Mental illness in CA

Laura's Law, Mental Health Services Act (MHSA) and Serious Mental Illness in California


California State Auditor, again, finds “significant issues with how people with serious mental illnesses are cared for.” Key findings for people on conservatorship include:

“[L]imited treatment options due to the level of care the require…”

“Counties cannot access state-managed data … that could better inform decisions about care.”

“[O]nly 19 counties [33%] have adopted assisted outpatient treatment [Laura’s Law], which allows individuals to continue to receive care in their communities.”

“Although the state invest billions of dollars each year in the county-based mental health system, stakeholders cannot assess the impact these funds make on people’s lives.”

Read the Auditor’s Fact Sheet and complete Report.


Join our “Serious mental Illness in California” Facebook group

Laura’s Law (Assisted Outpatient Treatment/AOT) and the Mental Health Services Act (MHSA) were both enacted to help the most  seriously mentally ill. MHSA funds may be used for individuals in Laura’s Law, but mental health commissioners divert MHSA funds to the highest-functioning, and tell their Boards of Supervisors that they need incremental funds for those in Laura’s Law. This is discrimination against the seriously ill that MHSA was intended for. It explains why the seriously mentally ill in California are sent to shelters, jails, prisons and morgues rather than treatment in spite of the over $1.5 billion raised annually by MHSA. This site details Laura’s Law and MHSA and provides county by county information.

Intro to Laura’s Law

“Laura’s Law” is California’s version of Assisted Outpatient Treatment (AOT). It allows courts–after extensive due process, to order a small subset of people with serious mental illness who have been noncompliant with treatment and meet very narrowly defined criteria to accept treatment as a condition of living in the community. It also allows courts to order the recalcitrant mental health system to provide treatment. National research shows AOT works. Research in California shows it works. For example, Nevada County found:

  • Hospitalization was reduced 46%;
  • Incarceration reduced 65%;
  • Homelessness reduced 61%;
  • Emergency Contacts reduced 44%;
  • Saved of $1.81-$2.52 for every dollar spent as result of reducing incarceration, arrest, and hospitalization.

17 counties implemented Laura’s Law as of 2/2017: Alameda, Contra Costa, El Dorado, Kern, Los Angeles, Mendocino, Nevada, Orange, Placer, San Diego, San Francisco, San Luis Obispo, San Mateo, Shasta, Santa Barbara, Ventura, Yolo

Guide to Laura’s Law

Functional outline

Political summary (including eligibility numbers)

Intro to MHSA

In 2004, California voters altruistically passed Proposition 63 (Mental Health Services Act (MHSA), a 1% tax on millionaires to help people with “severe mental illness” and to “prevent mental illness from becoming severe and disabling.” It raises over $1.5 billion annually and is an important program that does a lot of good. But mental health commissioners, CalMHSA and the oversight commission (MHSOAC) encouraged social services programs that have little to do with serious mental illness to masquerade as mental illness programs to enable them to claim MHSA funds. This leads to programs that fail to serve the seriously ill being showered with funds while those that do serve the seriously ill go unfunded. Our report, MHSA: A Bait and Switch found this unmitigated mission-creep, insider dealing, and lack of oversight, found

Why is public in dark about this? $11 million in MHSA funds went to hire a P.R. firm that works to convince the media that all is well. They continually issue press releases and call editorial boards to extol the virtues of the program. County mental health directors and recipients of the diverted funds benefit from the status quo and therefore defend it. Governor Brown, former state Senator Steinberg and his successors appointed recipients of MHSA funds to sit on the Oversight Commission. As a result of this conflict, MHSA is being overseen by beneficiaries of funds and cheerleaders for mission creep, rather than stewards of the public purse. This is not what voters wanted to happen or were told would happen. Money is not the issue. Leadership is.

Laura’s Law Fact Sheets

Laura’s Law Funding Addressed

Laura’s Law Source Documents


Other California Issues

Selected Laura’s Law op-eds and articles

MHSA Fact Sheets

How to fix MHSA

MHSA Source Documents and Links to Agencies

MHSA Media

County by county info

County by County Information (cont.)

