Miscellaneous

Fear of Commitment

By Anne Skove, Esq.

Nothing boosts policy reform like a sociopath!

Ever since the Virginia Tech massacre, Virginians have been scrambling to change their mental health system.

But even before a Hokie opened fire on his fellow classmates and professors, Virginia was on the road to reform. A few years ago, Chief Justice Hassell created a solid task force to study mental health in the Commonwealth. What did he get for his trouble? He was criticized as an "activist judge." To his credit, CJ Hassell never said "I told you so!" Hindsight is terrifying.

The executive branch was not known for peak performance in the mental health area. Here's a little story from the consumer's point of view:

During the days of then-Governor Allen we were part of the Legal Practice Clinic's Mental Health Project at Washington & Lee. A patient who escaped from Central State caused a sea change in policy and practice. The policy focus shifted from treatment to "public safety." (And what an excellent job they did!)

The new rule was that anyone committed via NGRI was no longer allowed outside. Right. Not for a smoke, not for a job, not for visiting family. Not even a "stroll around the grounds until you feel at home." Whether the patient was in Central State or miles away, whether the patient had built up a stash of the mental hospital equivalent of Brownie points, and no matter what doctors and staff recommended. One day we were in the stairwell at Western State when a little bit of graffitti caught our attention: "I hate Governor Allen." One size fits most.

Fast-forward to 2007, when we heard the trickle of horror come through the radio talk show host's voice as she announced that several people on the Virginia Tech campus had been shot. This time the entire world followed the story: We Are Virginia Tech. This time, the news was not limited to small-town papers or hallway walls.

Where had the system failed? Just about everywhere. The school system, the culture, the mental health system, the gun laws -- every one suddenly had obvious cracks.

This month, newly-passed legislation lowers the standard of commitment. As the rest of the free world knows, a person can only be committed if the person is an imminent danger to self or others, or unable to care for him- or herself.

The new standard for commitment is whether there is a substantial likelihood the person would cause serious physical harm to himself or herself in the near future, or could suffer serious harm due to substantial deterioration.

Will that help the CSB know that a person hasn't shown up for the treatment it ordered, or help the hospital realize that a person has been committed? Let's hope we never have to find out.

See House Panel Moves to Ease Commitment Laws, Chris L. Jenkins, Washington Post (January 26, 2008).

Full post as published by court-o-rama.org on January 26, 2008 (boomark / email).