Mental Health Series
Following the murder of three people by a deranged Nevada County man, the California Legislature passed Laura”s Law to give counties a new way to practice preventative mental health care. After two local horrific murders and three attempted murders by Aaron Bassler, whose family had also sought mental health treatment for their son against his wishes, Mendocino County Supervisors now have Laura”s Law on their Tuesday, Oct. 25 agenda. If Mendocino County passes the law, it would be the first in California to voluntarily adopt the full 2002 law — unless Orange County approves a proposal next week.
Why have 56 of California”s 58 counties rejected or ignored this law, touted by thousands of mental patients and families as an innovative way to divert mentally ill people from downward cycles of terror, jail and hospitalization?
As both a reporter and former mental health worker, I investigated this question, reviewing documents and talking to people in Nevada, San Francisco, Orange and Los Angeles counties (where a limited pilot program is in use). Mendocino County Supervisor and Chair Kendall Smith said one hurdle would be finding Mental Health Services Act (MHSA) funding to pay for Laura”s Law. The county”s 2011 MHSA spending update was finalized at the end of June — shortly before the murders. Laura”s Law can tap MHSA funding but cannot, by law, replace existing programs.
“Therein lies a challenge, we already have all our MHSA dollars accounted for,” Smith said. She also worries the law could pass, then no concrete action taken, as has happened on other occasions.
“There is a lot of interest right now from the public. What I don”t want to see is we adopt Laura”s Law but nothing ever happens; we never implement it. I don”t want to do a pro forma thing,” Smith said.
Nevada County was forced to adopt Laura”s Law as part of the lawsuit settlement with Laura Wilcox”s family. For this investigation, I talked to a man named Rick who was shot the same time Wilcox was shot to death. Rick now lives in Fort Bragg and spoke for the first time here about that traumatic day.
When I first met Rick, I was a job coach for a disabled man who was having a tough first work week in Fort Bragg. Rick walked up, smiled big and said to the man, “I had a really bad day at work once. A guy shot me eight times.”
Rick, 47, pulled up his shirt and revealed the horrible landscape left by eight entering and exiting bullets and numerous subsequent surgeries.
For a moment, the group of men standing there became wide-eyed and amazed, stunned that Rick had survived such extensive injuries.
A very different Rick was a cook at Lyon”s Restaurant in Grass Valley on Jan. 10, 2001 when Scott Thorpe walked in and asked to speak to the manager. Thorpe then shot and killed Michael Markle, 24, who had been the assistant manager for just three days. Rick pressed the alarm, but it didn”t work. Others fled the restaurant while Rick offered the gunman his wallet and thought the danger had ended. Rick went to his truck to call 911. The gunman came up behind him and riddled him and his truck with bullets, shattering Rick”s stomach and liver and collapsing his lungs.
Unknown to those at Lyon”s, minutes before Thorpe had shot and killed Pearlie Mae Feldman, 68, and intern Laura Wilcox, 19, at Nevada County Mental Health, believing them to be FBI agents. There he also shot Judith Edzards in the head. Daisy Switzer was badly injured when she leaped out a second-story window to avoid the gunman.
The murder spree resulted in “Laura”s Law” which could just have easily been called “Pearlie”s Law” or even “Rick”s Law.” Rick wouldn”t have liked that.
“One reason we came here to Fort Bragg was to get away from over there,” Rick said.
He asked his last name not be used, nor his two workplaces in Fort Bragg. Since the murders of Jere Melo and Matt Coleman, Laura”s Law has become a hot local topic. Coast advocates for better mental health services like Sonya Nesch and Richard Miller M.D., Fort Bragg City Councilwoman Meg Courtney, businessman Larry Knowles, activist Tom Wodetzki and James Bassler (Aaron Bassler”s father) are pushing for the law.
No local opposition has emerged.
“Society needs to get its head out of its [butt] about the issue of mental health. The system we have is broken, ridiculous,” Rick said.
Rick developed post traumatic stress disorder (PTSD) as a result of being shot, so has seen the mental health system from two different and painful angles, but is able to cope.
“I have a loving and supportive wife, who has become like my therapist,” he said.
Rick supports the Brady Bill and wonders why society doesn”t do more to keep guns from going into the wrong hands. Both Bassler and Thorpe were openly gun enthusiasts. Bassler feared space aliens, Thorpe a vast FBI conspiracy; both men built elaborate bunkers in the home of relatives.
“Families of people with mental illness have a responsibility to do something when a person in this type of condition has guns,” said Rick.
He wants to study how Laura”s Law actually works more before deciding whether to support it.
What does Laura”s Law do? It allows court-ordered “assisted outpatient treatment” (AOT). People involved in the court system can be talked or ordered into 180-day treatment plans early. Currently, nothing can be done until they are about to hurt themselves or others. Families, usually first to see a person in both mental decline and denial, would finally have the means to force treatment like Bassler”s father wanted.
Rick remembers one night when an excited Thorpe shrieked with laughter at a menu, acting so unhinged Rick had to call police, who removed him from the eatery but had no means to do more.
Under Laura”s Law, a relative or roommate, peace officer or agency director can initiate a process that may result in voluntary or court-ordered outpatient treatment, usually for a six-month period.
