Care vs. incarceration

When Lisa Currier’s son experienced a mental health crisis last October, he should have received treatment, Currier told the CN&R. Instead, he was locked up in Butte County Jail.

It’s been a heart-wrenching few months. As Currier fought for his treatment for schizoaffective disorder, she encountered roadblocks. In the meantime, his condition escalated. He eventually was incarcerated and charged with a felony for threatening violence.

“Why does my son have to have a felony in order to get help?” Currier asked. “As a mom, it’s heartbreaking. It’s horrendous torture.”

Currier isn’t alone. For years, she has helped others in crisis through her nonprofit, Crisis Care Advocacy and Triage, and has stood alongside other parents in similar situations and the Butte County chapter of the National Alliance on Mental Illness (NAMI) to advocate for local implementation of Laura’s Law.

The state law was adopted in 2002 after 19-year-old Laura Wilcox, of Nevada County, was fatally shot by a man with severe mental illness. It would allow Butte County judges to order intensive assisted outpatient treatment for certain individuals with severe mental illness who have threatened to harm others or themselves or have a history of hospitalizations or incarcerations.

Though the Butte County Board of Supervisors and county staff considered implementing such a program in 2016, the discussions didn’t go anywhere. There were reservations about the efficacy and cost.

This year, however, local advocates have a glimmer of hope. Last month, Scott Kennelly, interim director for Butte County Behavioral Health, informed the Board of Supervisors of a major grant opportunity: $4 million to launch a four-year assisted outpatient treatment program, funded by the U.S. Substance Abuse and Mental Health Services Administration. If awarded, the grant would allow the county to recruit a highly specialized team of medical professionals that would get started in July. They’d identify eligible clients through community referrals and outreach. Individuals ordered to enter the program would receive intensive case management, with therapy, daily check-ins and assistance with a variety of things, such as employment, housing and drug and alcohol addiction treatment.

Twenty California counties now have such programs in place, and there’s data to draw from, Kennelly told the panel. Outcomes are mixed but compelling enough to be seen as valuable in the department director’s eyes. Other counties have found that the intense engagement and supportive services offered have resulted in “significant reductions in hospitalizations, crisis contacts, homelessness and incarcerations,” he told the supervisors. That has translated into cost savings when it comes to psychiatric hospitalizations, emergency room visits and law enforcement contacts. Conversely, there are higher costs associated with county counsel, public defenders and courts.

Kennelly told the CN&R that he believes in the model, and such a program is “part of our continuum of care … that can potentially bring great benefit to our clients.”

If the county isn’t successful in securing the grant, that’s not to say the program is quashed, but it would be challenging to implement, Kennelly told the CN&R.

The county receives about $12 million per year in state Mental Health Services Act (MHSA) funding, which it could use a portion of for a Laura’s Law program. Currently, the funds are committed to other services that either would have to be cut or downsized to add programming. Assisted outpatient treatment programs can be quite expensive because much of their services are not reimbursed through Medi-Cal, Kennelly added. However, statewide reform for both Medi-Cal and the MHSA program this year could provide the county some flexibility.

Regardless, Supervisor Tami Ritter told the CN&R the program is worth implementing, for the sake of the individuals who need the treatment, as well as the cost savings.

“We’re incarcerating people who don’t need to be incarcerated. They need services,” she said. “I do think there are some things that we need, even if it means shifting around funding. Ultimately, in the long run, it’s going to save us money.”

Local advocates are pushing for the program along the same lines: They’re determined to see it prioritized and implemented. Colleen Phipps, president of NAMI, said the grant is an incredible opportunity, but the county could choose to fund an assisted outpatient treatment program with MHSA dollars, irrespective of whether or not they get the grant.

“I get calls every week from people who are in a position that they cannot help their loved ones. And that person is not quite dangerous enough to cause a crime or … to be [placed in a psychiatric hold],” she said. “With Laura’s Law … they have somebody standing by them … so they get on their feet and they start to feel stable.”

Similarly, Currier argued that many homeless people she meets through her nonprofit work who have schizophrenia, bipolar disorder, multiple personality disorder and/or substance abuse disorder would qualify for such a program. In the meantime, they are falling through the cracks.

Both women told the CN&R they believe assisted outpatient treatment could have helped their loved ones. In 2003, Phipps’ son caused a fatal car accident while in a psychotic state. He was convicted of murder and drew a lengthy prison sentence.

“I would not want this tragedy that happened to our family to happen to any other families,” Phipps said.

Currier told the CN&R that her son could have been helped on that first day back in October, rather than 13 weeks later, while he was in the midst of a “full-blown, astronomical psychosis.”

“Laura’s Law would’ve given the opportunity for him to … get the help that he needed without being a criminal.”