State lawmakers and Gov. Kathy Hochul finally released details on their agreement to make it easier to involuntarily commit severely mentally ill people, included in part of the sprawling state budget that’s set to be voted on beginning Wednesday.
The new changes include much of Hochul’s original proposal to expand the criteria hospitals must consider before committing somebody and loosening the requirement around what medical professionals must sign off on on a commitment.
Under the law, someone could only be involuntarily committed if they showed a substantial risk to physically harm themselves or others.
That will now be expanded to include the substantial risk of physical harm to themselves due to an “inability or refusal, as a result of their mental illness, to provide for their own essential needs such as food, clothing, necessary medical care, personal safety, or shelter,” under the law.
Additionally, someone may now be committed after sign-off from an examining physician and a nurse practitioner. Commitment used to require the sign-off of two examining physicians.
Those practitioners would have three days after someone is brought to the hospital to decide whether he or she should be committed. They would be required to make attempts to contact someone’s medical providers and any designated points of contact prior to ordering commitment.
Hochul faced resistance on the proposal from both houses of the state legislature as well as mental health advocacy groups.
The critics argued that strengthening involuntary commitment measures alone wouldn’t solve the issue and that the changes needed to be accompanied by supporting other aspects of the mental health care system like follow up care planning and supportive housing to avoid people slipping through the cracks.
As a result, the final deal includes additional requirements for psychiatric centers and local social services agencies to coordinate more effective discharge planning for follow ups once someone is released from care.
This includes…
- Providing a summary of the discharge plan to any of the person’s medical providers
- Making a follow up appointment with a provider for the patient within a week or “as soon as possible thereafter”
- Giving the discharge plan to a “post-discharge care manager” in the case of an individual with complex needs
The deal would also create a new behavioral health crisis technical assistance center at the state level to further develop protocols and best practices around involuntary commitment and deliver annual reports on the measure’s effectiveness.
Mental health groups had also been pushing, as an alternative to Hochul’s proposal, forcing the state to conduct critical incident reviews after mentally ill people commit particularly egregious acts.
Language included in the budget bill separate from the section on involuntary commitment would require the state to complete at least one critical incident review on a situation involving a fatality at least once a quarter.
But the toothless provision once again lets state mental health officials off the hook by stipulating the findings of those panels can’t be released publicly.
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