A mental health provider-turned state legislator plans to introduce an involuntary commitment and treatment law in Michigan, where the mental health system is in such disarray that the issue might be less contentious than usual.

State Rep. Virg Bernero, a Democrat from Lansing, was scheduled to announce "Kevin's Law" on Aug. 17, the first anniversary of the murder of Kevin Heisinger. The bill will be modeled after "Kendra's Law" in New York, which followed a highly publicized death in that state.

Michigan mental health groups are waiting to take a position on the new bill, and might actually support it if it meets their standards. When they realized that legislation on the issue was likely, several groups formed a task force to develop a model assisted outpatient treatment program.

The model should be completed by mid-September, said Mark Reinstein, policy director for the Mental Health Association (MHA) of Michigan. MHA will use the model to evaluate Bernero's bill.

Reinstein seemed receptive to the idea of involuntary treatment I it meant improving services.

"This may well represent a promising opportunity to get treatment for those who need it and are not receiving it," he told MHR.

IT'S NOT SO UNUSUAL

Bernero's legislation might have nationwide significance because Michigan is a big state. The two most prominent states in the involuntary treatment battle have been New York, where Kendra's law was bitterly opposed; and California, where a year-long effort to craft a bill has been interrupted only by the energy crisis (MHR, July 20, p. 128).

Involuntary treatment legislation has been a vocal issue in those states because of the large presence of patient support groups, said Jonathan Stanley, assistant director of the Treatment Advocacy Center (TAC). But TAC, which supports involuntary commitment and treatment, has seen efforts succeed in other states. West Virginia, South Dakota, and Wyoming all have expanded the legal use of involuntary treatment - but get a lot less notice, Stanley told MHR.

Kendra's Law was the 41st state law on assisted outpatient treatment, but it was a big deal because other states were not using their existing laws, Stanley said. They have generally stuck to a "dangerousness only" standard.

The Michigan bill could be boosted by the fact that diverse advocacy groups - some of which might traditionally oppose involuntary treatment - have already met to form a consensus on the issue. The task force includes a psychiatrist, consumers, a children's advocacy group, a community mental health agency, the local Alliance for the Mentally Ill and the state chapter of the International Association of Psychosocial Rehabilitation Services. While "things get spirited" in the group when members disagree, Reinstein said, the members are working out their differences.

Another advantage is that Bernero is addressing other issues likely to garner widespread support in the mental health community. For example, he has proposed establishing an Office of Mental Health Ombudsman for consumers and families.

Finally, involuntary treatment might sound good in a mental health system that got a failing grade in a report card issued by state advocacy groups at the end of June. The system met very few of the groups' standards. For example, the state uses publicly operated psychiatric inpatient beds at a rate of about half the national average.

FUTURE IS UNCERTAIN

Still, Stanley acknowledged the challenges of moving Kevin's Law forward: Bernero is a freshman Democrat in a state House of Representatives where Republicans have a slim majority (and the governor is a Republican). But mental health issues usually do not run along party lines, Stanley said. The bill's cosponsor, Tom George, is a Republican.

Bernero likely will have to respond to at least some of the same criticism - sometimes vituperative - that greeted Kendra's Law. One argument has been that public policy should not be dictated by isolated high-profile events. Critics of involuntary treatment say this stigmatizes the mentally ill by associating them with violence. Defenders such as Bernero say a law helps prevent stigma by decreasing the number of violent incidents.

Such laws are names after specific people as a political ploy, Stanley said. Other legislative efforts use high-profile incidents to bring an issue to life.

Heisinger was a social work student who was beaten to death in a Kalamazoo but station by a man suffering from paranoid schizophrenia. Bernero told MHR he had a copy of Kendra's Law in his briefcase when Heisinger was killed.

"I felt I hadn't done enough" to push a law in Michigan, Bernero said, and he wants to avoid such incidents from happening again. Bernero was not yet elected at the time; he was leading the Michigan Association for Children with Emotional Disorders, which he represented last year at the surgeon general's conference on children's mental health (MHR, Oct. 13, 2000, p. 173).

Bernero promised that community services would be a necessary part of his legislation. He noted that funding is obtained thorough a separate legislative process and that he would support the effort to fund treatment.

Bernero and George will not formally introduce the bill until the state legislature returns in September.

Contact: Rep. Virg Bernero, (517) 373-1770, email: [email protected];
Mark Reinstein, MHA of Michigan, (248) 557-6777, email: [email protected].
[Jonathan Stanley, Treatment Advocacy Center, (703) 294-6001, email: [email protected].]

Reprinted with permission from: Mental Health Report, August 17, 2001; Vol. 25, No. 6; Pg. 149. Published by Business Publishers, Inc., 8737 Colesville Road, Silver Spring, Maryland 20910, (800) 274-6737.