i'm pleased to be here. my name is ham fisher. i'm a board member of the national alliance on mental illness. i am the parent of a son who has graduated from san francisco behavioral health corp., and i can say the assisted outpatient treatment that he received through the court has turned his life around. he is now registered for classes at city college. he is living in his own apartment. i am supremely grateful to the care he received. i'm sorry he had to go to jail and get in trouble with the law to receive that care. please pass laura's law. thank you. supervisor alioto-pier: thank you. next speaker please.

>> good morning. my name is roberta english. i am a member of the california board of directors, and i was here last hearing, and i stated then that california has always supported the concept and the implementation of laura's law, and our intention and hope is that it will be in every county in california sooner than later because each day that passes means perhaps a life is lost. we work together to see the county -- the county's implement this. it is really your job, your opportunity to create this historic moment in the next coming days where laura's law can be implemented here in san

francisco, and i am very much trusting in all of the work you have done. the materials have been given to you, and i know you have reviewed it carefully and have the best of intentions, but i do want to say because i am the mother of someone with a mental illness -- some years ago, -- this is the city of my birth, by the way. i think that how many times i walked the streets and rode the buses and knew about mentally ill people, i thought, until my own daughter became mentally ill. at that point, i was afraid to bring her to san francisco. i did not want my daughter on the streets of san francisco with a mental illness. i hope in the future, that is not the same kind of concern that it would be today. she is in marin county, doing well, but the point is really what you are out to do, and it is historic, and i do want you to rise to that occasion in the coming days when you have that opportunity. thank you very much. supervisor alioto-pier: thank

you. >> i'm a retired psychiatric nurse and a family member of someone who has a serious mental illness, and for the past eight years, i have been leading a support group for family members, and i want to speak to the anguish that i hear in his meetings. the primary reason people come to the support group is because they have a son or daughter or brother or sister or a partner who is in serious crisis from their mental illness. they are afraid for the person's life. the person is resisting treatment, so these family members are ready to provide financial help, to provide fiscal help, whatever is needed, and they cannot do that because they cannot break through the delusions' of the person who needs help. one of our family members did lose an adult child to suicide,

and they all feel that such an outcome, either suicide or whatever the outcome would be would do great harm to their loved ones, so i just want to speak to the tremendous amount of suffering [inaudible] supervisor alioto-pier: thank you. next speaker please. >> i have a son who started to hear voices when he was 17. it started as radio static, and then he would say, "mom, can you hear the crowds? where are they?" he heard this mumbling sound, and it developed to the point where he would hear and see seton, and he started to take all the food out of the cabinets in the kitchen because state and had been in there, and thank god we got him to a psychiatrist. he was not so paranoid yet that

he had started to miss trust us, which happens. people tend to not trust anyone when they get really sick, but we got him in, and he started right in on medication, and he did very well very shortly after that. he was so relieved. he has always stayed on his medication. he does not feel any negative side effects, so i am one of the lucky parents who has a son who was able to take advantage of the treatment that was offered, but i'm here on behalf, also, of my friends whose children probably just did not want to say anything, and then they got progressively so ill that the weapons came out. when you are being chased by satan, you really feel you have to protect yourself, and here is where all the tragedy begins. i really want people to be able to help the person they love

when this kind of an illness happens, and you save a lot of lives this way, and i beg you to pass laura's law and enforce it. supervisor alioto-pier: thank you. next speaker please. >> i am division director of city-wide case management and community focus. we have been providing case management to the highest risks, the most severely mentally ill adults for the last 30 years. we know intensive case management wraparound services works, and we know very few people are we are unable to coax into treatment, but there are a significant number whose mental illness precludes them from participating on a voluntary basis. we know that assisted outpatient treatment works because we are doing it in our clinics through

the san francisco behavioral health corp. we are the primary treatment for a writer. we have two groups of clients in our clinic. those who are there voluntarily, and those there because of the behavioral health corp., and you cannot tell the difference. they are both severely mentally ill. many of which have suffered severe sleep problems. they're both participating in treatment. when we asked them their satisfaction with services, they are both -- they both rate highly, almost identically, their satisfaction with services. what is the difference? the difference is once you had to be arrested before they could participated in treatment. that is bad for them. they now have an arrest record. it is bad for the community because frankly, the crimes they committed put the community at

risk. it is bad for the families who had to help the family members could be arrested before they could participate in treatment. it is bad for services in general that we have been filling up our jails with people who are mentally ill and should be in treatment. our goal is to put our involuntary behavioral health for people out of business and get those folks in -- into treatment before they get arrested, and we think laura's law will go a long way towards doing this. we also know that this is not an issue of protecting people's civil rights. there is no -- it is not humane for so warrants to be on the streets, a psychotic, delusional, angry, and threatened. thank you.