Los Angeles County

LA Dept. of Mental Health tells Supervisors how to help seriously mentally ill in LA – 9/2017

2017 Memo to Board on improving care in LA

2017 Laura’s Law Numbers (not results)

Los Angeles adopts Laura’s Law – 7/2014

How to make a Laura’s Law referral

Laura’s Law Brochure

Results in Nevada and Los Angeles (PDF Version)

Board of Supervisors votes for statewide Laura’s Law

Treat, don’t jail, mentally ill – Jaffe, LA Times letter

2012 LA County favors renewing Laura’s Law

2011 Mental Health Dept. says Laura’s Law pilot works

2011 Supervisor Antonovich endorses

2011 Press -Telegram endorses AOT

LA MHSA Stakeholder Process fatally flawed

Marin County

2/2017: Novato supports Laura’s Law

1/17: Marin County Supervisors support Laura’s Law

10/16: Behavioral Health Dept. pretends Laura’s Law not needed

4/15: Marin County police and firefighters endorse

9/14 Marin County mulls Laura’s Law

Mendocino County

Mendocino sheriff helps mentally ill – 2/2017

Mendocino adopts, but refuses to use Laura’s Law – 3/16

Mendocino delays implementing Laura’s Law – 6/15

Mendocino supervisors reconsider Laura’s Law – 11/14

Mental Health Dept convinces Sups to not implement – 7/12

James Bassler: AOT could have stopped son from Ft. Bragg killing

James Bassler: the logic of Laura’s Law

Manhunt for Aaron Bassler due to mental health failure – LA Times

Letter to Editor: Mendocino needs Laura’s Law – Jaffe

Laura’s Law might save county money – Ft. Bragg Advocate

Mendocino County Proposition 63/MHSA Home Page

MHSA Plan 2013 Update

Mental Health Dept convinces Supervisors to not use Laura’s Law – 7/12

Ft. Bragg Advocate on Laura’s Law

Nevada County

2014-2015 Results in Nevada County

Results in Nevada and Los Angeles Counties (PDF Version)

Grand Jury Report on Laura’s Law – 2012

Judge Anderson encourages all counties to adopt Laura’s Law

County Behavioral Health Dir. on Laura’s Law

Q&A: Laura’s Law by Nevada County officials

Laura’s Law success in Nevada County – Video

DMH to NV County: OK to use MHSA for LL

2012 Grand Jury Report on Laura’s Law

2008 Nevada County adopts Laura’s Law

Orange County

2015 OC Grand Jury Mental Health Report

Misspending Plagues Orange County MHSA programs

9/2015 OC stashing, not using MHSA funds

2/15 OC refusing to use Laura’s Law

5/14 OC Register, LA Times, NBC, NPR, Voice of OC on OC adopting Laura’s Law

Preventable Tragedies in Orange County (PDF Version)

OC should adopt Laura’s Law (Voice of OC)

2011 OC Health Care report to supervisors is wrong – MIPO

2011 OC Health Care Agency report to supervisors is wrong – NAMI OC & TAC

Health Care Agency misleads supes on Laura’s Law – OC Register

2011 Health Care Agency Report to Supervisors on LL

Ending Homelessness in OC – testimony

Seal Beach Salon shooting shows need for Laura’s Law

Letter in OC Register – Jaffe

Seal Beach Salon shooting and Laura’s Law

Mentally ill Kelly Thomas shooting shows need for Laura’s Law


9/2014 Placer County adopts Laura’s Law

Could Laura’s Law come to Placer County


2020 Sacramento MHSA Plan

Mental illness tragedies in Sacramento

Grand Jury finds “shameful neglect of mentally ill” – 7/15

7/15: editorial on Grand Jury Report – SacBee, 7/15

Laura’s Law languishes – Sac. News/Review

San Diego County

Mental illness tragedies in San Diego

Problems in San Diego, Jaffe, Union Trib

Video explaining Laura’s Law in San Diego – 2016

Laura’s Law might have prevented this horror – NBC, 4/16

San Diego Supervisors adopt Laura’s Law – 4/15

County stashing, not using mental health funds – 2015

San Diego moves closer to adopting – NBC, 2015

San Diego approves LL planning – 1/15

SD rubber stamps misspending MHSA funds – Jaffe/Bish (PDF) 2013

County report says ‘implement LL’ – 2013

2013 Supervisors authorize Laura’s Law study

Laura’s Law: pro and con – SD City Beat

get the book

Available in all formats at Amazon and Barnes and Noble

County by County (cont.)

