Bill’s focus is mental health of defendants
Amid a nationwide mental health crisis and calls for increased gun control, some Tennessee lawmakers want to bolster the state’s ability to mandate psychiatric treatment and monitor certain offenders with diagnosed mental illness or intellectual disability.
House Bill 1640, which is moving through the Tennessee General Assembly, would mean individuals charged with serious misdemeanors and above who are deemed incompetent by a judge to stand trial because of mental illness or intellectual disability meet the commitment criteria for involuntary care and treatment.
Those meeting that criteria who are charged with a felony would be ordered to participate in treatment.
Involuntary treatment could include inpatient or outpatient care, and a person would remain committed until their competency to stand trial is restored or the court approves a mandatory outpatient treatment plan, according to a summary of the bill.
“The goal of this bill is not to truncate anyone’s rights back. It’s to get them committed — off the street — and get them the help that they need,” Rep. William Lamberth, R-Portland, one of the bill’s sponsors, said during a House committee meeting in February.
Legislators are calling the bill “Jillian’s Law” after 18-year-old Belmont College student Jillian Ludwig, who was shot and killed while walking near the Nashville campus in November. Shaquille Taylor, who was charged in connection with the shooting, had previously been found not competent to stand trial because of an intellectual disability.
Lamberth said during a House committee meeting that there are “hundreds of individuals throughout this state” who have been deemed incompetent to stand trial.
“Unfortunately, instead of those folks being committed, instead of them getting the help that they need, they are just let loose into the community. Their cases are dismissed,” he said, noting in a separate meeting that jail is not the appropriate place for people with mental illness or disability.
Other key provisions of Jillian’s Law include:
› For those who meet the criteria, the default is that people will be committed, but the judge has the ability to weigh each individual circumstance.
› Require courts to report information regarding individuals found incompetent to stand trial to the FBI and the state Department of Safety and monitor individuals until competence is restored.
› A person could be committed based on a finding that they are incompetent to stand trial in a criminal court.
› Makes it a misdemeanor offense for anyone who’s been legally committed or deemed incompetent to stand trial to possess or attempt to purchase a firearm.
› Rather than having their cases dismissed, cases for those deemed incompetent to stand trial because of mental illness or intellectual disability would remain pending.
› The judicial process would resume and full rights would be restored if and when competency is restored.
Elliot Pinsly, a licensed clinical social worker and CEO of the Behavioral Health Foundation — a nonprofit, nonpartisan Nashville-based research center focused on mental health and addiction — said there are aspects of Jillian’s Law addressing important issues, such as ensuring firearms stay out of the hands of those deemed incompetent to stand trial.
“That is a loophole that currently was not clear in state law,” Pinsly said, noting Sen. Jeff Yarbro, D-Nashville, also has a bill addressing that problem.
However, a law that leads to more involuntary commitment and inpatient care, though well intended, could be counterproductive to mental health, he said. That’s because inpatient psychiatric hospitalization — especially involuntary treatment — increases one’s risk of suicide, Pinsly said, pointing to research that found suicide risk at least doubles for several years after hospitalization.
He also cautioned against the misinformed notion that people with mental illness are more prone to violence and said they’re actually much more likely than others to be victims of violence.
“If we’re trying to focus on solving mass violence, then mental health may be one piece of it, but it is not the entire answer,” Pinsly said.
During a House committee meeting in February, Rep. Gloria Johnson, D-Knoxville, said she supported the idea behind Jillian’s Law but expressed concern the state may not have room in its current facilities to house an increase in patients — particularly for people with intellectual disabilities.
Services for people with intellectual disabilities are different from those for people with mental health disorders and overseen by a separate state department.
“I am still hearing that there is a lack of placement for individuals that have the intellectual disability because mental health care for the mentally ill is not appropriate for those types of individuals,” she said. “I want to make sure that we do everything we can possibly do to have facilities in place for folks to go in order to be able to enact this piece of legislation.”
The state’s treatment facility for people with intellectual disabilities is staffed with four beds and “currently operates near capacity on a regular basis,” according to a copy of the fiscal note for the bill — which estimates it would cost $2.1 million annually to implement the law.
“If the additional commitments cause the facility to exceed the current capacity, there will be a significant increase in expenditures for personnel and supplies to expand the facility,” the fiscal note states.
On the mental health side, Marie Williams, commissioner of the Tennessee Department of Mental Health and Substance Abuse Services, has expressed in recent budget hearings the need to expand capacity at the state’s psychiatric hospitals as well as increasing the workforce to meet the current demand for services.
On top of improving the state’s inpatient psychiatric system, Pinsly said focusing on “upstream solutions” — such as broadening access to voluntary services and expanding communitybased interventions — is crucial to boost mental health in the state.
“We really want to avoid getting to the point that someone may need a psychiatric hospitalization,” he said. “If we’ve gotten there, that means something probably has