Columns
New: ON MENTAL ILLNESS: Involuntary Treatment
There is a nationwide push toward giving more power to the mental health treatment systems, in states and counties across the US. The justification is, at some point, innocent people have been killed by consumers off their medication. Thus, in California we have "Laura's Law," and in New York we have "Kendra's Law."
One organization that promotes these laws is based in Virginia and called "Treatment Advocacy" whose slogan is, "Removing the barriers to mental health treatment." The model for these laws which are being enacted in states across the country is to give more power to the counties to decide that a mental health patient should receive outpatient involuntary treatment (which includes forced medication), when county officials decide that a patient is deteriorating.
These laws which give more power to the counties would be fine if we could always trust county officials to behave in a fair, just and compassionate manner. However, this will inevitably not always be so.
The Patient's Rights Movement took place especially because treatment professionals had too much power, and were abusing this power on a regular basis--through the cruel and inhumane treatment of persons with mental illness. Hence, state legislations promoted by Treatment Advocacy will usher in an entirely new "dark ages" of mental health treatment, and the hard fought gains made by the Patient's Rights Movement will be deleted.
I understand a lot about Laura's Law because I have read a lot of its text and have comprehended it. When a law is drafted with the purported intent to solve a problem, often it has unanticipated ramifications, such that we are often worse off when new laws are enacted. For example, California's notorious Prop.13.
I suggest that the readers go to the California Legislature website, read about Laura's Law, and think critically about how it would work in practice. For the readers' convenience, I have included the following link:
When evaluating the text of Laura's Law, the reader should consider what isn't being said as well as what is being said. Laura's Law doesn't incorporate a grievance process. Treatment by treatment teams could occur in the absence of outside witnesses, and this could cause of a lack of accountability. The only mechanism to obtain justice, if a patient is unhappy with how they are being handled, is through the court system.
The court system can be very difficult for someone to navigate who may have limited capabilities. It can be more difficult for a mental health consumer to know his or her rights, in comparison to people in the general public.
Every citizen in the State of California deserves equal protection under the law. Enactment of Laura's Law would make persons with a mental illness into an underclass of people who are essentially incarcerated within invisible, legislative walls. It's not nice for me to know that if county officials suspect that I am medication noncompliant, I could be forced to appear in a court of law to maintain the liberties that I currently enjoy. (Ordinarily, to have a court appearance, I would need to do something wrong.)
I am not arguing with the idea that we need a way of getting severely mentally ill people who lack insight about their condition into treatment. However, just as Obamacare apparently needs some tweaking, Laura's Law needs to incorporate safeguards that assure humane and competent treatment. This law needs a better system of checks and balances to assure that people are treated fairly. An appearance in court (which actually, according to this law isn't completely required--proceedings can take place in the patient's absence) is not adequate to do this.
