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How San Diego County Deals With Severe Mental Illness

Evening Edition

Dr. Michael Plopper, the chief medical officer of Sharp HealthCare Behavioral Health Services, and Piedad Garcia, assistant deputy director of San Diego County’s Adult/Older Adult Mental Health Services, talk to KPBS.

Aired 12/18/12 on KPBS Midday Edition.


Dr. Michael Plopper, chief medical officer of Sharp HealthCare Behavioral Health Services

Piedad Garcia, assistant deputy director of San Diego County’s Adult/Older Adult Mental Health Services.


San Diego County Mental Health Resources

Crisis line: 1-888-724-7240

Psychiatric Hospital of San Diego County

San Diego County Office of Violence Prevention

The school shooting in Connecticut has sparked a national dialogue on what can be done to treat people with mental illness. While it is not known whether the gunman, 20-year-old Adam Lanza, suffered from a mental illness, there have been several reports that he had a developmental disorder.

In California, Laura's Law would allow court-ordered outpatient treatment to people who show they could be a threat to themselves or others. Counties can opt in or out of implementing the 2002 law. Only one county in the state, Nevada County, has opted into the law. Los Angeles County has implemented Laura's Law as a pilot program.

San Diego County's Mental Health board voted in 2011 to implement Laura's Law, but the San Diego County Department of Health and Human Services decided not to implement the law.

Piedad Garcia, the assistant deputy director for one of that department’s programs, told KPBS they decided not to pass the law for a number of reasons, including costs and not burdening hospitals.

"The protection of the individual’s rights that we were also concerned about," she said. "And we thought that after stakeholder input and balancing the pros and cons of this implementation, that we would provide an alternative to Laura’s Law."

Instead, the county's behavioral health department chose to implement a different program, the In-home Outpatient Treatment or IHOT, in January 2012.

Alfredo Aguirre, behavioral health director for San Diego County Health and Human Services, says IHOT serves a broader population compared to Laura's Law.

He says the mental health professionals who make up three county IHOT teams work to get people in the program healthy and to find them resources including drug and alcohol rehabilitation. This year, 127 people are participating in San Diego County's IHOT program and nearly half of them are "engaged", meaning they've agreed to receive services.

But Dr. Michael Plopper, chief medical officer for Sharp HealthCare Behavioral Health Services, says while IHOT is a good program, it shouldn't be a substitute for Laura's Law.

"Laura's Law is the most reasonable way for people to get the treatment they need" he said.

Plopper says he sees emergency rooms full of people suffering from mental illness who come back time and time again and refuse treatment. He says implementing Laura's Law in San Diego would help reduce health care costs and over crowding in jails.

An earlier version of this story incorrectly described one of the provisions of Laura's Law. The law does not force people to take medication. The story has since been corrected.

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Avatar for user 'Missionaccomplished'

Missionaccomplished | December 18, 2012 at 11:58 a.m. ― 4 years, 3 months ago

We can thank both RONNIE AND the ACLU for putting homeless mental health patients on the streets.

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Avatar for user 'carlacjac'

carlacjac | December 18, 2012 at 2:31 p.m. ― 4 years, 3 months ago

Laura's Law is a law in California that could help reduce violence. If a person has a history of hospitaliztions, jailings or threats of harm to self or others---and is deteriorating--that person can be court ordered to comply with a treatment plan and the mental health system must give that intensive 24-7 community based treatment. It is proven to reduce tragedies and help the person get well and stay well in the community. And, it saves money. Nevada County, which has fully implemented the law, found $1.81 savings through reduced hospitalization and jailings for every $1 spent on the program. It saves money, its saves lives. But each County Board of Supervisors must resolve to use it and the vast majority of them have not. Write your boards of supervisors and demand they implement this lifesaving civil treatment law.

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Avatar for user 'ericr'

ericr | December 18, 2012 at 3 p.m. ― 4 years, 3 months ago

Dr, Garcia stated that issues against implementing Laura's Law involve stakeholder participation, coerced treatment, civil liberties and costs. Over 500 stakeholders from public safety, family members, mental health professionals and those with major mental illnesses have signed a petition of support. This law was vetted by the CA State Attorney General's office and supported by the ACLU for LPS Reform. There are due process protections incorporated into the law, including the right to court-appointed legal representation and habeas corpus. It does not force treatment. Even though treatment may be court ordered, the "participant" is not required to accept it and cannot be arrested for failing to honor either the court order or a settlement agreement. However, most do accept the judge's order. This law reinforces the right of those who are not aware of their illness so that they can get the treatment and recovery help that will help them recover while protecting the rights of society from possible harm. Laura's Law saves money as has been evidenced by its implementation in Nevada County and other areas of the country. Must it take a devastating incident in our county before we implement it?

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Avatar for user 'roadrunner'

roadrunner | December 18, 2012 at 9:09 p.m. ― 4 years, 3 months ago

I currently have no opinion on whether it is a good idea or not to implement Laura's Law in San Diego County. But years ago I was a medical transcriptionist in psychiatry for the County and also for UCSD, and I must say all those doctors and nurses were dedicated and compassionate people who did the best they could to balance patient rights with society's needs. That said, I don't believe most mentally ill individuals are a threat to themselves or others.

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Avatar for user 'William2'

William2 | December 19, 2012 at 5:51 a.m. ― 4 years, 3 months ago

May I suggest not offering mind altering drugs so freely to the youth of today. I see a relationship between the prescription drug increase and school shootings. One way to test these drugs before administering them to students would be to give them to the manufacturers and stock holders of the company four times a day for a period of six months. If at the end of this time the manufacturers and stock holders agree that it is a bad idea to needlessly drug children, I would consider the drug successful.

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