“This should be a no-brainer. An idea that could save money for Washington State, make it a much safer state, and allow us to more adequately care for people with severe mental illness,” writes hospital psychiatrist Dr. Jeff Skolnick in the Seattle Times. 

“Repair the broken legal system used to commit people with psychiatric illness.”

Dr. Skolnick has more than 20 years of experience working with patients in both community mental health and in involuntary psychiatric hospitals.  He has seen the legal system that keeps people detained and feels it needs serious revision.

“In my hospital, at least half of all patients who are committed against their will are discharged by the court against medical advice. Many of these people are very ill, still psychotic and often likely to quickly become a danger to society, their families and themselves,” he points out. “Poignantly, from the outpatient side of the equation because the criteria are so stringent to get people committed, it can take a great deal of time and courage for their families to get them detained in the first place. To see them back where they started — often in three days — is exasperating and heartbreaking.”

Washington State’s Involuntary Treatment Act provides for both inpatient and outpatient civil commitment – and has a progressive criterion for intervention when someone is “gravely disabled.”  That’s a good starting point; two proposals aim further so that the law will be better used to help those with severe mental illnesses. The first, HB 1349, provides additional grounds for renewal orders in the community so that humane care can be provided when needed, before there is a likelihood of serious harm.  This important change of standard has unanimously passed through the House and Senate and awaits the Governor’s action. The second, HB 1486, would ensure that close relatives are consulted when involuntary proceedings are being conducted so that their knowledge, experience and history can be given voice.

In the words of Dr. Skolnick, “[s]avings, safety and quality: a change long overdue”.