Policy reform is well underway in the state of North Carolina, as the House Committee on Involuntary Commitment and Public Safety calls for public input on what is working and what is not in the state‘s mental health system. The committee was formed following the passage of “Iryna‘s Law,” a bill purported to address high profile safety issues but that mental health advocates fear will increase the number of criminally charged mentally ill people in an already overburdened system. Calling for feedback from patients, families, clinicians, and advocates, legislature signals that policy reform should be based on practice, not just pleadings.
In North Carolina, individuals with chronic mental health issues may bounce from the hospital to the emergency room to jail, with some people pushed into involuntary hospitalization as a way to cope with their issues when no one in the community will step up. Policymakers, hearing about long delays, overcrowded emergency rooms, and insufficient follow-up treatment, are weighing concerns for public safety with deepening commitment to civil rights and recovery-based treatment. Advocacy organizations in the state caution that overly broad commitment criteria become traumatizing and discourage voluntary treatment efforts.
Next report, due in April, may make recommendations around amending Iryna’s Law and refining the process by which involuntary commitment occurs, is documented, and monitored. Proposals to reform mental health policy may include reforms to crisis services, clarification of criteria to commit, expanded oversight of facilities, and investments in community-based supports that can hopefully prevent resort to coercion. Emergency physician and committee cochair Rep. Tim Reeder has said he expects legislation in the next session.
For those and families impacted by involuntary commitment, the opportunity to tell one‘s story can be both painful and empowering. Many prisoners feel that they have been ignored, traumatized, and dehumanized even while acknowledging that crisis intervention can sometimes save lives. One way that the mental health system could better serve its clients is through reform geared toward increasing transparency, humanity, and personcentered care.
Outside North Carolina, we see this debate emblematic of debates taking place across the country concerning the intersection of mental health and public safety with regard to mental health policy. As states observe the direction of NC mental health policy, we hope some lessons learned here lead to wider state reform that results in fewer people slipping between the cracks, increased intervention before a crisis occurs, and improved systems that treat individuals with dignity when they are at their most exposed.
Source: Lawmakers seek public comment on mental health system – NC Health News
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