We need the courage to treat mental illness when it gets dangerous
By Lois Henry
Davon Mosley should not be sitting in the Lerdo jail right now.
I'm not saying he didn't commit a crime. By all accounts, he did. A serious crime at that.
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What is Laura's Law
Laura's Law was passed by the Legislature in 2002 and named for a young woman, Laura Wilcox, who was killed by a mental patient in Nevada County.
The Legislature left it up to each county to implement and so far, only Nevada County has done so, although Los Angeles County has a pilot program.
And after two recent headline grabbing incidents, both Mendocino and Orange counties are looking into the law.
A mentally ill man in Mendocino, Aaron Bassler, was recently killed by authorities following a frantic manhunt after Bassler killed a city councilman and another man in August. Before the August killings, Bassler's father had begged authorities for help to no avail as his son became more paranoid.
In Orange County, two Fullerton officers are accused of beating to death a mentally ill man, Kelly Thomas, after Thomas allegedly wouldn't comply with their orders.
Advocates say those deaths might have been prevented under Laura's Law.
Laura's Law allows family members or others to petition a court to mandate outpatient-only treatment without a crime having to occur.
The court can only act if a strict set of criteria are proved.
Among other things, the person must have history of refusing treatment leading to at least two hospitilizations or jail stays in the prior 36 months or been violent at least once in the prior 48 months; have a substantially deteriorating condition; and not doing something would likely result in the person harming themselves or others.
In Nevada county, the court order comes with a "civil standy" meaning the patient is on the cops' radar. So, if they flake on treatment and get worse, they can be involuntarily hospitalized.
Aside from that, however, there isn't a way to force patients to accept treatment.
And, as always, there's money.
To enact Laura's Law, counties must have an Assertive Community Treatment, or ACT, program in place.
ACT is a very intensive, full embrace kind of program where counselors have very low caselaods, are available weekends and after hours and help patients with everything from meds to housing.
It's funded by Medi-Cal and has a good success rate.
Sounds perfect for a Laura's Law client, except one of the rules under Laura's Law is that you can't cut services to those seeking them voluntarily in order to make room for those under court order.
That means counties have to pony up the money for ACT teams for involuntary services.
I know, I know, you're going to say we can't afford it.
But a study of Nevada County's program released in January shows for every $1 spent on the program, $1.81 is saved in reduced jail and hospital visits by the severely mentally ill.
The Nevada County study also found once a court ordered patients into treatment, most stuck with it even after the order expired.
Not to mention, many patients' conditions actually improved, which is kind of the point of mental health services to being with.
Listen to KERN 1180 AM from 9 to 10 a.m. Monday through Friday when Californian staffers discuss this issue and others. You can get your two cents in by calling 842-KERN. Lois Henry hosts every Wednesday. To listen to archived shows, visit www.bakersfield.com/CalifornianRadio
But it should never have happened, and outdated state laws are partially to blame.
That's why I wholeheartedly support adoption of Laura's Law in this and every other county in the state. But more about that later.
Davon is seriously mentally ill. He has been most of his life. He suffers from a combination of bipolar and schizophrenia, according to his parents, Bruce and Lorraine Mosley.
Bruce is a longtime local barber and his wife works at the Delano prison. Davon is the only one of their three sons with mental problems. They've struggled with his care for years.
On the proper medication, Davon is fine.
But off his meds, he can become dangerous, his parents said.
Lithium is the chief medication that keeps him stable, Bruce said. But Davon doesn't like it because it drains his energy.
While he was a juvenile, Bruce and Lorraine insisted he keep on track with the lithium. But about three weeks ago Davon turned 18.
According to the law, he's an adult capable of making his own decisions. When he told his psychiatrist he wanted off lithium, she had to agree.
"If I had the power to overrule that, some kind of authority over what he takes, I would have said no," Bruce said.
Even when he's stabilized, Bruce said, Davon isn't aware enough of his own disease to make any kind of medication decisions.
