The recent deaths of two women with mental illness who were the subject of police calls
in Minneapolis and St. Paul have prompted a reexamination of the way officers are trained
to handle such incidents. However, that's only a small part of the problem. These two
tragedies, which occurred within 24 hours of each other, also indicate the need to change
Minnesota's mental health system to promote early intervention and treatment to prevent
these confrontations from happening in the first place.
In New York State, a significant barrier to earlier intervention is needed, standard
for involuntary civil commitment, which is based on a criminal model, not a medical one. A
judge must determine that a person is a danger to himself/herself or someone else, or
dysfunctional, before being committed. Meeting that standard makes the process of getting
involuntary treatment for a loved one difficult, if not impossible, for many families.
Even for voluntary patients, many insurance companies mirror this legal standard as a
qualification for care.
As a result, family calls for help for many persons with mental illnesses often go
unanswered until a situation reaches a crisis level and then the front-line respondent all
too often is an armed police officer ill-equipped to handle a person in such an
unpredictable and, by that time, potentially dangerous mental state. I know from my own
family's painful experience with our adult son's mental illness that early intervention by
mental health professionals -- before a crisis occurs -- would be far preferable. I've
read letters and E-mails from other families who are struggling with this same dilemma.
We found that many of our mental health policies with regard to involuntary commitment
were developed in a different era of treatment -- one in which lobotomies, bone-breaking
electric shock treatments and medications with severe side effects were commonplace.
Stricter safeguards were necessary to prevent abuses of involuntary commitment. Now,
improved treatment techniques, new research and the development of medicines with less
onerous side effects have lessened the possibility of such abuses.
In addition to preventing violent confrontations between police and persons with mental
illness, early intervention and treatment of certain mental illnesses can prevent
permanent and irreversible brain tissue degeneration, making full recovery more possible.
We need to lower the legal bar for involuntary commitment when necessary to allow for
early intervention, including short-term hospitalization of up to 30 days in order to
encourage the use of newer medications that take longer to kick in. This must be followed
by community care. The biggest hurdles to overcome will be objections from civil
libertarians who oppose removing any barriers to involuntary commitment, and finding the
funding needed for expanding community care programs.
Additionally, because next year is a funding year, we also will be pushing for changes
in the mental health system that will be more universally supported. They may include
measures that would:
1. Reduce the need for involuntary treatment.
2. More appropriate services could be use as part of outpatient commitment or
3. Integrated services across state and local agencies that would be more effective in
meeting consumer needs.
4. Include a strategy to counteract the stigma of mental illness.
5. More culturally sensitive services is needed.
6. Assess the cost of unmet needs for mental health care.
7. Include strong accountability provisions that would focus on outcomes while
supporting flexibility and control.
8. Propose alternative methods of financing and payment that would support the above
objectives.
While the task may be formidable, the need for such changes in the system grows with
each new headline about persons with mental illness dying at the hands of police or by
their own hands in a crisis that might have been avoided. To do nothing is fair to neither
police officers nor persons with mental illness, both of whom become victims when these
situations turn tragic.
