso said.

While family members are among those who can refer individuals to the program, there are strict legal requirements for individuals to meet in order to qualify for the assisted outpatient treatment program, Almeida said.

The person must be an adult with a known mental illness who is not engaged in care and “is on a downward spiral,” she said.

Additionally, the person’s mental health must have either resulted in a psychiatric hospitalization or incarceration two or more times in the past three years or resulted in threats or acts of violent behavior to themselves or someone else in the past four years, according to Almeida.

Almeida said the city anticipates that fewer than 100 people in San Francisco will be eligible for the voluntary program this year.

Elsewhere in California, the counties of Orange, Nevada, Placer and Yolo have already implemented their own versions of Laura’s Law, Almeida said, noting that few cases have had to go through the court process, as many individuals voluntarily agree to the assisted outpatient treatment programs.

Alison Livingston, who is the team lead tasked with providing treatment for those individuals who are court-ordered into outpatient treatment, said the city has prepared 25 slots for those who specifically qualify for court-ordered assisted outpatient treatment programs this year.

San Francisco Supervisor Mark Farrell, who authored the city’s law on Assisted Outpatient Treatment that passed in July 2014, said that across the United States there is a mental health crisis, and “in San Francisco we see it on our streets every single day.”

Farrell said the hard work is yet to come, and that these services show that the city is supportive of families struggling with mental illness and aims to put people on a path to a better life.

The program’s first evaluation is due to the state in May 2016, at which the public will learn just how many people utilized the city’s new program.

Referrals to the program can be made via phone at (844) 255-4097 or online at

Hannah Albarazi, Bay City News

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