 San Francisco County

2020 MHSA Plan

SF 2019 Laura’s Law Report

SF annual AOT report -3/2017

How to access Laura’s Law – 2/2017

Laura’s Law working in SF – 1/2017

San Francisco Annual AOT report – 2017

San Francisco Adopts Laura’s Law – 7/14

NBC News on Teresa Pasquini’s fight for better care – 7/15

San Francisco Examiner says implement LL (PDF) – 12/20/13

Preventable Mental Illness Tragedies in San Francisco (PDF)

Op-ed, editorial, article SF Chronicle

SF Mayoral candidates misunderstand Laura’s Law

SF Ignores mentally ill

SF Chronicle op-ed: Support Laura’s Law (DJ Jaffe)

Why Laura’s Law has such limited impact (SF Chronicle)

Ignore mentally ill and court disaster (SF Chronicle)

Where the Mayoral Candidates stand

San Luis Obispo

SLO MHSA Home Page


NIMBY groups defeat housing for mentally ill 11/2016

Board of Sups tells MH Dept. to plan to implement Laura’s Law – 11/2015

Untreated mentally Ill woman kills mom due to lack of LL

SLO Tribune report on mental illness

San Mateo County

San Mateo County MHSA Home Page

Preventable Tragedies in San Mateo (PDF here)

San Mateo approves Laura’s Law – 6/24

San Mateo Mental Health Dept. recommends Laura’s Law – 2015

San Mateo Health System Chief Jean S. Fraser, misleads on LL 2013

2011 Analysis of San Mateo Officials Claims About Laura’s Law

San Mateo Health Dept and NAMI Presentations to Board of Supervisors Committee

Presentation on Laura’s Law by local mental health officials

Preventable Tragedies in San Mateo (PDF Version here)

Santa Barbara County

09/2017 Report: 58% AOT of referrals unserved

02/2017: Diverting incarcerated mentally ill to treatment

02/2017: Status of Laura’s Law in Santa Barbara

Santa Barbara MH Dept presentation to MH Commission (PDF)

03/20/15 Status of Laura’s Law in Santa Barbara 

Santa Maria Sun endorses

Santa Barbara prison mental health services questioned

Shasta County

MHSA Funded Suicide Prevention Activities Fail

Siskiyou County

Tragedies are preventable

Sonoma County

12/2016: Shifting mentally ill from jail to treatment

2011 Health Care Director defends status quo (and read our response)


8/2017 Analysis: Results Group Report Inaccurate

7/2017 Results Group Report

2/2017: Forum to consider Laura’s Law

2/2017: Advocates push for Laura’s Law

1/2017: Stanislaus to study Laura’s Law

1/2017 Supervisor Olson favors Laura’s Law

11/2016: Doug Dunn leads push for Laura’s Law

11/2016: Stanislaus considers Laura’s Law

Ventura County

Guest column: Discrimination a major issue in the Ventura County mental healthcare system (Haffner Op-Ed) – 09/08/2020

Behavioral Health Director “Berates” Behavioral Health Board Member for advocating for the seriously mentally ill (VC Reporter) – 07/29/2020

A failure of care: One family’s harrowing journey reveals inadequacy of mental health services (VC Reporter) – 07/08/2020

Leadership is key to dealing with Ventura County’s mental health crisis (Hayden Op-Ed) – 01/2020

Ventura County has a mental health crisis (Haffner Op-Ed) – 11/2019

The need for more in-patient psychiatric beds (Haffner Op-Ed) – 02/2019

Legislators add to broken mental health system (Haffner Op-Ed) – 07/2018

Mental illness laws must be changed (Hayden, Haffner Op-Ed) – 05/2018

Treatment before tragedy (Hayden Op-Ed) – 10/2017

Laura’s Law set to start (VC Star Editorial) – 01/2017

Close revolving door for mentally ill (Hayden Op-Ed) – 07/2017

Laura’s Law starts (VC Star) – 01/2017

Ventura jails mentally ill (Padilla Op-Ed) – 10/2016

Mental health funds are being misspent (Hayden Op-Ed) – 09/2016

Yolo County

Yolo gets great results – 10/2017

Yolo county gets good results -6/2015

6/14/14 Yolo Supervisors approve full implementation –  6/2014

Yolo supervisors approve Laura’s Law Pilot – 6/2013

Yolo residents want Laura’s Law – 6/2013 Sups Meeting

Yolo ADMH Report on Laura’s Law