We’re collaborating to support the most vulnerable

The Community Voices (“Why are so many seriously mentally ill still homeless?,” Oct. 24) brought up some important issues about Laura’s Law. The opportunity to discuss complex issues like mental illness among the homeless population and compelling individuals into treatment is welcomed, especially around how we are trying to serve homeless individuals suffering from mental illness. Laura’s Law, also referred to as Assisted Outpatient Treatment, was specifically created to provide services to individuals who repeatedly cycle through jails and inpatient facilities and who pose a danger to themselves or others as a result of their untreated symptoms of mental illness. This program started in Kern County six years ago, in 2015, and has been funded through the Mental Health Services Act.

After receiving a referral, the Kern Behavioral Health and Recovery Services AOT team will connect with AOT candidates at their homes, in hospitals, jails and on the street — wherever the client can be found. An intensive period of engagement occurs, with the goal of getting the individual to connect to mental health services. It is the ultimate outcome that an AOT client consents to services voluntarily and if not, a petition to the court will be made in partnership with county counsel and the Public Defender’s Office. If the court finds the conditions have been met, a recommended treatment plan is presented to the court, county counsel and public defender. The treatment plan includes recommended services such as case management, therapy and medication management. Although medication cannot be forced, it can be recommended and encouraged by the collaborative team.

AOT has been very successful for the individuals served, as 60 percent have voluntarily accepted treatment without having to petition the court. For those who are ordered into treatment, these clients are staying engaged in services and making progress, by reducing hospitalizations, incarcerations and keeping them housed.

Despite limitations in criteria, AOT does have a role in efforts to help people struggling with mental illness living on the street. However, this is just one of many needed solutions. AOT’s strict criteria, defined under Laura’s Law, will not apply to many people living unsheltered with mental illness as they won’t have the necessary history for recent, repeated incarcerations and hospitalizations. This limitation reenforces the necessity for outreach efforts from the KernBHRS Relational Outreach and Engagement Model team and Flood Ministries.

The ROEM team was specifically established to address the needs of homeless individuals, resisting both mental health or substance use treatment and available housing options. The team will work to establish a relationship with the client, finding ways to build trust and rapport, while also continuously assessing the needs, safety and vulnerabilities of the person served. While the primary outcome for the ROEM team is connection to mental health or substance use treatment and housing, some ROEM clients have been found to meet criteria for 5150s and have required hospitalization. This starts what may be a long process, including failed housing placements, potentially multiple hospitalizations and possibly ending in petitions for conservatorship or AOT referrals. The ROEM staff will follow the individual throughout this entire process until outcomes for stable housing and treatment are met.

Working with homeless individuals struggling with mental health and substance use issues has illuminated the complexities of finding solutions to end homelessness. It has highlighted the need to have many resources and solutions. It has also emphasized the need to have a collaborative team working together with shared goals. I’m very grateful that in Kern, we have a very strong collaborative successfully working together to build out a full array of needed services, with partners who are dedicated to serving the most vulnerable and in need, treating them with dignity and kindness. I appreciate that Kern is a county that opted to establish an AOT program and that we have such strong partners working together to support comprehensive solutions to help our most vulnerable.