Protections for People Subject to Involuntary In or Outpatient Commitment Proposal I Wrote Last Year

Alison Hymes, member, Commitment Taskforce, November 15, 2007

 

Summary of Protection of Subjects of Involuntary Commitment Issues (Draft)

1.. There is a clear need for independent medical monitoring and follow up of subjects of commitment whose treatment includes psychotropic medication. (Not just neuroleptics, but all psychotropics including depakote, Tegretol, lithium and others.)
 This could be a G.P. or Internist hired by the CSB overseeing the
outpatient commitment to monitor all clients or it could be contracted out, but it is necessary to prevent medical harm and permanent injury. (Psychiatrists in CSB’s do not have the time to monitor medical health beyond cursory screenings if that, they will not have more time in the future if Kendra’s Law is passed.)

 

 2.. No one who is involuntarily placed in a hospital or in outpatient treatment should be forced to pay out of his or her own money for his or her unwanted treatment. If the state wants a person treated against their will, the state needs to pay for it.  Likewise all drugs that a person takes under a judicial authorization of treatment must be paid for by the state or
CSB,not the person who does not want to take them.  To do otherwise is to levy a civil fine on an individual who has not committed a crime or a tort in my opinion.  (The response by members of the Access Taskforce that this could lead to people preferring involuntary treatment to voluntary shows a clear lack of insight into the nature and effects of coercion and force seems based in a view of people with mental illness and their real lives that I can not even fathom.)

 

3.. The Medicare days of a subject of involuntary commitment (limited to lifetime of 180) should not be used for his or her hospitalization leaving him or her with no days left for voluntary hospitalization in a hospital of his or her choice in the future.
 

4.. Subjects of involuntary inpatient commitment and TDO’s should have the following protections as a matter of course:

A.   The right to have whomever they choose notified of their whereabouts at all times including when they are transferred to a different facility.
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 B.   Protection from eviction from apartments, nursing homes, Adult Living
 Facilities and group homes.

 C.   Protection from default judgments

 D.   Protection of their credit rating through requiring they be helped to access any bills they pay each month such as credit card and utility bills and given the chance to pay them from the hospital or other facility.

 E.   Freedom from exposure to unnecessary risks: The right not to be housed with NGRI’s with an arrest for a crime of violence, and the right to be allowed to choose to be housed in a single sex unit.  (The current human rights regulations do not even begin to address these concerns and have never been interpreted to do so.  This would need to be a new right/protection/statute.    The concern about NGRI’s with a record of arrest for a crime of violence and their need for a less restrictive environment is laudable but could be accomplished without endangering people who have not been arrested for a crime of violence by having separate step-down units for NGRI’s.  People who have been civilly committed are vulnerable to exploitation and violence and experience demoralization when they discover they are in the same unit as someone arrested for a violent crime.  Both women and men with mental illness are more likely than not to have a history of abuse.  For some, the safety of a single sex unit is necessary for their recovery and avoidance of re-traumatization.)

5.. Persons subject to commitment should have the right to have their own private provider testify by phone, deposition or fax at their commitment hearing.

 6.. The use of handcuffs shackles and police vehicles should be a last resort, not the first, in transporting people subject to commitment.  No one subject to commitment should be strip searched by a police officer for any reason.