Responding to mental illness needs resources

Oh, those inconvenient people – the mentally ill. They fill our jails, they scare their neighbors, they drive their families crazy and sometimes bankrupt, and once in a while they kill somebody, or create a disturbance that leads the police to kill them.

The upcoming legislature will probably revisit the painful issue of how to deal with mentally ill people who pose a real or potential threat.

Albuquerque Mayor Richard Berry recently spoke in support of a bill that almost made it though the legislature in 2015.

As last amended during the 2015 regular session, the bill is intended to give the legal system a broader range of choices for dealing with mentally ill people who come to the system’s attention. The bill number was Senate Bill 53, sponsored by Sen. Mary Kay Papen, D.- Las Cruces. Berry said it’s expected again in 2016.

The bill is similar to “Kendra’s Law,” first enacted in New York. That law resulted from an incident when a schizophrenic man pushed a woman in front of an oncoming subway train. It allows a judge to require a mentally ill person who meets certain criteria to undergo treatment, including medication, for up to a year.

The title of the bill is “Assisted Outpatient Treatment.” What does that mean?

“Assisted” doesn’t exactly mean assisted. It means forced. That’s not necessarily bad. If someone in crisis is acting out in a violent or dangerous way, threatening themselves or others or just scaring everyone around them – but they have not committed a crime — what’s the right thing to do? And who should do it?

The ideal result would be that mentally ill individuals who have not complied with treatment voluntarily would start to comply, attending therapy sessions and taking medications, and would be much less likely to have crises. Most states already have such a law, and reports are generally that hospitalization is down, costs are lower, incidents are fewer. It’s less clear whether the law has been beneficial for the mentally ill patients – and how that can be measured.

But a few big questions remain.

First, is it right or constitutional to force someone to take medication or attend treatment if that person has not committed any crime, but is just a nuisance? Some long-suffering families of mentally ill individuals would probably say yes. As I think of friends whose lives have been overwhelmed by the problems of a mentally ill child, I have deep sympathy for that position.

Jim Jackson of Disability Rights New Mexico says no. He says the bill is too broad, that a mentally ill person is not necessarily incompetent to make life management decisions, and that existing laws already provide sufficient means of control, such as guardianships for those who are incompetent.

Second, if New Mexico enacts this law, could the state implement the treatment programs a court might mandate? Probably not. As readers recall, New Mexico’s behavioral health system was smashed to smithereens in 2013 by the abrupt and still unexplained action of the Human Services Department, when it forced a number of behavioral health nonprofits out of business. The gap has not been filled.

Senator Jerry Ortiz y Pino commented: “What’s the use of being given the authority to order outpatient treatment if there are no outpatient treatment resources? In the southern part of the state right now there are literally no resources to help out in these situations. We need to reconstruct the behavioral health network.” Yes, we definitely do.

Finally, we can’t lose sight of the more troubling question of what’s causing all this mental illness. That’s a question for science, not law enforcement – but whether the causes are sociologial, genetic, nutritional, environmental, something in the water or something even less apparent, both compassion and economics demand that we find the answers.


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