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Thursday, March 30, 2017

Without dissent, General Assembly overrides governor's veto of bill allowing courts to require outpatient mental-health treatment

Mental-health advocates lobbied for "Tim's Law" outside the
state Senate chamber on March 29. (Photo by Melissa Patrick)
By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. – Cheers of celebration rang in both the Senate and House chambers as lawmakers overrode Gov. Matt Bevin's veto of a bill meant to end the revolving door between jail, hospitalization and homelessness for those with severe mental-health conditions.

Senate Bill 91, or "Tim's Law," would allow judges to be able to order mentally ill adults who meet strict criteria into an "assisted outpatient treatment" program, and confine them if they don't comply.

The legislation is called "Tim's Law" for Tim Morton, a Lexington man with schizophrenia who was hospitalized involuntarily 37 times by his mother because this was the only way she could get him the treatment he needed. Morton died in 2014.

Dozens of mental health advocates, dressed in red, lobbied lawmakers in support of the measure as they made their way to the Senate chambers, where it returned from the governor's office because it originated there.

"This is the culmination of so many hours and minutes and days of work and prayer and people pulling together," Sheila Schuster of the Kentucky Mental Health Coalition said with tears of joy in her eyes. "And to have come back from what looked like a defeat and now we are celebrating a victory --it made me think about what the families and the people who struggle with mental illness go through, that up and down, into the valley of despair and then back up again. It's just wonderful. It's just fabulous."

Advocates of the long-sought bill rode the legislative roller-coaster all week. First, they anticipated a signing of the bill into law by the governor, only to learn that he had vetoed it; then they quickly shifted into a whirlwind of advocacy to encourage lawmakers to override the veto; and finally enjoyed a celebration.

The bill had passed the House without dissent, and with only three "no" votes in the Senate. Without any debate in either chamber, the override votes were 35-1 in the Senate and 91-0 in the House.

Various versions of the bill have been filed in the General Assembly since 2013; this year's version has more stringent requirements.

It says a judge can only order outpatient treatment in cases where the person has been diagnosed with a serious mental illness; has been involuntarily hospitalized for mental illness twice in the past 12 months; and doesn't recognize their diagnosis or treatment needs. The person can only be ordered into treatment after a mental-health professional certifies that the law's requirements have been met.

The law will not be implemented until the state secures funding for it. Advocates have explained that the state cannot file for federal funding until the program is in place. It remains to be seen if the state will do that, in light of Bevin's opposition to the law.

Bevin''s veto said that while "well intentioned," the law "would set a dangerous precedent that would threaten the liberty of Kentucky citizens. . . . It would allow the Commonwealth to restrict the liberty of individuals based on nothing more than a finding that they are 'unlikely to adequately adhere to outpatient treatment on a voluntary basis.' Not only would this permit the restriction of liberty for individuals who have not committed crimes and do not pose a threat to anyone, but it would do so based on speculation about what might or might not happen in the future."

Schuster disagreed, saying that people with severe mental illness don't know they are ill and that this "black robe effect" will help them adhere to treatment long enough to recognize the benefit of it, explaining that while there are some provisions to address this issue that involves involuntary hospitalization, this only last between 72 hours to a few weeks, which she said is not enough time to establish long-term patient stability and more often than not creates a "revolving door" between hospitalization, incarnation and homelessness.

Schuster said this approach is an "evidence-based practice" and has been approved by the Substance Abuse and Mental Health Services Administration. Forty-four states have passed some version of this law. She said, "This bill will change the lives of families and people with serious mental illness in Kentucky."

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