Get mentally ill Coloradans the treatment they need
Over the past few weeks, Colorado public defenders have filed 64 requests to remove mentally ill people from jails around the state. Deemed incompetent to stand trial, these individuals must await treatment before their cases can continue. Many are being held for low-level offenses and would have had their day in court by now if they were mentally competent. Instead they are being held in jail without a conviction.
The Colorado Department of Human Services is supposed to get such individuals into treatment within 28 days of being declared incompetent to stand trial but officials claim there is not enough facility space to take them. One man has spent 270 days in jail awaiting treatment. These mentally ill men and women need access to treatment not only so their cases can be adjudicated but because they need help and cannot help themselves.
Over the past year, a growing awareness of the problem of severe mental illness has led to legislative action. During the 2018 session, the Colorado General Assembly passed a bipartisan bill to establish a statewide program to help individuals in crisis get treatment after a 72 hour involuntary mental health hold in a hospital. In November, Denver voters passed a .25 cent sales tax for mental health and addiction treatment services. These are good steps but more action is needed because there are people with severe mental illness languishing in jails and on the streets.
In 2019, the state legislature should more adequately fund in-patient and other mental health services for mentally ill Coloradans. Additionally, legislators should consider how to ensure mentally ill persons in jail receive timely treatment to restore competency so their court cases can move forward and mental health services are available for those who are convicted and serving time. Lastly, the General Assembly should review the legal criteria for involuntarily commitment. It may be too difficult to get people into inpatient facilities in the first place, leaving them vulnerable to life on the street and in jail.
Under current law, individuals can be involuntarily committed for up to 72 hours if they are deemed a danger to themselves or others.
A person deemed “gravely disabled” because his mental state seriously hampers his ability to care for himself can also be committed. Certification by a court is required for commitments of three months or longer. The court can also mandate outpatient services.
According to a recent 9 News investigation, some 35,000 people were placed on a 72 hour involuntary mental health hold last year. Another 5,000 experienced more than one involuntary hospital stay and 86 individuals were held six or more times. This suggests that some patients need more than 72 hours of inpatient care.
Some parents of schizophrenic and severely bipolar adult children maintain that it is too difficult to get long term involuntary commitment for their loved ones. A series of Supreme Court decisions in the 1970s beginning with O’Connor v. Donaldson made it more difficult to involuntarily commit mentally ill people who are not a danger to themselves or others. The decisions were meant to curb real abuses and ensure civil liberties. There’s a reason the words “mental asylum” evoke scenes from the movie One Flew Over the Cuckoo’s Nest or even grainy photographs of Victorian era institutions where untreated mentally ill people and inconvenient spouses were warehoused. Investigations of abuse in modern institutions add weight to the belief that outpatient services are always preferable to institutionalization.
This assessment ignores the improvements made to mental health facilities since the 1970s and the fact that not everyone who needs outpatient care will seek it.
While most mentally ill people can get the help they need from community support and intensive outpatient treatment, some people will live their best life in an institution. For them, the alternative is a life on the street combing through garbage bins and occasionally running afoul of the law. Though technically free to live as they please, they are tragically bound by the chains of delusion.