Most States Receive Poor Grades for Mental Illness Treatment Laws

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Where a person lives should not determine the treatment he or she is able to receive, says the Treatment Advocacy Center.

Where a person lives should not determine whether or not he or she receives treatment.

The majority of U.S. states are in need of significant improvements to their mental illness treatment laws to protect and provide for individuals in psychiatric crisis, according to a new study by the Treatment Advocacy Center. What’s more, most states grossly underuse the laws they have.

"Mental Health Commitment Laws: A Survey of the States" analyzes the quality and use of laws each state has enacted to meet the needs of people with severe mental illness who cannot recognize their own need for treatment, trapping them in a vicious cycle of homelessness, incarceration, repeated hospitalization and other ills.

"We found the likelihood of people in psychiatric crisis receiving timely treatment to be highly variable from state to state and often limited by the state’s laws," said Doris A. Fuller, executive director the Treatment Advocacy Center.

"This is inexcusable," she continued. "When someone is in the middle of a psychiatric crisis or deteriorating into psychosis, where a person lives should not determine whether or not he or she receives treatment."

The Treatment Advocacy Center graded each state on the quality of the civil commitment laws that determine who receives court-ordered treatment for mental illness, under what conditions and for how long. States also received grades on their use of treatment laws based on a survey of mental health officials.

Key findings:

  •     No state earned a grade of "A" on the use of its civil commitment laws.
  •     17 states earned a cumulative grade of "D" or "F" for the quality of their laws.
  •     Only 14 states earned a grade of "B" or better for the quality of their civil commitment laws.    
  •     27 states provide court-ordered hospital treatment only to people at risk of violence or suicide even though most of these states have laws that allow treatment under additional circumstances.
  •     Only 18 states recognize an individual’s need for treatment to prevent further psychiatric deterioration as grounds for hospital commitment.
  •     12 states rarely use court-ordered outpatient treatment (often called "assisted outpatient treatment" or "AOT"), including eight states with AOT laws on their books.

Recommendations in the study include:

  •     Universal adoption of need-for-treatment commitment standards to provide a legal way for intervening in a psychiatric crisis before a person becomes dangerous to self or others.
  •     Enactment of AOT laws by the five states that do not yet have them – Connecticut, Maryland, Massachusetts, New Mexico and Tennessee.
  •     Wider use of court-ordered treatment for qualifying individuals everywhere.
  •     Provision of sufficient psychiatric beds for individuals in need of treatment to meet the standard of 50 beds per 100,000 in population.

"The cost of not treating severe mental illness – to the individuals suffering from it, their families, communities and taxpayers – is incalculable," Fuller said. "The failure of most states to enact and or use common-sense laws that would reduce these impacts should be recognized as the national disgrace it is."

Read the executive summary of "Mental Health Commitment Laws: A Survey of the States" and the full report on the website.

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Jamie Mondics
Treatment Advocacy Center
+1 (703) 294-6003
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