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March 21, 2018In The News

Pa. bill would change outpatient commitment standards

Pittsburgh Post Gazette, by Kate Giammarise and Paula Reed Ward

A bill in Harrisburg would change outpatient commitment standards for people with serious mental illness.

The bill, which passed the state Senate Health and Human Services Committee Tuesday in a unanimous vote, is opposed by several mental health advocacy groups, but has the support of some families and a treatment advocacy group.

The bill would establish a new standard for court ordered assisted outpatient treatment in the community, said sponsor Rep. Tom Murt, R-Montgomery.

“We have a mental health ‘Catch 22’… on the one hand a law that prohibits intervening with seriously mentally ill individuals early enough to help prevent them from becoming a danger; and on the other hand, when they are a danger we lack sufficient access to inpatient treatment services, and they often wind up in jail with little or no treatment at all,” Mr. Murt wrote in a memo seeking co-sponsors for the bill.

Levi Staver, as a boy and after being charged with killing his grandmother in 2013.

Advocates for the bill say that it will provide structured, court-ordered outpatient services for those with serious mental illness — assisted outpatient treatment — through a civil process that already exists in 46 other states.

Without the legislation, said Frankie Berger, the director of advocacy at the Advocacy Treatment Center in Arlington, Va., the least restrictive alternative right now in Pennsylvania is either jail or involuntary inpatient treatment.

The legislation, Ms. Berger said, would allow those who are too sick to realize they need help to receive court-ordered outpatient treatment.

However, the legislation, House Bill 1233, does not provide any new funding for community mental health services, and groups such as the Mental Health Association in Pennsylvania, NAMI Keystone PA, and Disability Rights Pennsylvania are opposed to it.

“We have many concerns,” about the bill, said Carol Horowitz, managing attorney at Disability Rights Pennsylvania.

Among the issues Ms. Horowitz and other advocates have raised: the bill provides no new mental health funding, and doesn’t require counties to add mental health services they don’t already offer. Ms. Horowitz and other advocates also say they believe it is unlikely to prevent violent tragedies, as some proponents of the bill have said.

“Not all counties have Assertive Community Treatment Teams or mobile medication units and this bill will not make such services available even if an individual needs them,” according to an alert sent by Disability Rights Pennsylvania urging a ‘no’ vote.

Assertive community treatment teams offer community-based treatment for individuals with severe and persistent mental illness, such as service coordination and crisis assessment and intervention. Mobile medication services are for individuals who have difficulty managing medications on their own

“Since there is no funding attached to the legislation, the intensive supports that a person might need will not be available in all areas. It will matter a great deal which county you live in.”

A number of family members of people with serious mental illness have championed the bill.

Ruth Johnston’s son, Levi Staver, is in prison after pleading guilty but mentally ill to third-degree murder for the 2013 stabbing death of his grandmother. Ms. Johnston has written two letters to legislators advocating on behalf of the bill.

Staver has been diagnosed with paranoid schizophrenia, and his family struggled for years to try to force him into treatment before he committed his first violent act — killing his grandmother.

Each time they sought help, they were told nothing could be done because Staver was not dangerous.

“Everyone knew we were waiting for that one dangerous moment, hoping it might not be too serious,” his mother wrote in a letter to a letter to the chairwoman of the Senate Health and Human Services Committee.

“That’s the only strategy state law allowed.”

Ms. Johnston urged passage of the bill.

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