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Ft. Myers News-Press

May 7, 2004

Reprinted with permission. All rights reserved.

Alternative to Baker Act should be law; Bill enables medication of mentally ill

The Florida Legislature has finally filled in a major gap in the treatment of people with mental illness. Now it’s up to Gov. Jeb Bush to sign the measure, and for the health-care community to start using it.

Senate Bill 700, passed in the closing hours of the session, will allow what the professionals call "assisted outpatient treatment," or court-ordered medication for patients who are not in a mental institution.

Modern medications can allow many people with mental illness to stay out of institutions and live safe, productive lives in the community - but only if those drugs are used faithfully.

Too many patients fail to follow their treatment plans. They then may pose a danger to themselves and others, living in the streets, landing in jail or even dying in tragic encounters with police.

That guy on the street corner, gesticulating at passing cars and creating an uncomfortable and potentially dangerous nuisance, could possibly be leading a normal life if he could be pressured into taking his medication.

Under current law, patients who get into difficulty are either involuntarily committed to an institution under the state’s Baker Act if they are dangerous enough, or left to fend for themselves until they are - a clear invitation to disaster.

Senate Bill 700, on its way to Bush’s desk, is similar to laws already in effect in 41 other states. It allows court-ordered medication of outpatients, without their having to be committed to an institution.

The idea of forcing an ill person to take medication is a very uncomfortable one; these medications have unpleasant side effects, which is why some ill persons avoid taking them.

Even more patients who fail to take their medications do so because their condition leaves them unaware that they are ill.

Advocates of this legislation believe that experience has shown that a patient is much more likely to comply with treatment plans if they are court-ordered.

As of September 2003, for example, New York Office of Mental Health data showed that for people placed in assisted outpatient treatment under a law similar to the one just passed in Florida, 63 percent fewer were hospitalized, 55 percent fewer experienced homelessness, 75 percent fewer were arrested and 69 percent fewer were incarcerated.

Numerous procedural safeguards have been incorporated in this legislation to protect patients against abuse.

Physically forced medication is not the intent of this law. It could hardly be, since the goal is to keep people in the community, where they will ultimately still have to make their own decision to medicate every day.

The Florida Sheriffs Association, whose members are so often left to deal with outpatients who don’t take their medications, has provided the big push for this law, along with the Virginia-based Treatment Advocacy Center. This is the third time the Legislature has considered the reforms, so it is careful legislation, as it should be.

Urge the governor to do what he has indicated in the past he would do, and sign this bill into law.