Involuntary Outpatient Commitment
Senate President Codey has introduced a bill (S2760) which would establish involuntary outpatient commitment to treatment. Hearings were held on August 11 by the NJ Senate Health Committee. S2760 is in keeping with the recommendations of the Governor’s Task Force on Mental Health on Outpatient Commitment.
Background: Serious mental illness can often go untreated. Untreated mental illness causes great pain and suffering for the person who is ill, their family and community.
There are many causes of this lack of treatment, including stigma, poor supply of treatment services, services not designed for engagement of the seriously mentally ill, side effects of treatment and medication, hopelessness, disorganization and lack of information. A major cause is also the impairment of thinking and judgment that can be caused by the illness itself. Because of this, all states have laws allowing individuals to be hospitalized and treated against their will.
In the first half of the twentieth century, these involuntary hospitalizations were easy to obtain. Treatments were also poorly developed and many individuals were subjected to unnecessary confinement without clear benefit. As a result, states acted to protect the rights of people with mental illness by enacting standards and procedures to safeguard these rights. Generally these standards require a level of risk of dangerousness to sel or others within a particular time frame. This process coincided with the increase in advocacy by people with mental illness (consumers), who have guarded against encroachments on their liberty.
However, serious and persistent mental illness, when untreated, can have tragic results for the person with the illness and for others. These results have included the death of consumers, their family members and others in the community. Although incidents of violence by people with mental illness are uncommon, the impact is dramatic because everyone is a victim in the process, and because it often seems to have been preventable with proper treatment. Family advocates in particular have argued for more flexible ability to get treatment for their ill loved ones before their illness leads to greater damage.
As a result, many individuals and groups, such as NAMI NJ and the Treatment Advocacy Center have been advocating for some type of Involuntary Outpatient Commitment. Beginning in 2003, members of NAMI NJ began working on a model “Need for Treatment Bill” which would
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Ensure access to timely treatment, by providing legal authorization for involuntary community treatment, under carefully defined conditions
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Treat persons who have a mental illness in hospitals rather than prisons, and stop the revolving doors between hospitals, prisons and the streets; and
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Improve the quality of treatment by engaging and empowering persons with mental illness and their families;
The Governor’s Mental Health Task Force did not reach consensus on the bill, but recommended a version incorporating some provisions. There has been considerable debate on this bill. NAMI NJ and NAMI Mercer have testified in support of the bill. The Mental Health Association in New Jersey and the Consumer Self Help Association have spoken against it.
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