In fact, a condition known as anasognosia often accompanies bipolar/schizophrenia. It's a neurological syndrome in which the person is totally unaware that they're acting abnormally, according to the Treatment Advocacy Center.
They psychiatrist was going to try and wean Davon off the lithium and replace it with another drug, Bruce said.
"I started to say something," Bruce told me. "But I thought she must know better than me so I kept my mouth shut."
It wouldn't have mattered. Without some kind of legal authority over Davon, such as a conservatorship (almost impossible to get), Bruce's opinion would have carried no weight.
In less than a week things started to go bad.
"We saw it and we started calling people," Bruce said.
They called the psychiatrist, they called Davon's probation officer, they called the Mary K. Shell Center. No help.
Even after Bruce caught Davon walking down the street dragging an ax and called again, no one came.
"I kept expecting to hear 'We're on our way.' But that was the last thing I heard."
Bruce didn't call the Sheriff's department, which may have been able hospitalize Davon on a 5150 (danger to self or others). Bruce said he was told the Sheriff's Department wouldn't step in until Davon "did something."
On Sept. 27 he did.
In an apparent psychotic break he allegedly took a machete to two of his brothers in law and cut their arms. One man required more than 30 stitches.
Davon is now facing a maximum nine years in prison or possibly longer in a state mental hospital, according to Bruce.
"Every door was shut in our face," Lorraine said. "They all said 'Wait until he does something.' Well he did something and now there's no help for him."
The Mosleys are hardly alone in their frustration.
Which brings me back to Laura's Law, passed by the Legislature passed in 2002, but left up to each county to implement. Only Nevada County has done so.
Laura's Law allows court-ordered treatment for severely mentally ill people before a crime is committed, or they so degenerate that they hurt themselves.
The law is specific to people who are refusing treatment so some mental health professionals wondered if it would apply to someone like Davon, who was in treatment but not taking a specific medication.
It isn't perfect by any stretch. But I think its potential benefits outweigh the drawbacks (see sidebar).
Local attorney Fawn Dessy is planning to make a presentation on Laura's Law to the Kern County Board of Supervisors.
She's fed up with the revolving door she's experienced with her daughter, also bipolar, paranoid schizophrenic.
"My daughter has been hospitalized over 60 times in the last six or seven years," she said. "Yes it's my daughter, but I'm a taxpayer too and I have to wonder what the hell they're doing? Nothing! Nothing! Except getting our kids incarcerated or killed."
A 5150 hospital hold is fairly brief, though it can go longer if the patient doesn't get stable. Once they're stable, though, patients are let back out on the street and without some kind of outpatient treatment, they often end up right back where they started.
Even getting that brief 5150 hold can be a crap shoot, Dessy said as making that determination is very subjective.
"They wait until some terrible crime happens like up in Mendocino and then they run around saying, 'Oh my god! Oh my god! We have to do something!'
"Well why not do something before it gets that bad?"
Counties have drug courts, she said. Why not mental health courts? Not to mention an overhaul of state laws governing conservatorship over the mentally ill.
No one wants to go back to the days of lifetime confinements and forced sterilizations. But there's got to be a middle ground, she said.
"Laura's Law is a stop gap measure, but at least it provides some service under the supervision of the court," she said.
And right now, it's all we've got.
Meanwhile, the Mosley family is mulling how to pay Davon's $120,000 bail so they can get him out of jail and into a hospital.
Right now, Davon is on mood enhancers but still not getting his lithium, Bruce said. He appears calm, but that can be deceiving and Bruce fears what might happen if he's confronted by another inmate.
"I know it's the devil," Bruce said of Davon's illness. Then his booming, graveled voice breaks. "Half these people, they don't wanna help you...but I know God will help. It just may not come when I want it to."
Opinions expressed in this column are those of Lois Henry, not The Bakersfield Californian. Her column appears Wednesdays and Sundays. Comment at http://www.bakersfield.com, call her at 395-7373 or e-mail lhenry@bakersfield.com






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