>> good morning. in the interim director of mental health association second direct -- of san francisco. we oppose the resolution authorizing the implementation of a system outpatient treatment pursuant to the call for an alternative section code section, commonly known as laura's law pirie the basic principle of law in united states is that all adults are presumed to be competent. that is, they are presumed be capable of making their own decisions about their own lives and their own medical care, including mental health treatment. every state has court procedures for determining when and if someone is incompetent. only a tiny percentage of people have ever been declared incompetent under these procedures. is corresponds with reality that almost all persons with even the most serious mental illnesses are competent most of the time. that is they are capable of making their own decisions about

whether to seek treatment and support and what treatment and support they should receive. the association acknowledges that a.b. 1421 was passed in the interest of public safety, but we believe that if proposition 36 and other funding resources for outpatient mental health services were fully utilize, there would be far less need for a measure of the source. second, the bill if enacted has the potential to go beyond its value as a tool of public safety. in regard to the safety of san franciscans have the unenviable job of guarding the rights and dignity of this population of disabled citizens. thank you. supervisor alioto-pier: thank you. next speaker please. >> first of all, i want to acknowledge and make sure that everyone hears that i do know there is real suffering out on the street, suffering here, and

that people do behave in ways that could easily be characterized as mental illness. i do not disregard that. i was at the last hearing where we were informed that the dsm 4 has come up with a diagnosis where someone is lacking in side about their mental condition, and this really struck me as a catch-22 because i remember there was a diagnosis of a slave who did not accept his or her condition of slavery was considered mentally ill. i really think that someone who is unable or unwilling to accept the treatment that he or she knows and now probably everyone in this room has knowledge has

severe physical and psychological effects that are irreversible. why that would be a sign of illness -- it really does not even make sense to me. the other thing that i do want to ask -- and i hope you will consider -- is how many people ever get off the assisted outpatient treatment. is it a leash for life? i mean, that is -- that really seems to be a question of civil rights. and basic dignity of the human. the other thing is i'm going to attach the third rail, perhaps, when no one else will, but who really benefits from these laws? i think ms. jacobs spoke earlier and said what makes it work,

according to the statistics, is the fact that it is a combination of a court order and services, but if you tilt the forced or coerced of medication out of it, how many people would still be in favor of this? thank you. supervisor alioto-pier: thank you. next speaker please. give me two seconds. let me just call up some more people. >> i have no pre-determined

thoughts to share. i'm coming up here totally spontaneously, representing those mental health clients. although i have not ever even been hospitalized, i have never had any sort of dramatic episodes in my life. my father, though, when i was hospitalized, and it did not help him. i'm not one to take a stand and do margins and the sort of thing to prove a point, because i feel both sides, but i would like to tell you that because of what happened to my father, i would not go near the mental health system. i just would not. not until 2006, when my 20- something daughter said that those having mood swings and maybe i ought to do something about it. and i am not pro-medication.

so she had some will be trained that the doctor had given her to quit smoking, and i tried it, and it was good -- she had some welbutrin. when i ran out of samples and could not afford to continue my treatment, i went to the county and asked for help to get the medication, which i did not take seriously at all, so the point is i got off the medication when i felt i no longer needed it, and the point of the story is that it just seems like too much attention is given to mentally ill as serious -- very, very, very serious -- and not to the majority of people who are not mentally ill or not that mentally ill. what is serious? it is a matter of opinion. just like everyone in this room as their experience, has their opinion, so this is an extreme

measure, it seems to me. so i'm just stating my experience, which is all any of us can really do, and this is from my heart. thank you. supervisor alioto-pier: thank you. next speaker please. >> i think that'si think it is o decide for me what i need or what i want. i have been on both sides of the table in regards to this situation with mental illness. i have been labeled mentally ill. i am "mentally ill." i have lived incarcerated. i have lived in the jail system. i have been forced to have to take treatment that i did not feel was the right treatment for me. i went along with it because i was forced into the decision to

be free or not be free, to make my own decisions or have them made for me. in that situation, of course i went along with the choices made for me even though i did not agree with them. i was not well at that time. i took the medication. i played the role, but i was not well. if anything, i would say the whole process made me sicker and not better. one of the things i know and have to say is that i have been working on my wellness and recovery. i have done that because i have a treatment team that understands me and allows me to voice my own feelings. we make choices together about what is best for me. i do not have to worry if i am having a bad day and feeling

kind of psycho, i do not have to worry about being incarcerated or committed to an institution because my treatment team knows my needs. they know that is not the best thing for me. i believe that voluntary choice is best for the person, the individual. we can spend a lot of money on laura's law or we can spend less money and have it be more productive by creating a crisis respite centers in the community. society has failed the people labeled as mentally ill. laura's lot is just another escape that. -- glarus -- laura's what is

just another way to escape that. thank you. >> good morning. i am dauphine brody from the california network of mental help clients. i am here to speak on behalf of the coalition advocating for rights, empowerment, and services and on behalf of the california network of mental help clients we strongly oppose this legislation. we urge the committee to reject it. was l-- it is an iron fist in a velvet glove. it is a way to coerce people to what is first turned a voluntary settlement. if they refuse, they are presented with a petition. it is a form of forced treatment.

