by Morgan True vtdigger.org The House of Representatives gave preliminary approval Thursday to a bill that changes current practices for treating people with severe mental illness and streamlines aspects of the judicial review process to medicate a small number of patients against their will. The House voted 132-6 in favor of the legislation, which must be reconciled with the Senate-passed version before landing on the governor’s desk.
Supporters say the bill strikes a difficult but necessary balance between protecting people’s rights and providing appropriate treatment to them when they lack the capacity to be involved in treatment decisions because they’re experiencing acute psychosis.
“This bill, from one perspective, is a very rational straightforward bill that simply adjusts timeframes to allow for more flexible access to the court process on health care decisions for people not able to make that decision for themselves,” said Anne Donahue, R-Northfield, who has long been active on mental health issues, “From another perspective it tampers with existing law and a very delicate balance regarding an almost unthinkable power of state law to force drugs that alter our very thought processes upon a person who does not want it.”
Despite that apparent contradiction, supporters believe that changes had to be made to the current system to address the amount of time some patients are held against their will, while refusing to take prescribed medication and awaiting a court decision on whether they can continue to be held and in some cases forced to take medication.
There are roughly 40,000 Vermonters with some degree of mental illness, but only a small fraction will ever be the subject of legal proceedings over involuntary treatment or medication.
Vermont had 52 involuntarily committed patients at four psychiatric facilities in January. There are more awaiting beds in emergency departments across the state.
Only 14 of those had symptoms severe enough for clinicians to petition the court for them to be medicated against their will, according to figures from the Department of Mental Health.
Opponents of the bill argue that coercion in the mental health system should be limited — which they point out is enshrined in state law — and the proposed changes will be used to medicate more people against their will.
“This puts a Band-aid on a larger problem in the mental health system,” said Rep. Vicki Strong, R-Irasburg, a member of the House Judiciary Committee, which took testimony on the topic of involuntary medication.
“It’s helping (hospitals) not have to deal with these situations,” Strong said, “It’s a resource problem that’s the underlying issue.”
Sen. Diane Snelling, who voted in favor of the Senate-passed version of the bill, made a similar point to her colleagues when the bill was debated in that chamber earlier this year.
“I think this generates a lot of concern from a variety of people because to them it appears this is what we’re doing about the mental health system,” said Sen. Diane Snelling, R-Chittenden.
“I want everybody to take a solemn vow as a state and as a Senate to examine all possible options of treatment for individuals in mental health crisis,” Snelling said.
Rep. Tom Koch, R/D-Barre City, and others have made the point that part of the resource issue in the mental health system will be addressed when the new state psychiatric hospital opens this summer increasing the number of beds available for patients that need to be committed to a secure facility.