When a Mentally Ill Child Becomes a Mentally Ill Adult

OC parents find they are out of care options unless Laura's Law is adopted

Lonky joined the Orange County chapter of National Alliance on Mental Illness (NAMI), which offers support for families. She teaches parents and other caregivers of children and teens with mental illnesses how to navigate the medical, school and legal system. "We warn parents of 16- and 17-year-olds, 'You think it's hard now to get your kid's cooperation? Wait until you don't even have the right to do it. You have to use the little bit of power you have now to gain their trust.'"

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Passed by the California Legislature in 2002, Laura's Law would act as a cushion for those who cannot be helped by traditional county services. Named after Laura Wilcox, a 19-year-old in Nevada County who was shot and killed by a schizophrenic man who had refused treatment, the law provides outpatient treatment—against one's will, if necessary—to those who meet strict legal criteria, such as repeated hospitalizations and arrests. New York has a similar law called Kendra's Law.

Now that her son, Matthew, is legally an adult, Jennifer Hoff can't get him the treatment she believes he needs
Kenneth M. Ruggiano
Now that her son, Matthew, is legally an adult, Jennifer Hoff can't get him the treatment she believes he needs
Photos of Matt Hoff
Kenneth M. Ruggiano
Photos of Matt Hoff

The services called for by Laura's Law may be paid with funds from Proposition 63, a.k.a. the Mental Health Services Act. It's up to each county's Board of Supervisors to opt into the law, and so far, only Nevada County has done so. Los Angeles County has a small pilot program. According to Carla Jacobs, who helped draft the legislation, it has been shown to save lives and money. Last year, the Los Angeles County Department of Mental Health filed a progress report that showed a 78 percent reduction in incarceration and a 77 percent reduction in hospitalization among participants.

Right now in Orange County, Jacobs says, the behavioral-health department "acts as the gatekeeper to all aspects of treatment," and Laura's Law would give families more options.

Her husband, Brian Jacobs, chairman of government affairs for NAMI Orange County, describes the current situation as "It's like you're out on the street, and your house is burning down, and there's a fire hydrant and fire hose in front of you that the system is saying you can't use."

But some question whether Laura's Law is the right solution for Orange County residents. The law cannot force a person to take medication, which some officials say is what severely mentally ill patients need most, and a report by the county Health Care Agency estimates that implementation of the law would cost $5.7 million to $6.1 million per year. (Supporters of the law claim those numbers are grossly inflated and don't account for the savings.)

Orange County Supervisor John Moorlach has been studying Laura's Law for months. "It probably is a great concept, but when it comes to implementation, it gets a little dicier with funding and spending," he says, adding he's "very aware and intimate with the program in Nevada County," but "their population is 99,000, and ours is 3.1 million."

He continues, "We're trying to get some resolution based on all the constraints."

If Laura's Law were in place today, Matthew Hoff would qualify. Jennifer knew very early on that her son would need treatment throughout his life, and by age 8, she saw a glimpse of "how bad things could get."

She had to take him out of two preschools for being disruptive. He could make friends easily, she says, but he could never keep them.

In elementary school, Matthew started having hallucinations and refused to sleep; he would eventually pass out on the floor. Sometimes, he would sit there and pick at his arms until they bled. "He had a brain that was frightening to him," Jennifer says. "He was so scared to be alone."

As he grew older, her son's behavior became "reckless," Jennifer says. He'd get into verbal fights and hitch rides with strangers. At 12, Matthew was enrolled in Orange County Mental Health services and "exhausted every educational environment California had to offer," Jennifer says. When he reached junior high and high school, Jennifer and Gary decided to send him to locked psychiatric facilities in Texas and Montana for his protection.

In the months before he turned 18, Matthew was excited. "He wanted to go to community college, wanted a girlfriend, wanted a driver's license," Jennifer says. "He was as ready as he was ever going to be to face the world."

But, Gary adds, he was also overcome by "enormous anxiety."

"He was counting down the minutes until he turned 18, but he was scared to death of what would happen when he got there," he says. "Because what was there for him?"

When he finally became an adult, Matthew spent two months in a county-funded home in Anaheim for "transitional-aged youth"—or what Jennifer refers to as "the frat house." "The very first day, there were drugs and alcohol," she says. "There's no curfew, no residential manager, nothing. They made the distinction of taking a kid who couldn't hold it together and had to be on the highest level of restriction, and then transitioning him into all the freedom of a young college person. He had never demonstrated the ability to handle that."

Within months, Matthew opened a neighbor's car door and stole an electronic device.

"There's a huge chasm in the law," she adds. "You're a child, you're kept safe. Then it's like the Grand Canyon, and if you can't make that big a leap, if you're not the kind of person who can navigate the system of care on your own, there are no services for you. Some people need to be told to take care of themselves. I don't see why that's so hard to believe. They make us wear a helmet. There's all sorts of stuff we're mandated to do."

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