Mental Health Advocates Question 72-Hour Involuntary Hold Proposal

Sep 24, 2015

Wade Borchers, a captain with the Lenexa Police Department, and Julie Solomon, chief strategic management officer at Wyandot Mental Health Center, discuss a proposal that would allow treatment facilities to hold people in crisis situations for up to 72 hours as involuntary patients. They spoke Wednesday at a meeting of the Kansas Mental Health Coalition.
Credit Dave Ranney / Heartland Health Monitor

Several advocates for people with mental illness on Wednesday panned a proposal that would allow treatment facilities to hold people in crisis situations for up to 72 hours as involuntary patients.

“This is a deprivation of liberty,” Mike Burgess, a spokesperson with the Disability Rights Center of Kansas, said during a meeting of the Kansas Mental Health Coalition.

It would be better, he said, to expand access to voluntary treatment.

“Instead of creating something new, we should be tweaking the existing processes to make them more community-minded,” Burgess said. “We are supportive of more voluntary opportunities for folks.”

Glen Yancey, a former executive director with Breakthrough House, a Topeka-based day program for people with severe and persistent mental illness, said the measure would mean that an already-underfunded mental health system will be expected to do more with less.

“We are in a fiscal climate of scarcity rather than adequacy,” said Yancey, who’s also a past president of the mental health coalition. “We’re talking about this because our budgets have been decimated. I’m concerned about taking away civil rights in that environment.”

The proposal, which is still in draft form, is the product of an informal coalition of law enforcement, district court and mental health officials from Wyandotte, Johnson, Douglas and Shawnee counties. The group has been collaborating for about 18 months.

Julie Solomon, chief strategic management officer at Wyandot Mental Health Center, said the proposal is meant to give law enforcement officers a safe place to take someone who appears to be mentally ill and in crisis.

Many of these people often end up in jail or in a state hospital because they pose a danger to themselves or others, are uncooperative and have nowhere else to go.

“With the system the way it is now, we’re criminalizing an illness, we’re increasing stigma and we’re increasing the likelihood of their being charged with a felony,” Solomon said. “Because once they’re in jail if they assault a corrections officer, it’s an automatic felony.”

Wyandot Mental Health Center data, she said, show that an average of 65 of the center’s patients are known to be in the county jail in any given month.

“Collectively, these 65 people are spending 346 days in jail per month at $92 per person per day,” Solomon said. “And the unfortunate reality is that the vast majority of them — more than 80 percent — are in for very minor crimes … city misdemeanors.”

Wade Borchers is a captain with the Lenexa Police Department who also is active in crisis intervention training efforts throughout the state. He said his officers would much rather take someone who is in a mental health crisis and who hasn’t committed a serious crime to a treatment center than to jail or an emergency room.

“If we take them to an emergency room, we’ll routinely have an officer there for eight to nine hours, waiting,” he said. “But that’s in Johnson County. We’re fortunate. In other parts of the state, you’ll have officers spending two and three days in the emergency room.”

From a law enforcement perspective, Borchers said, it makes more sense to take someone in crisis to jail than to an emergency room because an officer standing next to a hospital bed is “no different” from a corrections officer watching them in jail.

“There may be more dignity in a hospital setting, but the end result is the same,” he said. “They’re not getting treatment, and you’ve got law enforcement people making decisions that ought to be made by mental health professionals.”

Borchers said he shared the civil liberty concerns that Yancey and Burgess raised. But a lack of options —such as the proposed involuntary crisis-stabilization facilities — leads to people being taken to jail because of illness rather than crime, he said.

“What we don’t have today is right-away treatment,” he said.

The proposal, Solomon said, is not a requirement of treatment centers. Instead, it would create an option for treatment facilities to hold someone for up to 72 hours. Most people in mental health crises, Solomon said, can be stabilized within 72 hours.

Coalition members are expected to discuss the proposal again next month.

“Part of what we do is develop consensus statements and polices,” said Susan Crain Lewis, the coalition’s president. “And this may or may not be an issue that we can come to a consensus on. That remains to be determined.”

Many coalition members, Lewis said, are wary of “building a new system that would further divert funding from the one that’s in place.”

Eric Harkness, a past president of the National Alliance on Mental Illness group in Topeka, said he won’t support the proposal.

“I’m very uncomfortable with this,” he said, citing recent cuts in mental health services, the moratorium on admissions to Osawatomie State Hospital and proposed restrictions on access to Medicaid-funded prescription drugs.

“And now they want to take away my civil liberties for 72 hours?” Harkess said. “I feel like I’m under attack.”

Solomon said the bill’s proponents have asked to meet with groups that represent the state’s police chiefs, sheriff’s departments, hospital administrators, county attorneys and district court judges.

“We’re asking for feedback,” she said. “We want to hear their concerns.”

Dave Ranney is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.