OUR mental-health system is at a breaking point, due in large part to the growing number of people facing involuntary treatment at a time of inadequate resources for much-needed mental-health services.
The crisis will grow more acute on July 1, when a new law goes into effect relaxing the criteria the state uses to commit people against their will. By some estimates, this new law will increase detentions statewide by 15 percent.
As we continue to confront this crisis, let’s be sure not to overlook the need to protect the civil liberties of all citizens, especially people with mental illness.
This issue is front-and-center right now at King County’s involuntary commitment court, where public defenders represent people facing potential involuntary commitment. What we increasingly hear is something that concerns us deeply — the suggestion that some rules meant to protect the rights of the mentally ill are mere technicalities.
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In recent weeks, for instance, much has been made of provisions in the state’s Involuntary Treatment Act that set time limits by which designated mental-health professionals must decide whether someone brought to a hospital for possible involuntary commitment should be detained.
When those time limits are missed — and that can happen for any number of reasons — the individual’s defense attorney raises the issue in court, seeking dismissal on the ground that the delay violated the person’s due-process rights. We do so because much is at stake when someone stands to be committed involuntarily — an act our U.S. Supreme Court recognized as a “massive curtailment of liberty.” We do so because it’s our job to represent our clients.
Time limits are commonplace in the U.S. legal system. Someone jailed for a crime has a right to go before a judge within a set time. Americans have the right to a speedy trial. Rules govern our judicial system, and many of those rules establish time limits.
It’s no different for someone who has been detained due to mental illness. Before modern involuntary-commitment laws, government abuses were rampant. There was a time, for instance, when an unhappy spouse, usually the husband, could get his wife committed because he wanted to be rid of her.
Thankfully, Washington now has a reasonable law that seeks to balance the state’s interest in committing people at risk of harming themselves or others with the individual’s right not to be confined if he or she doesn’t meet the criteria. The requirement that a designated mental-health professional make this determination within a deadline is not an obscure provision of that law. It’s key to this critical balance.
And while considering the importance of time limits, let’s not forget how a person with mental illness comes into the hospital. He or she can be strapped to a gurney, placed in seclusion, locked in a windowless room and subjected to antipsychotic medications. It’s a far different experience than that of a person who voluntarily comes to the emergency room with a broken arm.
There’s also an important policy consideration to timely evaluations. The sooner a person is evaluated, the sooner a critical ER bed would be freed up should the individual be released. Allowing a person to languish in an ER, awaiting an evaluation, is not in anyone’s interest, including the government’s.
The real solution, of course, is the one that often proves elusive: We need to adequately fund our mental-health system. Those involved, including designated mental-health professionals, are hardworking and committed. No one wants to see individuals needlessly wait in emergency rooms.
It’s critical that we continue to take a hard look at our overburdened mental-health system. But as we do so, let’s make sure we understand the importance of upholding the rights of those who stand to lose their liberties should confinement take place. Like all Americans, they deserve due process, and those rules that help ensure due process are far from technicalities.
Mike De Felice, an attorney at the King County Department of Public Defense, supervises the public-defense team at the involuntary commitment court at Harborview Medical Center. He’s been a public defender for 24 years.