Changes pressed in urgent mental health reviews Bill tightens rules on credentials
12:30 AM, Jun 18, 2012 |
The News Journal
Jamie Prince has an insider’s perspective on the debate over Delaware’s emergency mental health evaluation law.
The 45-year-old Newark man knows what it’s like to be handcuffed in the back of a police car and shuttled around as officials tried to figure out what to do with him. That happened more than a decade ago. And though he doesn’t agree with his subsequent diagnosis, he does cooperate with the treatment prescribed for him. It helps him keep his job and other relationships, he said.
“But I would say the less police involvement the better,” Prince said. He resisted when a state trooper tried to take him into custody that day and still hopes to get that charge removed from his record. “My diagnosis was done by cops.”
The state Department of Health and Social Services wants to change how emergency evaluations are conducted, preventing unnecessary encounters with law enforcement and avoiding needless trips to emergency rooms and psychiatric hospitals. House Bill 311 changes the process and tightens credentials needed to make such decisions.
On Tuesday, the Delaware Consumers in Recovery Coalition, whose members are in recovery from mental illness, expect more than 100 people to show up for a public meeting on the issue. The meeting starts at 7 p.m. at Dover Presbyterian Church, 54 S. State St.
“We want to be involved with policy changes and we want to be consulted when these changes are taking effect,” said Bryce Hewlett, who started as the coalition’s director about three months ago. “We don’t feel like this administration has intentionally kept us out, but we recognize that we haven’t been included in the process. …Even in the most sympathetic environments, we still don’t want people to speak for us. We want to be able to use our own voices. There should never be legislation passed down from top levels without input from the people who actually experience the ramifications of that legislation.”
Under current state law, anyone can sign a complaint saying that someone is a “dangerous mentally ill person.” That complaint gives police the power to take someone into custody without a warrant or other legal representation and deliver them to any doctor for a decision on whether they should be detained for evaluation.
About 3,000 people are detained that way every year in Delaware, a number Jim Lafferty found shockingly high. Lafferty, executive director of the Mental Health Association in Delaware, urged lawmakers to revamp the outdated process.
HB 311, sponsored by Newark Democrat Mike Barbieri, would require any decision to detain a person – whether for 24 hours (adults) or 72 hours (minors) – be made by a psychiatrist or a state-credentialed mental-health screener. The credentialing process, not yet defined, would include training related to the kind of mental health services available – an effort by the state to prevent unnecessary hospital commitments.
A significant debate remains over legal immunities extended by the law. Barbieri and other supporters say those who make these decisions must be immune from lawsuits related to that process.
But attorneys and the State Council for Persons with Disabilities have said the immunity provision is too broad, especially since unlicensed mental-health workers could now be included in the evaluation process if they have earned the state credential.
Brian Hartman, director of the Community Legal Aid Society’s Disabilities Law Program, said the state should wait to change the law until after a panel of experts weighs in on how the entire mental health code should be changed. That overhaul is long overdue, Hartman said, and that panel would start work in a few months if House Joint Resolution 17 is approved.
“If kids are being held for 72 hours and adults for 24 hours and malpractice occurs in their medical treatment during that time period, there would be no recompense, no remedy for them,” Hartman said. “That’s not the case for anybody else going to a hospital … so you’re treating kids and adults with mental illness as second-class citizens.”
Shaku Bhaya, past president of the Delaware Trial Lawyers Association, said the association wants to see an amendment that would limit the immunity to the mental health assessment and the clinical decision that comes from it.
“We believe that immunity means no one is held accountable or responsible for their actions,” she said. “Why should someone detained involuntarily have less rights than someone who goes there voluntarily? This is a pro-civil rights amendment.”
State officials say they need time to develop regulations and the credentialing process – changes they say already are long overdue.
Hewlett says DCRC members have mixed opinions but agree generally that the bill brings needed change.
“We view that any loss of civil rights for any amount of time is unacceptable,” Hewlett said, “but we’ve decided to support this bill because it takes so many steps in the right direction. It will give each person who is in crisis access to a mental health professional who will help them with their specific needs instead of just being thrown into a police car and taken to DPC or some other psychiatric institution.”