Laura’s Law Offers Relief for Small Population of Mentally Ill Homeless in L.A.

Navigating the system of mental illness treatment can be more complicated than helpful, and new approaches are essential to reaching those who are suffering from a mental illness, specifically those living in the complex environment of the streets.

In July 2014, Los Angeles County adopted an already existing California state law that provides less restrictive treatment for those suffering from mental illness. Currently in its initial implementation stages, this policy change will offer treatment to 135 already identified individuals, with a disproportionate amount of them suffering from homelessness. The new law is a reform to the existing California Welfare and Institutions Code 5345-53-49, commonly referred to as “Laura’s Law.” But Laura’s Law in Los Angeles County will not solve the considerable problem of being mentally ill and homeless.

Laura’s Law adopts a treatment option called “Assisted Outpatient Treatment,” (AOT) which is court-ordered treatment for mentally ill individuals who show signs of being a danger to themselves or others. Instead of a traditional treatment that is administered in an institutional setting, AOT allows an individual to remain in the community while receiving treatment. For those who qualify for this treatment and live on the streets, AOT comes with the guarantee of permanent housing.

The law requires very specific conditions to committing an individual to this treatment. An individual must have a specific history of noncompliance in hospitalizations or arrests. Fifty-five of the 135 individuals who qualify for AOT in the county have already voluntarily accepted the treatment being offered.

The county has received funding for a total of 200 beds for individuals receiving assisted outpatient treatment.

While Laura’s Law offers a long-needed reform, advocates in Los Angeles say that the particular adoption of this policy in Los Angeles County is not enough to address the complex issue of mental illness within the homeless population.

According to Treatment Advocacy Center, which offers data and information for the general public in support of reform to policy affecting those with mental illness, an estimated 30 percent of the homeless population suffers from a mental illness. With the homeless population estimated to be around 45,000 in Los Angeles County (according to the Los Angeles Homeless Services Authority 2015 Homeless Count), this means about 12,000 of those individuals suffer from mental illness. Mark Gale, who is currently on the board of the National Alliance on Mental Illness and part of the commission to implement AOT in Los Angeles County, calls for reform to the overall involuntary commitment system for mental illness.

“Clearly there is a segment of the mental illness population that does not engage voluntarily in treatment,” he said. “They’re not helped by all these voluntary services that are being offered to people.”

If assisted voluntary treatment only scratches the surface of treating the mentally ill homeless population, involuntary commitment should be the next treatment offered, Gale said. But involuntary commitment is not a popular policy across the country.

Institutions for Mental Diseases do not qualify for federal mental illness funding. These institutions are classified as having more than 16 beds for individuals who are involuntarily committed for mental health treatment. The federal government has focused most of its funding on voluntary services in response to the deinstitutionalization movement of the 1960s and the fear of abusing an individual’s constitutional rights, according to Gale.

While this remains speculative, experts believe that the lack of these types of beds is one of the reasons those who are severely mentally ill remain on the streets, cycling through hospitals and jails. More research is needed in this department to make a final judgement of what is and is not working. But Gale likes to look on the bright side.

“[AOT] will save [mentally ill] people [who] are not being saved,” he said, “and to me, that makes it a worthwhile endeavor.”


Maddie Keating is a candidate for a Master of Nonprofit Leadership and Management degree at USC’s Sol Price School of Public Policy. She wrote this article while taking the school’s Media for Policy Change course.

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