Strange political bedfellows have blocked the law from Marin to San Diego. Social service cutters have defeated the law with the help of important mental patient advocacy groups, who oppose utilizing this means for taking away hard-won patient civil rights.
“The Bazelon Center opposes all involuntary outpatient commitment as an infringement of an individual”s constitutional rights,” the organization told San Francisco Supervisors. “Outpatient commitment is a dangerous formalization of coercision within the community mental health system. Such coercion ?causes many consumers to avoid contact with the mental health system altogether.”
Michael Heggarty, who heads the Department of Behavioral Health in Nevada County, was tasked with implementing a law forced on the county.
“It absolutely changed my mind. I came here from another county and was not a supporter of Laura”s Law. I thought it was going to be too expensive and didn”t see how going to be helpful,” Heggarty said.
Heggarty and Nevada County Judge Tom Anderson now speak often about the benefits.
“Laura”s Law really fills a gap between the 5150 commitments and regular outpatients,” Heggarty said.
One big savings for Nevada and Mendocino counties comes in the current practice of involuntarily committing people to the mental hospital under section 5150 of the California Welfare and Institutions Code where they lack in-county mental hospital beds. Mental patients deemed dangerous to themselves or others are driven and placed in hospitals outside the county.
Supervisor Smith said this very expensive budget item has been reduced through hard work by staff. Smith didn”t know what happened to people who are refused hospitalization, but as a former driver, I can”t see a good outcome for people on the edge who are rejected for monetary savings. Laura”s Law could treat people for less and in the comfortable surroundings of home. This would avoid many horrifying drives in a locked car to hospitals whose patient care quality ranges from terrific to horrible.
Nevada County uses both Medi-Cal and MHSA to pay all costs of Laura”s Law. Smith wonders whether the three years it took for Nevada County to implement the law was needed to arrange these funding streams.
“That”s one of the questions I hope to get the answer to,” she said.
Financial skies have darkened since then. Smith said budget forecasts show some funds drying up, even Medi-Cal that originates with the federal government.
“We are not expecting to get any new funding streams at this point,” she said.
Nevada County has proof the law saves money.
Heggarty has monitored the time that 30 people referred into the program have spent in county jail and in the mental hospital, both before and after the passage of Laura”s Law. This study shows Nevada County has saved $1.81 for every $1 spent, Heggarty said. Studies of Kendra”s Law in New York State, which Laura”s Law is modeled on, show even more encouraging long-term savings and reductions in recidivicism.
The state has some rigorous requirements, such as a high staff-to-patient ratio, which is 1-10 patients in Nevada County.
“That”s one of the factors that creates high initial costs,” Heggarty said.
But the law also allows much local flexibility. Dual-diagnosis patients (substance abuse and mental illness at the same time) are accepted into treatment under Laura”s Law. Many programs reject dual-diagnosis patients. Aaron Bassler, both a drug user and in severe mental health decline, would have qualified based on the violence he committed when he crashed his truck at Fort Bragg Middle School in February.
Most court-ordered plans demand that patients take strong mental health drugs that have side effects. Fail to take them and one could go back to jail or the mental hospital. (It is illegal to forcibly medicate any outpatient) Some opponents say no treatment can possibly work until someone admits they have a problem. Heggarty says that isn”t so. For example, courts often demand repeat alcohol offenders enroll in Alcoholics Anonymous.
“There is a good analogy with substance abuse,” said Heggarty, who is also the county”s substance abuse program co-coordinator. “These programs do work, even for people who don”t want to be there at first.
“A symptom of some mental illnesses is an inability to recognize the illness,” Heggarty said. Once drugs and therapies kick in, these symptoms lessen and the patient may like life better.
“There is an element of coercion,” he concedes.
Instead of being forced into a Laura”s Law hearing, most accept voluntary treatment plans that may have more flexibility and consumer input.
The vast majority of mental patients can”t be helped by Laura”s Law. Mendocino County Chief Executive Officer Carmel Angelo in her preliminary online report says just two percent of mental health clients would qualify.
Yet those are among the most troublesome to both mental health and criminal justice systems.
“None of those [30] people would have been in treatment without Laura”s Law. They didn”t believe they were ill and they had refused treatment in the past,” Heggarty said.
Highly structured Laura”s Law recovery plans have helped Nevada County better focus its mental health mission, which Smith says is sorely needed here.
However, Smith says any Laura”s Law court must at least rotate to the coast for it to make sense to her. She mentioned numerous programs over the years intended for the entire county but were only offered inland, such as Drug Court.
“It simply would not be possible for most of the people who need these services to drive to Ukiah for them,” she said
The biggest problem with Laura”s Law in Mendocino County may be the extremely low level of mental health services here. With Fort Bragg mental health services often rising to the top of county staff”s cut list, most of the experienced staff left this year, including long-time director Aaron Goertzen. Laura”s Law mandates basic services of psychotherapy and psychiatric be available so recovery plans can be implemented. Mendocino County has consistently been unable to provide reliable services and has reportedly been relying on volunteers in Fort Bragg recently.
In subsequent articles in this series, I will examine what kind of services are currently being provided for the mentally ill in Fort Bragg and Ukiah and what services should be provided.
Thorpe eventually was found not guilty by reason of insanity. He was sentenced to life at Napa State Hospital where he receives the therapy for his mental condition his family hoped for before the shootings.
