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"The Cook County Jail is now, in effect, the largest mental hospital in Illinois. There are more people with mental illness in our state prisons than in all our public and private psychiatric institutions combined."

- Mark Heyrman, a University of Chicago Law School professor and chair of the public policy committee for the Mental Health Association of Illinois, in The Chicago Tribune, May 16, 2002. The mentally ill are nearly four times more likely to be killed by police than members of the general population. Read more on the effects of criminalization of those with mental illnesses.

Recent News

PRESS RELEASE: Governor Rod Blagojevich has signed Senate Bill 234 into law, to the elation of many who have been fighting for years to improve the state’s strict mental illness treatment law. " Because of the work of so many advocates, Illinois’ law has gone from one virtually mandating non-treatment of those lost to severe mental illnesses to one that can and will save lives. Illinois has joined the national trend toward making mental illness treatment laws more rational and humane," said Jonathan Stanley, TAC acting executive director. This standard will make it easier to use assisted outpatient treatment (AOT) in Illinois. AOT has been shown to reduce rates of hospitalization, homelessness, arrests, and incarceration, saving both lives and money. Read the Treatment Advocacy Center's analysis of SB 234.

SB 234 is law!  Thanks to the hard work of advocates in Illinois, on September 11, 2007 Governor Rod Blagojech signed SB 234, thus changing the Illinois commitment standard for both inpatient and outpatient assisted treatment. Senator and chief bill sponsor, Dale Righter and Representative David Leitch should be commended for working for five years through three legislative sessions for the passage of this law. SB 234 will go into effect in June 2008.

Change in law. Illinois legislators tweaked the medication-over-objection statute in the 2006 session with Senate Bill 998. The two most significant modifications:

• When making a treatment over objection determination, the court has explicit permission (although it is not a requirement) to “consider evidence of the person's history of serious violence, repeated past pattern of specific behavior, actions related to the person's illness, or past outcomes of various treatment options.” 

• When an inpatient refuses medication, the physician must determine and state in writing whether or not the person meets the criteria for medication over objection. If the person does meet the criteria, the facility director must either petition or state why he chooses not to petition in the person’s medical record. This provision applies only to state facilities.

UPDATE: Senate Bill 1983 commandingly passed the Illinois Senate but stalled in the House Developmental Disabilities and Mental Illness Committee.

Senate Bill 1983 could bring vital psychiatric care to thousands in Illinois who are now abandoned to untreated severe mental illnesses like schizophrenia. If passed, SB 1983 would be the most significant change to your state’s commitment laws in two decades. Under current Illinois law, people overcome by the symptoms of severe psychiatric disorders can only be placed in treatment over objection when their condition presents an immediate danger of serious physical harm to themselves or others. Dangerousness-based criteria like this one often result in tragedies that were preventable, preventing judges from helping people before they reach a crisis point.

This weak treatment standard also means that Illinois' assisted outpatient treatment (AOT) law is rarely used. AOT allows someone to receive treatment on an outpatient basis, which is less restrictive than inpatient hospitalization and is proven to be highly successful for the small population that needs it. Illinois' stringent commitment eligibility criteria mean that people are left incapacitated by schizophrenia or bipolar disorder despite the availability of effective treatment and treatment delivery mechanisms like AOT.

RESOURCE Guide to voluntary and involuntary treatment - NAMI of Greater Chicago strongly recommends that persons suffering from serious mental illness complete an advanced directive called the Declaration for Mental Health Treatment which provides guidance to their family and friends and the treatment professions regarding treatment in the event that the person lacks the capacity to consent to mental health treatment. 

LEGISLATION Illinois' commitment standard changes for the better - On August 21, 2003 Illinois Governor Rod Blagojevich signed into law a substantial reform of his state’s assisted treatment laws. Sponsored by Senator Frank Watson, Senate Bill 199 reforms a statutory scheme that for decades - as described in a Chicago Tribune editorial supporting the measure - had made "families find the challenge of medicating and maintaining the mentally ill overwhelming." SB 199 took immediate effect.

The new law clarifies the state’s dangerousness-based criteria for the placement of someone overcome by a severe psychiatric disorder in treatment, insulating it from overly strict interpretations that unnecessarily preclude assisted treatment. "Threatening behavior or conduct that places another individual in reasonable expectation of being harmed" is now specifically delineated as grounds for inpatient or outpatient court-ordered treatment in Illinois.

Another, and perhaps more important, provision of Senate Bill 199 holds that people incapable of caring themselves can still be found to meet the state’s "gravely disabled" commitment criteria even if concerned loved ones are providing for their basic physical needs. No longer will families in Illinois be told that the only way to get care is to turn a loved one out to the streets in order to create the actual risk of physical harm required to justify a commitment under the former law.

We commend Senator Watson and the advocates who made this reform happen. Illinois law still has a good ways to go before it matches the most progressive states, but a resounding first step has been taken.

PREVENTABLE TRAGEDIES The Preventable Tragedies database includes summaries of news articles of which an individual with a neurobiological brain disorder (usually untreated) is involved in a violent episode, either as a victim or perpetrator. Search for Illinois episodes by choosing IL in the drop down box.

History

COLUMN In "Fatal shooting by cop renews angry debate," Chicago Tribune columnist Eric Zorn reflects on whether police have the right training to deal with people with severe mental illness who are in crisis - in the wake of two deaths in less than two weeks. Tim Crotty, 49, shot by police after wandering incoherent into a Chicago police station brandishing a knife; and Andrew Sallenger, 35, killed in a struggle with police after his family called them for help.
Chicago Tribune, May 12, 2002

EDITORIAL Our opinion: Flexibility, funding are key - In Illinois, the legal bar is set very high to get a court order for involuntary outpatient treatment or commitment to a mental health center. The court must find that a person is "expected to inflict serious physical harm upon himself or herself or another in the near future" or is "unable to provide for his basic physical needs so as to guard himself or herself from serious harm." By the time this standard is met, a tragedy has often already occurred.
State Journal-Record, May 5, 2002

NEWS Family wanted Salinger committed - “Andrew Sallenger's family knew he was having problems and had sought Monday [April 30, 2002] to get him involuntarily committed - but he did not meet the required state standards. ... [F]riends and family members recounted how they'd tried to find help for the 35-year-old man, who, after being restrained by police Tuesday, was hospitalized at St. John's and not expected to make it through the night.”
Copley News Service, May 1, 2002. Andrew Salinger died in the hospital.

LEGISLATION Illinois has an active Senate resolution (SR0373) to create a 22-member mental health task force, which would be tasked with examining the state's treatment standard (among other things).
April 2002

OPED Let us treat them now. There were many signs that Illinois native Russell Weston needed treatment. Now he will likely get it - in prison, after killing two Capitol police officers in Washington, DC.
Washington Post, Aug. 1, 2000

EDITORIAL Whether it's the approximately 10,000 seriously mentally ill people who end up at Cook County Jail every year - which in effect has become the largest psychiatric hospital in Chicago - or the thousands of disoriented souls living on the city's streets year-round, all signs point toward a bankrupt, do-little state policy concerning the mentally ill.
Chicago Tribune, June 7, 1999

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