The Divide Over Involuntary Mental Health Treatment : Shots - Health News Mental health programs are getting extra attention after the killing spree in California. A law in the state lets authorities require people to get treatment. But it's not clear whether it will help.
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The Divide Over Involuntary Mental Health Treatment

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The Divide Over Involuntary Mental Health Treatment

The Divide Over Involuntary Mental Health Treatment

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DAVID GREENE, HOST:

Many are wondering if a deadly rampage in Santa Barbara last weekend could have been prevented since the young shooter Elliot Rodger was showing signs of mental health problems. It's a difficult question that's come up after other mass shootings. Like many states, California has a law to mandate mental health care for people who've been refusing it, but as NPR's Kirk Siegler reports, local officials have been slow to adopt it.

KIRK SIEGLER, BYLINE: The story behind Laura's Law, as it's known here, begins in 2001. In rural Nevada County, near Lake Tahoe, 19-year-old Laura Wilcox was shot and killed by a 41-year-old man with a history of mental illness. Tom Anderson was the county's chief public defender at the time and represented the gunman in court. He recalls that the man's family had tried to alert mental health officials numerous times before the shooting.

TOM ANDERSON: You know, they were declaiming privacy issues and stuff and wouldn't communicate with the family. He was - started amassing guns and setting up booby traps around his house and he had this psychosis of he was going to be attacked any minute.

SIEGLER: Anderson is now Nevada County's presiding judge, he's also a vocal advocate for Laura's Law. It was passed by the state legislature in 2002. It allows counties to compel outpatient treatment for people whose family or other acquaintances are concerned about their mental state. It's seen as an intermediate step before someone is forced into inpatient psychiatric care.

Anderson says it could be one tool to prevent future violent incidents, including mass shootings. And the patients, they often respond positively.

ANDERSON: The beauty of the program - the wonderment of it to me - is that roughly about 60 percent of the people that they do outreach to, where they go out to intervene after the person's been referred, voluntarily accepts services at that time.

SIEGLER: But implementation of Laura's Law is left to the counties, and so far only two, Nevada County and Orange County, have gone forward. The state hasn't allocated any specific funding to it. And its controversial - the mental health community is divided. There are concerns that involuntary treatment could make mentally ill people vulnerable to civil rights abuses.

STEVE PITMAN: You do have to be conscious that even though these people are mentally ill, they do have rights.

SIEGLER: Steve Pitman is the president of the Orange County chapter of the National Alliance on Mental Illness. Pitman, whose brother battled mental illness for 50 years, says family members need more power to intervene and force treatment. He says they're the ones who often know what's really going on, while police or a county mental health official may only have just a few minutes to drop by for a welfare check.

PITMAN: The problem in so many of these cases is that when they're interviewed to see if they meet those kind of threshold requirements, they don't give off any signals of being a danger to themselves or others. And somebody who's experienced in these kinds of things knows all the right answers to give. They don't want to go to the hospital, and so they say all the right things.

SIEGLER: That scenario echoes Elliot Rodger's alleged behavior prior to the Santa Barbara incident. But experts, Pitman included, are cautious about linking reforms like Laura's Law too closely to recent mass shootings. For one thing, they say, intervention cases that fall under Laura's Law may take weeks, if not months, to fully implement. And that may be too late.

JEFF DEENEY: I simply don't think that involuntary commitments are going to be an effective tool for stemming mass shootings.

SIEGLER: Jeff Deeney is a social worker in Philadelphia who also writes about mental health for The Atlantic monthly.

He says just a tiny fraction of mentally unstable people are a threat to public safety.

DEENEY: I think what we don't have that people want so desperately is the program that stops nonviolent non-offenders from committing their first violent crime because of a mental illness.

SIEGLER: Deeney wants to see the conversation shift away from involuntary treatment programs and toward preventative measures that are starting to happen at high schools and college campuses. Kirk Siegler, NPR News.

GREENE: This is NPR News.

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