February 24, 2014

Mental health option hits snag

In the Legislature, as in life, sometimes the greatest power lies with whoever is in a position to say no. For a bill to expand treatment and diversion programs to criminal defendants with mental illness, that whoever may be Glenn Grothman.

The Republican state senator from West Bend wants to bottle up the bill, now before the Senate Judiciary and Labor Committee, which he chairs. Many bills do die this way, stalled in committee, although it’s possible this one will pass over Grothman’s objections.

That’s because, aside from Grothman, the bill has overwhelming support. SB 374 and its companion, AB 457, have 27 Republican and 23 Democratic cosponsors. The Assembly version passed in November on a 94-0 vote. The Joint Finance Committee voted 15-0 to recommend passage.

Ten state lobby groups, including Disability Rights Wisconsin and the Wisconsin Counties Association, have registered in favor; none is against. No one testified against the bill at either of two hearings.

The state is currently funding treatment alternatives and diversion (TAD) programs in 21 counties. These offer treatment courts or deferred prosecution for non-violent offenders, giving them a chance to avoid criminal convictions if they meet certain conditions.

Currently, these programs are oriented to substance abuse problems; those with only mental health treatment needs are ineligible. SB 374 would let counties create TAD programs specifically for people with mental illness, and allocate $375,000 for this purpose in each of the next two years.

This is a good bill,” says David Callender, government affairs associate for the Wisconsin Counties Association. “Jails have become the last-resort mental health providers for people in crisis. This would help us keep those populations out of jail and get them the treatment they need.”

A 2011 study by the University of Wisconsin Population Health Institute found that TAD programs have high graduation rates, reduce recidivism and save the justice system $1.93 for every dollar spent.

Sen. Glenn Grothman thinks some people will try to game the system, and others be victimized by it.

But Grothman, whose committee held a hearing on the bill in January, calls expanding TAD programs to people with mental illness “obviously problematic.”

He says mental health treatment normally involves some sort of medication. For him, the program amounts to the government saying, “You don’t have to go to jail if you take strong drugs.” He deems this unethical.

Grothman also thinks some defendants will game the system by falsely claiming to be mentally ill, abetted by professionals “who have a reputation for overdiagnosing.”

Joann Stephens, who chairs the Wisconsin Council on Mental Health’s criminal justice committee, agrees that treatment often involves medication. But, she adds, “If they go to prisons and jails, they’re going to be put on those drugs anyway.” They just won’t get an array of other services to help them get better.

And while some defendants may attempt to feign disorders, Stephens has faith in the assessment tools used by psychologists and other providers.

Stephens says groups including hers have worked for years to expand TAD programs to people with mental illness. And now, all the stars are aligned, except for the one cast into the firmament by Grothman.

It’s just upsetting,” she says, “to have all that work be stopped by one person.”

Dan Romportl, chief of staff to Senate Majority Leader Scott Fitzgerald, notes that while Grothman’s opposition can keep the Senate version of the bill on ice, the Senate could still take up and pass the Assembly version.

Fitzgerald, he notes, is a big backer of TAD programs. These were expanded in the 2013-15 state budget; on Feb. 20, the Joint Finance Committee approved adding another $3 million to the cause.

Romportl says this latest expansion may be higher on the Legislature’s to-do list than the mental health piece, but both could be taken up in March or early April.

If so, having overwhelming support might be enough to override one lawmaker’s objections. What a concept.

  • BRAVO to Senator Grothman!!! He’s 100% correct. If we want to force or coerce a competent, adult person to be “treated” to prevent danger to the public, we should at least be banned from pretenses that we are “helping” that person. Real help actually requires strict protection of the right to informed consent. TAD programs, “mental health courts”, etc. were invented to evade a duty to protect that right.

    This bill does nothing but hand over public responsibility for justice to self-proclaimed “experts” who are notoriously corrupt.

    • Donna Pitts

      And therein, Rand Kretchmar, lies the most misunderstood part of the need to implement AOT, Laura’s Law, etc. You’ve said it yourself: If we want to force or coerce a competent adult to be treated,” And there we can stop. The people for whom this bill is attended ARE NOT COMPETENT! Those who are competent do not meet the strict criteria for this bill; they need not be concerned with it. It is for those who become incompetent, like my son, who had to spend 5.5 months in jail before he could be treated for his brain disease. He was completely out of touch with reality and unable to speak with cometency on behalf of his own mental health best interest. So many people get up in the air and feel ‘their’ rights will be taken away. No. This bill is not for them. Pleaase understand that out of the entire population of people with mental illness, there is only 3-9% who meet the criteria for forced medication. When my son was in jail (for violating an order of protection by making a phone call), he was permitted to deny critical medication because he was under duress of a brain disease that blocked his ability to be self aware enough to know he was dangerously ill. Please do not listen to the dogmatic conversations regarding forced treatment. Now that he’s been given a chance to receive his medication and is again stabilized, my son says that: given a choice between remaining unmedicated and left to the madness of his progressive brain disease, he would choose assistance in reaching a point of stability. Please read Kendra’s Law: An Overview to see some stats on how effective this law can be, not only for the individual but for the community and states. Thank you, and my very best to you.