FILLING THE GAP: Proposed law would provide help in mental health crisis

Published 10:16 pm Friday, March 15, 2019

Pike County Probate Judge Michael Bunn wants to bridge one of the many gaps in Alabama’s mental health system, and he wants to do it with a new law.

“One of the problems with the mental health system is that there are gaps,” Bunn said. “And one of those gaps … is the ability to make contact and take an individual somewhere to be evaluated without a court order.”

He offered this analogy: “Right now, if law enforcement comes upon somebody bleeding from a gunshot wound who doesn’t have the ability to talk, officers can take that person for treatment, with no consequences,” Bunn said. “But if somebody is having a mental health crisis, our first responders have no authority or protection to take that person in for help.”

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That inability to help a person in crisis is what Bunn and others hope to resolve with proposed new legislation. Bunn brought a draft of the law before the Pike County Commission on Monday and received unanimous support for forwarding the resolution to state Rep. Wes Allen to enter as a local-private act in the Legislature.

As written, the law would allow law enforcement and medical personnel to place individuals on a 72-hour involuntary hold for evaluation in cases of suspected mental health issues or crisis. Modeled after Florida’s Baker Act, the law provides liability protection for first responders and health professionals, while seeking to protect the due process and rights of the individuals with suspected mental health issues. Currently, Alabama code provides for involuntary commitment of an individual for inpatient or outpatient treatment of a mental illness only under order of a probate judge. Those orders come only after a petition is filed and a hearing is held, and that can be dangerous, Bunn said.

Currently, when law enforcement personnel encounter someone in suspected mental health crisis, officers can deal only with the criminal issues at hand. “But if somebody seems to be in distress and is not really breaking the law, police can’t do anything about it,” Bunn said. “They’re not able to make protective custody arrangements. We end up waiting until the person is much worse – maybe he has broken the law by then or maybe has put himself in real danger – to address treatment issues .”

Bunn’s proposal would provide for immediate treatment and intervention during a suspected mental health crisis outside of the criminal justice system. “This law gives us the opportunity to deal with it sooner and hopefully deal with it in a way that is less stressful on a person,” Bunn said.

Troy Police Chief Randall Barr welcomes that ability. “Right now, we can’t do anything without a written order from a judge,” Barr said. “If there’s someone we suspect has a mental health issue, who isn’t breaking the law, we can’t pick them up unless we have that signed order or unless they were charged with a crime …

“Then they wind up in our jails not getting the treatment they really need.”

Under the proposed law, law enforcement personnel can place individuals in protective custody and transfer them to Troy Regional Medical Center, for an involuntary hold of up to 72 hours, pending approval of an attending physician, nurse practitioner or physician assistance. Within 36 hours, the individual must be evaluated by a representative of East Central Mental Health, who can then recommend the next step: release, voluntary inpatient or outpatient treatment, or petition for hearing for involuntary commitment. If an individual is released after 72 hours, law enforcement personnel will transport him back to his residence.

This law, Barr said, would provide another tool in the toolbox for treatment mental health issues. “And they are a tough topic,” he said. “There are not many families out there who haven’t been touched in some way, shape or form by mental health issues.”

Bunn agreed. “We are currently fighting a battle in this state to deal with mental health issues,” he said. “We don’t have all the tools we need to do this, but this  bill is an attempt to give us some of the tools on a county level.”

As probate judge, Bunn is responsible for conducting all the involuntary commitment and competency hearings in Pike County. “Mental health issues are something we deal with on a daily basis,” he said. “And almost every week we are dealing with two or three cases.”

Allen served as probate judge for nearly 10 years before being elected to the Legislature and is well-versed in the issues faced when trying to provide treatment for individuals with mental health issues. “I can’t tell you how many times during my almost 10 years as probate judge I would get a call from the hospital or law enforcement about someone having an acute crisis,” he said. “And you’re trying to make a decision about whether they going to get treatment.”

This law, he said, would allow physicians and medical personnel to provide the treatment needed immediately, without the delays caused by seeking a court order or the risk of an individual in crisis leaving a hospital against medical advice. “It’s providing emergency treatment to individuals for up to 72 hours when the hospital or law enforcement deem it necessary,” Allen said, adding that a similar act has been extremely effective in Jefferson County and provided a model for the Pike County legislation. “It gives the hospital and physicians more discretion to the make the determination.”

Pike County officials must advertise the draft legislation for four weeks before sending it to Allen to be entered as a local-private bill before the Legislature. The bill must be authorized by a vote of the Legislature, but officials are optimistic it will be passed.

“Several counties are working on similar bills now,” Bunn said.