NY Times Op-Ed: How a Bad Law and a Big Mistake Drove My Mentally Ill Son Away (Norm Ornstein)
How a Bad Law and a Big Mistake Drove My Mentally Ill Son Away
By NORMAN J. ORNSTEIN
MARCH 6, 2018
Ever since the school shooting in Parkland, Fla., law enforcement and other officials have been calling for changes in the Baker Act, a Florida law that allows involuntary commitment for 72 hours of people who are an imminent danger to themselves or others. If the Baker Act had been easier to deploy, they think, Nikolas Cruz, the accused shooter, would have been taken and treated before his horrible act.
However this law may be reformed, it will never be able to get people with serious mental illness the treatment they need.
I know something about the Baker Act. About halfway through my son Matthew’s decade-long struggle with serious mental illness, my wife and I invoked the Baker Act against him.
This kind, brilliant, thoughtful young man, who experienced the sudden onset of mental illness at age 24, was living in a small condominium we owned near Sarasota, Fla. One day the manager called us with alarming allegations about his behavior and insisted that Matthew was in immediate danger.
In a panic, we flew to Sarasota, went to the courthouse and filled out the forms to invoke the Baker Act. It was surprisingly easy.
When we got to the condo, Matthew was already gone.
We later learned what had happened next. He had just emerged from the shower when police officers cuffed him — without letting him dress or pick up his cellphone, or even explaining what was happening. He was transported to a county mental health facility.
We followed, desperate to see our son. But the staff members wouldn’t let us in. In fact, they said privacy rules meant that they could not even confirm that he was there.
Worst of all, we found out we had been duped. The condo manager who had called us had concocted the story as a pretext to get our son off the property. Because Matthew had long hair and a beard, smoked and tended to wander on the beach at 3 a.m., the manager thought he might scare away those renting other units — and he just wanted Matthew out.
The Baker Act allows 72 hours of involuntary observation to see whether someone is in fact an imminent danger to himself or others. Matthew was not, and after three awful days, he was put in a taxi and sent home. We were not informed when he was released.
Our relationship with our son was deeply damaged by this incident, making any further efforts by us to help him infinitely more difficult. It did nothing to help him deal with his condition and only increased his sense of being stigmatized and hounded. He moved out of Florida and died in an accident at age 34.
That episode, and our 10-year journey, taught us that the entire mental health system is broken.
First, the standard of “imminent danger to oneself or others,” which is sufficient to order a short period of involuntary commitment in many states, is ludicrous and often counterproductive. It results both in mistakes like ours and in worse problems at the other end of the spectrum, when it requires the release of individuals who are truly dangerous but who don’t meet the “imminent” standard.
Even if an individual is confirmed to be dangerous, the Baker Act allows him or her to be held for 90 days; a judicial hearing can then extend the commitment by another 90 days — far from enough time to provide any meaningful or sustained treatment.
Second, a system that keeps loved ones from any involvement in the treatment of people with serious mental illness, especially those who do not know or believe they are ill, is cruel and ineffective.
Finally, a vast majority of those with serious mental illness are not dangerous. We need a way to treat them, while also recognizing that failure to treat the small share who might be violent can lead to tragedies like suicide and murder.
The Baker Act is not going to solve these problems. We have far too few beds in mental health facilities, so most people who have a serious illness and are picked up for offenses like vagrancy from homelessness or drug possession (many people with mental illness self-medicate with drugs) end up in jails, where they lack treatment and almost invariably deteriorate.
Common-sense reforms, like ending a foolish Medicaid restriction that cuts off money for some larger mental health facilities, would help. But what is really required is a comprehensive treatment framework and the money to pay for it.
Ironically, a model exists near Parkland. Steve Leifman, a judge in Miami-Dade County, created a system in which those with serious mental illness who are charged with misdemeanors or nonviolent felonies are given a choice of going to trial or accepting an outpatient treatment plan, with a place to live and care from medical professionals and counselors. He has also provided crisis intervention and sensitivity training to police officers. Instead of languishing in jail, many of the beneficiaries are now getting good jobs and participating productively in their community. He has saved lives — and money.
States should use this as a model for all outpatient treatment, not just for those who enter the criminal justice system. There must be safeguards to protect people’s civil liberties, but families and mental health professionals should be able to petition a court to order someone to accept a comprehensive treatment plan if that person has gone untreated and is unaware that he or she has a serious mental illness and would otherwise be homeless, cycling in and out of jail or worse.
Instead, we are taking tiny steps forward, and giant steps back. Gov. Rick Scott of Florida has proposed spending $450 million to station guards in every school, with more funding for bulletproof windows, steel doors and so on, while adding a paltry $50 million for mental health care. Even as President Trump calls for bringing back “mental institutions,” his budget slashes Medicaid. Many Republicans in the meantime are demanding drug testing and work requirements for Medicaid recipients, which would cause many mentally ill people to lose their coverage — meaning no treatment and no housing.
To reduce the incidence of mass murders — and suicides — we have to reform the gun laws. Clearly, people with serious mental illness should not be able to own guns (and no civilians should be able to buy weapons of war like AR-15s). The background-check system is a farce. States need to adopt “red-flag” laws, which allow police officers and family members to petition a court to bar dangerous individuals from possessing guns.
But until we devote the needed resources to making the mental health system work, we will continue to have unnecessary tragedies. Locking people up for three days is no solution.
Norman J. Ornstein is a resident scholar at the American Enterprise Institute and a co-author of “One Nation After Trump: A Guide for the Perplexed, the Disillusioned, the Desperate and the Not-Yet-Deported.”