Finally, some people in positions of power in California and Washington are confronting the reality that they must be more aggressive in caring for the most severely mentally ill.
The Orange County Board of Supervisors last week voted to adopt Laura's Law, a 2002 state law that allows counties to set up courts in which judges can order mentally ill people to receive treatment while allowing them to remain in their homes.
To qualify, individuals must have a history of mental illness, an inability or unwillingness to remain in treatment, and a record of having been jailed or hospitalized for their illness.
The unanimous vote came after more than two years of study, and it makes Orange County the largest county by far to adopt Laura's Law, named for Laura Wilcox, a college student who was killed by a severely mentally ill man in Nevada County in 2001.
Until Orange County's action, only Nevada and Yolo counties had embraced Laura's Law. Los Angeles County has a limited program, though officials there are contemplating expanding it. San Francisco supervisors are contemplating a ballot measure to implement Laura's Law.
Orange County plans to use $4.4million from Proposition 63, the 2004 initiative that raised taxes by $1.4 billion a year on wealthy Californians to pay for mental health care. The Legislature last year loosened the strings on Proposition 63, allowing its funds to be used to pay for Laura's Law programs.
Laura's Law is not the only alternative. Using the existing conservatorship program, Sacramento County caseworkers have been providing intensive outpatient care since February for 10 individuals, in what officials call Care-Plus. The individuals receiving the care have been unable to live in the community for more than a few hours or days before being jailed or hospitalized. In Care-Plus, six have made it 50 days in the community and three have made it for 30 days. One had to be hospitalized. The overall cost will be about $650,000 this year.
In Washington, D.C., Rep. Tim Murphy, a Pennsylvania Republican, is pushing an important bill, HR 3717, which would expand care for the most severely mentally ill people. The bill would free federal funds to help states pay for hospitalization of severely mentally ill people, and relax a stringent federal privacy law that denies family members access to information about mentally ill loved ones.
Several Democrats, including Rep. Ami Bera, D-Elk Grove, and Rep. Karen Bass, D-Los Angeles, have signed on as co-sponsors of the legislation. Others from both parties ought to join in what should be a nonpartisan issue, caring for vulnerable people in need.
Unfortunately, the issue has become bogged down in partisanship. Several Democrats, including Rep. Doris Matsui, D-Sacramento, have lined up behind weaker legislation by Rep. Ron Barber, an Arizona Democrat.
Though it's an election year, they ought to find a middle ground. Several of the lawmakers involved have more than a passing interest in the issue. Barber was one of the victims of Jared Loughner, the mentally ill man who shot Barber's then-boss, Gabrielle Giffords. Murphy is a psychologist. Matsui has spoken of a sister who is ill.
Meanwhile, California authorities continue to spend Proposition 63 money on too many feel-good programs, including a recent Capitol event called Mental Health Matters! Day - The San Francisco Chronicle pegged the cost at $137,000 - and on billboards that are supposed to combat stigma.
Stigma is a problem. It can prevent families from seeking care for people who are deteriorating. But nothing fans fear of mental illness more than the all-too-often tragic results of untreated severe mental illness, as some thoughtful officials recognize.