the forced treatment will not include explicitly forced medication. that requires separate hearing for capacity. it is significantly more expensive and less effective to coerce people in this way. voluntary services are clearly the solution that has already been proven. expanding the raid to include -- the array to include a majority of choices include people where they are is what other counties need to do to meet the needs of people in distress. furthermore, current law already provides an array of involuntary commitment procedures that are more than adequate, including 72-hour holds, 14-day holds,

temporary and permanent conservatorship. all this implementation accomplishes is further division within the mental health community, as you have seen today. it undermines the integrity and success of voluntary programs we have begun to implement through the mental health services act. it dramatizes clients. it leaves them to associate voluntary and non-threatening support with coercive treatment. the collective experience of some many clients confirms that they often have prior negative experiences with involuntary treatment. we urge the committee to reject the legislation. thank you. supervisor chu: thank you. next speaker please. >> hello. i am sandra larson. i am a consumer. i work in the city and county as

a patient's rights advocate. i am not representing my organization. i am also a member of the california network of mental health clients and the sentences go network. i have a long history of mental health treatment. i am 69. i started when i was about seven. i have been institutionalized, shocked, treated with medication. when i got to california where there was openness and a sense of freedom with the presidential system, i was taken in. i began to meet my peers working to change the conditions in the system. i also met for-looking providers and legislators who wanted to change aulos -- the laws. we hope we have come up with the money to the friendlier and more welcome services for people are welcomed and do not feel that

they have been coerced and forced into treatment. i know that everyone has a serious and real concern for their family member. i have a son who had his first break. the treatment he received has him terrified. he does not want to go back. there are a lot of people who have this kind of response. they become afraid. that together with their illusions that are not all treatable with medication is very difficult. i do not think we are ever going to be able to save everybody. someone might be harboring the illusions and not acting on any of them. there might be a violent act. my thought was that this law was supposed to be for acts of serious threat and violent behavior if that was in your history. that is how the law in new york

came about. someone attempted to harm themselves and someone else with and so many months. but i hear that we're going to be picking up people on the street and helping them because they are mentally ill and keeping people in the system because they are resistant to treatment. we have a program for homeless adults are diagnosed with serious mental illness. it was very successful. there's a paper on effectiveness of integrated services reports to the legislature. it is available. i feel we can accomplish so much more without billing in this direction. thank you very much. supervisor chu: thank you. next speaker, please. [tone!] >> hello.

i am here with the california network of mental help clients. mental health clients. i wanted to comment that in my opinion, outpatient commitment is outdated and stigmatized. people with mental disabilities -- sorry. supervisor chu: take your time. >> since time immemorial, the traditional system has used coercion and force in its attempt to solve problems. anything that would use force

and force people to have treatment would be going backwards, not forwards. a transformed system will create options that maximize self- determination and autonomy. these are goals of the mental help services act. -- the mental health services act. in our opinion, course of treatment is ultimately ineffective. -- coercive treatment is ultimately ineffective. it will not stop non-compliance. that is viewed as a problem that more forced treatment was off. researchers have found that forced treatment causes noncompliance. the well-being research project supported by the california department of mental health

found that 55% of clients who had experienced forced treatment reported that fear of forced treatment caused them to avoid all treatment. that was for psychological and emotional problems. the study concluded that coercion undermines the therapeutic relationship between a client and his or her therapist. choice is essential for recovery. choice is an important concept for humankind and human dignity. [tone!] mental interventions should be soundly based in choice. treatment and civil rights are not antithetical to each other. good treatment can only occur in

an atmosphere of choice and freedom. we urge the committee to -- [tone!] -- reject this legislation. supervisor chu: next speaker, please. if there is anyone else who liked to, come on up. >> i am program director for the city-wide case management forensic program. i am here to urge you to vote in favor of implementing laura's law in san francisco for three reasons. it makes sense from a treatment perspective. for individuals with severe psychotic symptoms from schizophrenia and bipolar disorder, some do not believe they are ill. they remained untraded. that makes their illness worsened long run. i have worked for 15 years providing intensive service involuntary case management to the sickest individuals in san francisco. even with these services, a small percentage continue to refuse medication because of their mental illness.

this is the prevention and public safety measure. i helped create the san francisco behavioral help court to address the problem of the county jail filling up with the mentally ill. these people have committed serious felonies and violence because of untreated mental illness. the victims of these offenses are usually supportive of their perpetrators engaging in behavioral health court. they understand that the court will supervise these individuals closely and mandate treatment. that prevents future violence. the agency cannot force people to take medications. it does have leverage in ordering compliance with treatment. the leverage of having to appear before a judge or submit to the hospital for an evaluation is often enough to achieve compliance or treatment, as laura's law would do. assisted in outpatient treatment is sound fiscal policy. it saves the city money from expensive emergency services and criminal justice services. i believe implent