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Another View: Forced mental care drives patients away

Published: Sunday, Jan. 27, 2013 - 12:00 am | Page 2E
Last Modified: Sunday, Jan. 27, 2013 - 9:07 am

Unfortunately, in a desire to find easy answers to recent violence, some are pushing for coercive measures to force people with serious mental health disabilities into court-ordered treatment.

For example, The Bee recommended implementation of Laura's Law ("County shouldn't delay embrace of Laura's Law"; Editorials, Jan. 12), also known as AB 1421, as a response even though its usefulness is being tested in only one small, rural California county.

Laura's Law advocates insist its application would result in providing treatment to those likely to become violent ("It's time to stop ignoring mental illness law"; Viewpoints, Jan. 13). However, there is no evidence that violence can be predicted or that this law would enable detection of any future offenders.

Our knowledge of what works and what doesn't in mental health services is still evolving, but it is quite clear that the main result of forced services – as compared with voluntary services – is to drive people away. Just as we have learned over many years in public health, we cannot expect positive outcomes from forcing people to, for example, take AIDS tests. Instead, we know that the most effective way to persuade people to do what is best for themselves individually and for the public at large is to reduce fears of and build trust in our public health system.

California has been a leader in securing voluntary mental health services and taking steps to reduce stigma and discrimination. The landmark Mental Health Services Act funds an innovative set of programs based on voluntary compliance that have demonstrated success in saving lives and money. Programs include housing, community-based recovery services, 24/7 emergency response and family and peer support services.

Through federal initiative and with strong support from the state of California, we now have parity between mental and physical health services. We should apply what we have learned from the success of the Mental Health Services Act and many decades of research and trials of our physical health services to our mental health system – voluntary treatment works, coercion does not.

People will gradually buy into the treatment process as they come to trust it; they will not do it otherwise. Yes, children can be forced into treatment by their parents, but by the time they become adolescents they will become as creative in ways to refuse services as they are in avoiding homework – especially if they are afraid of the service system or its providers.

If we are looking to help young people because of the current spotlight on their acute need for mental health services, we need to give them the opportunity to develop rapport with therapists and counselors. The answer is not always medicine; sometimes talking with peers, extended family members and trusted social workers or other authorities are the best paths into the system.

The better solution is to invest in mental health services through comprehensive federal and state partnerships such as suggested by state Senate President Pro Tem Darrell Steinberg, author of California's Mental Health Services Act. His plan to strengthen the Affordable Care Act focuses on three areas key to ensuring access to mental health services: prevention and early intervention, access to mental health services in school-based health care centers, and a fuller continuum of services for people with serious mental health conditions.

Discrimination against those who seek help or who are identified as having a mental health condition is the greatest barrier to effective treatment. Expanding voluntary services is critical: Forced treatment has never been the answer.

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